Please describe what it is like to have bipolar disorder.
January 17, 2015 2:18 AM   Subscribe

Can you share your experience of bipolar disorder, please?

A relative, after 40+ years misdiagnosed as depressed, has been tentatively re-diagnosed as bipolar disorder (she doesn't know subtype).

I have read the DSM-V diagnostic criteria and am familiar with biomedical descriptors, but the actual experience is very elusive and vague-sounding to me. I don't really have a handle on what it is like to have a brain "on" bipolar disorder. In particular, I don't really see how the more muted subtypes, i.e., lack of Sally Fields-level mania, differ that much, if at all, from depression.

Those of you who suffer from bipolar disorder and are open to sharing, what is it like for you to experience bipolar disorder? If you ever felt "normal," or "pre-bipolar" in the past, how does the experience of the disorder differ? How is your functionality?

Thank you for your insight.
posted by Punctual to Health & Fitness (12 answers total) 14 users marked this as a favorite
You might look at Kay Redfield Jamison's An Unquiet Mind. It' s memoir of struggling with bipolar-1. Also, she's a prominent researcher on bipolar and wrote one of the definitive scientific/medical books on it.
posted by ROU_Xenophobe at 6:44 AM on January 17, 2015 [5 favorites]

Remember that everyone's experience is going to be different. Labeling someone as having bipolar does not mean that they necessarily have the same experience as other people who have bipolar. For example, I don't have that many severely depressed mood episodes, but I know others with bipolar that do.

I had all the typical manic symptoms before I was medicated. I am on a mood stabilizer now, and an anti-psychotic for those symptoms (not everyone with bipolar has this type of symptom). I am not on an anti-depressant since that type of med throws me into mania. So my daily bipolar experience is mostly struggling with the mild depressions and the mixed moods, and mild psychosis. For me, the mixed moods mostly show up as irritability.

I have a high level of functionality. I have a regular office job and a great relationship. I do sometimes have trouble concentrating, but everyone has downtime at their jobs, so it's not noticed. The meds make me tired, but I am used to it now. I still have impulsive thinking, but it's way toned down now. Medication has been important to me. I am also finding meditation to help my bipolar-related anxiety immensely. I feel like the treatment leads me to have a muted form of the illness, one that I can live with.

So I suppose my experience is now: with treatment, bipolar has just become another chunk of who I am. I wish you the best. In my opinion, try to focus more on what makes you uncomfortable rather than labeling that thing. My doc helps me using either meds or therapy depending on what I am feeling, to make things work best for me.
posted by veerat at 7:42 AM on January 17, 2015 [2 favorites]

I have treatment-resistant bipolar II. I am pretty much non-functional. I haven't been able to work since I was 26ish and I am 40 now. All the drugs I've taken stopped working within 18 months if they worked at all. I did have one two year honeymoon period with Lamotrigine where I was able to attend college regularly, but eventually when the drug stopped working I just stopped going to school. I have no motivation to do anything, nor do I usually care about anything. I do not cook, shop, clean my house, wash my clothes, etc. Sometimes I go for two weeks without showering, but those are low, low times. I am usually in the ideation stage of suicidal thought, but I've only attempted suicide three times. I have no friends.

What's it like? Well, there was a period when I was first diagnosed and started taking medication where I had hope for the future. I could imagine a life like veerat's, where I could have a job, have a relationship, maybe even have my own dog or something. I figured that if bipolar wasn't curable, at least it would be treatable. Unfortunately that is not how my case has progressed. After multiple drugs failed to maintain efficacy and I was continuously shuffled around to new and shittier providers as mine stopped taking my health insurance, I gave up on the future. I stopped doing my tests/treatment (which are one and the same) for my thyroid cancer and am hoping that it returns and kills me. I am reluctant to start anything new because I know that I will always end up right back where I am now, which is pretty much endless torment, self-hatred, and unrelenting sadness. I ruthlessly quash any hope that arises because it always leads to crushing disappointment, and periods of renewed activity can almost always be attributed directly to hypomania and not remission.

I don't remember a time where I didn't feel this way. My mother has a picture of me as a 4 year old kid sitting in a field of dandelions. I am holding one. My affect is completely flat and my eyes are dead. She says that's how I always looked. I remember always feeling that way. It's soul crushing.

So, that's my experience. It's not typical. Most people with bipolar can find some relief with therapy and drug treatment. But I think my description is pretty typical for untreated bipolar disorder, especially the kind with hypomania and not true mania. I have only had one true manic episode, and I ended up just leaving college and moving across the country in the middle of the night, leaving my parents to clean up my dorm room and deal with library fines. Mostly though, my hypomania just looks like normal life with reduced sleep--I can go about 40 hours without sleeping during those episodes.
posted by xyzzy at 9:09 AM on January 17, 2015 [15 favorites]

I was formally diagnosed in my early twenties, although I had symptoms starting around age 10. I've been primarily severely depressed most of my life, although I have experienced periods of mania. There was a time when I thought I might get better, but I'm facing 40 now, and that doesn't seem to be an option any more.

For years, I would describe my experience to people in the same manner: every day was different. I never knew how I might wake up each morning. Sometimes I would wake up extremely early and look forward to facing the day. I'd look forward to going to work and be so!!! excited about everything. My head would be filled with grand plans and the world would be filled with possibilities. The next day, I could wake up (if I did wake up) so depressed I couldn't get out of bed or go to work. I would literally paralyzed and unable to move. I once spent the day curled up in a ball on the floor of my closet. It was extremely difficult to be on that roller coaster.

Over the years, those symptoms and patterns have mostly gone away and I am on a much more even keel. Most of the time. I tried to commit suicide impulsively and very much out of the blue in 2013. While this was probably due to extreme stress not being on the right medication, it was pretty terrifying to feel that out of control. Currently, I am on a handful of drugs and see a psychiatrist regularly, and I think I am doing pretty well.
posted by impatient0 at 10:36 AM on January 17, 2015 [3 favorites]

Bipolar II here. For me, there's a major difference in the feel of depression and the dysthymia involved in being bipolar, as well as in how I behave. The long dark tunnel of depression doesn't differ from day to day. I was too sad to cry, totally unable to get out of bed, and suicidal. Things just got darker and darker with nothing but despair. With dysthymia, there is an incredible rage component that makes me hell to live with. Hell for other people, and hell for myself. Some days I don't want to get out of bed, but I do, and drag myself around thinking nothing is worth doing. Life is miserable, but I still can laugh a bit or engage with people, and there's no suicidal fixation. Other days, I can be 'normal' happy, busy, interested--that's actually how my hypomania exhibits--then a week or month later--bam. Rage. Then guilt. Then not caring. Until the cycle repeats.

The effects of the dysthymia is what plummeted me into a major full-blown depression. After the depression was addressed, I was still dysthymic, but was able to be treated.

Antidepressants saved my life. Lamictal made all the difference in the quality of my life. You will pry my meds away only under threat of death and dismemberment. People who think we ought to just get over it and think positive, stay busy and exercise, go outside more and eat better, or suck it up, because there are people in the world with real problems, can KISS. MY. ASS.
posted by BlueHorse at 1:32 PM on January 17, 2015 [5 favorites]

Best answer: I was diagnosed with bipolar II last summer. I'm 25. I was previously diagnosed with major depression at 15, and had a history of depressive symptoms starting around the age of 8 and full-blown depressive episodes at around 12. I started getting hypomanic episodes in my early twenties, and had a really bad reaction to sertraline last year (dysphoric hypomanic episode followed by six months of suicidal depression). I have frequently been suicidal but never made an attempt. Co-morbid anxiety, history of disordered eating and alcohol & substance misuse.

Each successive episode, on both ends of the scale, seems to be worse than the one before. The hypomanic episodes are getting more irritable and dysphoric, and the depression deeper, longer-lasting and more pervasive. I've been taking more appropriate medication for the first time these last six months, though, so it remains to be seen whether or not this is a pattern that's going to continue.

You asked how it differs from depression - in my experience, the answer is "not a lot" on the episodic scale, but on a macro level it seems different. I know plenty of people with unipolar depression, and what seems to be different is that they'll have an episode and then they'll be okay for a decent stretch of time (multiple years, even a decade) before they have another, and that they'll respond well to an SSRI or similar antidepressant and that medication will work for them, again, for a decent chunk of time. Whereas I've been having roughly an episode a year of depression for the last thirteen years (with enough grey bleurgh mood state in between that it's hard to tell where they began and ended), and I went through three SSRIs and a tetracyclic in five years without any of them making much of a dent in my mood - or in the pattern.

I made a graph of my mood since 2001 to take to a doctor (at a point where I was really exasperated about the fact that this just kept happening in a way that felt exhausting and relentless) and it was basically a spiky sine wave. That much mood movement from baseline to one extreme, let alone from pole to pole (which has started happening more recently) is really destabilising, even if the hypomania isn't as destructive as mania and the depression feels a lot like what other people say their experience of unipolar depression is like.

Since re-diagnosis, I've tried lamotrigine, which gave me a rash (not Stevens-Johnson, but they're super cautious with any skin stuff that happens on it, so I came off it pretty quickly) and lithium, which seems to be working pretty well with few side effects (except peeing at least once, often twice, in the night). The weekly blood tests when I was trying to establish a therapeutic level were a drag - the most tangible reminder of the whole "I have bipolar disorder" thing for me has been the sheer amount of medical appointments. "Normal" people don't seem to need to spend half their time going to appointments, chasing prescriptions, having blood taken, etc., and I've found that more othering than anything else.

I consider myself high-functioning. I studied at a school that was the best university in the world during the time I was there. I now have a good job at a place that really cares about its people - they've been nothing but patient when I've needed medical leave, reduced hours, etc. I'm in a stable relationship and I live with my partner.

It's also true, however, that a lot of those markers of functionality felt extremely tenuous at the time. I spent the majority of my time at the fancy university either asleep or blind drunk due to depression, and there were long stretches of time when I got my course work completed at the expense of all other life activities aside from eating and sleeping. My policy was one of forcing myself to do the bare minimum to pass and not be found out and put whatever limited energy I had into achieving that, and for a long time it worked. I did the same thing at various jobs, turning up and faking/essentially doing nothing for eight hours and then going home to sleep and cry. Rinse, repeat, for months and months of my life. Last summer was the first time I've ever had to take time off - it was bad enough that, for the first time, I couldn't turn up and fake it. I was too scared to drive to work, even, partly because my reaction time was messed up and partly because it was a forty-minute opportunity to drive my car into something.

Conversely, I wrote two novels during two different hypomanic episodes, both while working full time and then writing half the night. I've had weirdly splintered self-esteem since childhood, often tracking with my mood, from "I'm incredible and special and gifted" to "I'm the worst turd who ever lived", and, unfortunately, my regular-self and depressed-self tend to compare how I'm feeling/doing at any given point to what I've been capable of doing whilst hypomanic in the past. It's totally unrealistic and essentially a tool to make myself feel worse - "remember that time when you wrote a book and now it's taking you whole minutes to chew a mouthful of banana because you're too sad to open and close your jaw?" is not helpful self talk, but it's pervasive.

I don't have a massively solid sense of self, or of what I want. I've spent comparatively little time at baseline mood, and this has been going on since I was a kid - I grew up depressed, essentially, and it's had a big impact on my personality. It's hard to know what's reasonable to be able to expect of myself because I'm not used to feeling normal and don't have a good grasp of what I'm capable of when I'm in a stable place.

Right now, I'm feeling cautiously hopeful. Lithium is going well, I'm in therapy, I'm sober, I'm in a stable relationship with a loving and supportive partner, I love my job and still have a lot to learn there. But it's also true that I've only really been stable for a month or so right now (basically all of 2014 was a mood episode that I'm only just pulling out of) and I've never had more than about six months of stable mood in the past. And, as the other comments suggest, there is no "do this and it will get better long-term" for bipolar. It depends on the individual. So, hope. But very, very cautious hope.
posted by terretu at 2:20 PM on January 17, 2015 [5 favorites]

Mood Disorder Not Otherwise Specified here. Basically, I have the long periods of depression, and long periods of mania of Bipolar I, and I also have rapid cycling depression and mania of Bipolar II. I wanted to add them together and have Bipolar III, since I'm a super overachiever, but my psychiatrist wouldn't let me.

I'm currently taking two mood stabilizers for a physical medical issue, plus an antidepressant, also for a physical medical issue. I also have an anxiolytic for panic attacks. Right now, I'm in a period of rapid cycling. I don't know what's going on from one hour to the next. It's incredibly frustrating. I tend to be a control freak, and not being able to control this is making me crazy. And I know from crazy, because I are it!

I had a long period of depression from about the age of 8 until 17, when I flipped into a longish manic episode. I remember being suicidal when I was 8. I attempted suicide twice, when I was 14, and when I was 16. When the manic episode hit, I dropped out of school and moved across the country to marry a man I met online who was 40 years my senior. I was wife #3, and he had 3 children older than I. His youngest was 18 months younger than I, and his oldest grandchild was 5 years my junior. That manic episode lasted through me working 3 jobs, plus taking 21 credit hours at the community college, plus being physically and emotionally abused, having a double major and double minor in school, and eventually filing for divorce. Flipped back into depression around the time the divorce was finalized, and stayed there for a few years. You get the picture.

With the current rapid cycling, when I'm in a manic episode, I want to do ALL THE THINGS, and I want to do them all RIGHT FREAKING NOW. I recently moved in with friends, because I can't work at the moment, and was about to be evicted and living in my car. Their house is a wreck. I want to do the 8789 loads of laundry that are piled up in the laundry room, and scrub the kitchen floor, and unpack, and fix my closet bar, and, and, and, and, and. Drives me nuts because I have some physical stuff going on that prevents me from doing all the things right now. At the moment, I can only stand upright for about 10 minutes before my sacroiliac goes on vacation, leaving me curled up on the floor in agony.

When the depression hits, I don't want to do anything at all ever ever ever. I go to a place that's lower than suicidal, because what's the point of even trying, I'll just screw it up, like I screw up everything in my life, and it won't work, and there'll just be this giant mess I have to clean up and my back and knees are screwed up and it'll just hurt so much that I'll want to try suicide again, but I'll just screw it up get the idea.

If you or your relative have any specific questions, please don't hesitate to MeMail me.
posted by The Almighty Mommy Goddess at 3:16 PM on January 17, 2015 [1 favorite]

I have dysthymia and have had multiple episodes of major depression, and I live with someone who has bipolar disorder. Although the two things have superficial similarities, they are definitely pretty different, at least in my house.

I ran your question by my resident bipolar expert figuring his first-hand experience is more useful to you than my observational experience. Here were the high points he thought I should hit:

1) Bipolar disorder is extremely variable. He's talked to a lot of different people with the diagnosis in various support groups and similar settings, and one thing he's continually struck by is that one person's bipolar is very different than another. So as you're probably starting to see here, you should probably not try too hard to draw a line between any one person's experience and your loved one's likely experience. Better to seek out a variety of voices and stories, or if your family member is able to talk, talk to her about her individual experience.

2) A big difference is medical treatment for bipolar is all over the map and not terribly effective in a lot of cases. A lot of MDD can be pretty effectively targeted with antidepressants even if it may take a few tries to get it right. Bipolar seems to be a lot harder to find the right medication for, and when one does find something it tends to be a cocktail of multiple drugs, some to offset the effects of others, and after a few years there's a tendency for the current cocktail to fizzle out and to go back to the drawing board. This seems to be particularly true for the more depressive types; per his psychiatrist, mania is more easily handle-able, whereas bipolar depression can be really really treatment-resistant.

3) You asked about "normal." A big struggle for my partner is that he doesn't have any good sense of what "normal" is. For most of his adult life until more recent years, his "normal" state was basically hypomania, so he (and I) thought it was just "normal" for him to get by on very little sleep, work very intensely at all hours of the day and night, be constantly starting new projects he may or may not ever get around to finishing because he's gotten distracted by something new, throw really elaborate themed parties, etc., etc. He had that state, and he had occasional brief depressions - really not much in the middle. One of the goals and challenges of recent years is to figure out what "normal" looks like for him and how to get to and stay in that state.

We also talked a bit about cognition. For him, at least, cognitive challenges have been an increasingly big part of his bipolar disorder in recent years, and a bigger challenge to his functionality. I'm familiar with some of the cognitive stuff that comes with major depression and anxiety but what he deals with is a whole other level than what I do.
posted by Stacey at 5:42 PM on January 17, 2015 [1 favorite]

BP not otherwise specified. I was a very exuberant child when I wasn't deeply depressed. Back and forth like that ever since. I loved my hypomania! In manic periods I've planned successful political campaigns; written software manuals; kept up 40 hour work week by flipping night to day (therefore separating my raging cranky self from any potential customer). My first suicidal ideation age 7, first attempt age 12, second attempt age 21, just ideation since then, never hospitalized due to good fortune of loving partner and good friends.

First mental health treatment was for unipolar/major depression with fluoxetine at age 36; some relief from depression but not very functional. Haven't been able to work due to combo of physical & mental health issues for 23 years. Currently on fistfuls of drugs, including lithium, lamatrogine, tricyclic (for global pain reduction) and SNRI.

Most days are foggy, thanks to the drugs. I'm always attuned to if I'm hydrated (the lithium & tricyclic both dry out one's mucus membranes and anything else squishy). With the addition of extensive "alternative" treatments — mindfulness meditation; swimming three times/week; slow treadmill walking; fish oil; acupuncture; monthly talking therapy plus psych visits every 6 - 9 weeks, I still have frequent irritation, rumination, and fury. I no longer have the zippity-do-energy that mania provided, and I can remember but six or seven truly happy moments in the past few years.

It's important to reach out to others to share experiences. I found wisdom from these excellent "life with BP" narratives:
Madness: A Bipolar Life by Marya Hornbacher
Beautifully written, provides a visceral experience of being hospitalized, and family-provided care as an alternative to that. She takes you by the hand as her mind spins out of control, and then as it spins back to a center where she can write many beautiful books. (Available in print, etext, and audio)

Marbles: Mania, Michelangelo & Me by Ellen Forney
Lovely graphic memoir which blows up the "crazy artist" archetype as well as showing the difficult road Forney's travelled. (Print, etext)

Both authors employed non-official medication strategies to cope: Hornbacher achieved numbness with an eating disorder; Forney took cocaine; they both used copious alcohol.

How it feels to be bipolar is mainly, for me, wanting to feel something else, please, now.
posted by Jesse the K at 5:55 PM on January 17, 2015

I have rapid cycling Bipolar I. I was diagnosed at age 39, after a hospital admission for suicidal ideation. 3 years later I'm pretty stable, if always somewhat depressed. I work part time in a professional field and take care of my family. The people I interact with at work and church would never guess that I am mentally ill, though I am pretty open about it.
Bipolar to me means taking my emotional temperature constantly. I am always questioning myself about my mood. Am I really happy or is it mania? Am I being productive or am I getting manic? Is my level of irritation normal or am I about to have a manic rage? It can be pretty exhausting.
So I take my meds (4 of them now) and see my doc and get my blood tested. I try to get enough sleep, though I just can't fall asleep tonight. I am open with my husband and kids, so they can support me and see patterns in behavior that I miss. As far as I'm concerned, it's better to be diagnosed than undiagnosed.
Finding the right meds can be frustrating, so your relative has a challenging time ahead. Best of luck to them.
posted by Biblio at 9:27 PM on January 17, 2015 [2 favorites]

After a teenage diagnosis of major depression, I was diagnosed with bipolar at 29.

For me, bipolar is like waking up each day via an internal clock that sounds the alarm with:

Will it be a good day? Will it be a bad day? Will it be a hellish cycle of both? How can I make it a good day? What if I can't? What will I do if it's a bad day? What can I do to minimize the chances it will be a bad day? When was the last time I had a good day? Haven't they always been bad days? Can I think of any good days? Will I ever have another good day? And then come the memories of bad days.

It starts off quiet enough but can't be ignored for very long. It's quite effective at getting me up. Some days it's obvious from the start that it's a 'bad' day -- I pretty much just stay inside paralyzed by intense negative rumination and suicidal ideation. Sometimes I can bring myself to draw or write to help, but mostly I 'watch' movies. Unfortunately it's probably pretty awful to be around me when I'm like this... I'm incredibly negative (yes, about -everything-) and detached. I'm physically present but not really 'there', so I prefer to be alone on these days.

It's never really obvious when it'll be a 'good' day, but when it is, I feel refreshed and eager to explore the world. I'm curious and seek out learning opportunities. I feel more comfortable opening up to others and become more interested in them as a result. Rumination is minimal or easily diverted away from stormier thoughts. I want to move and be active -- do a full yoga set or a nice long hike with my boyfriend. I want to touch and be touched. I can laugh and smile -- feel pleasure and joy. The world seems filled with possibilities and chances to obtain contentment -- I spend the day filled with hope for the future, which is, sadly, a rare feeling.

More often though, my days are a somewhat hellish cycle of good and bad. Perhaps the day will start out well, but something small may trigger a poor mood that quickly spirals out of control into negative rumination (and occasionally suicidal ideation). Still, the day may be 'good' when I reflect upon it. The high/low aspect is what I struggle with most though. Things are either wonderful or absolutely awful -- there is no middle ground, and constantly yo-yo'ing between the two (and walking on eggshells to spare my mood) is exhausting.

That same high/low thinking is present in all areas of my life, making it difficult to navigate relationships with other people. And it leads to the greater difficulty of trusting my own judgement. When I make decisions I have to ask myself if it's really my answer, or am I depressed? Or manic? How would I know? Even when I'm enjoying myself or feeling 'good', I second-guess it -- is this 'normal'? Am I manic? Will it last? Of course it won't, so when will it disappear?

I'm currently unmedicated, but have tried numerous pharmaceuticals in the past, including lamotrigine (acquired rash), lithium and cocktails of SSRIs and their mitigating accompaniments. Cycling through meds is expensive when you're on a tight budget, and the constant blood tests the meds necessitated required frequent trips to the doctor as well. And the pharmaceuticals always came with their list of side effects. My digestive system has never been the same. I would spend my days in a fog -- emotionally dead and feeling as though I was watching someone else move my body. I also worked in the vitamin/supplement industry, and so tried that route for a while as well. Some things would help briefly, but rarely was it consistent and some caused just as bad of side effects as the pharmaceuticals. At some point I just got tired of playing guinea pig with my body.

For now I'm sticking to the basics for treatment. I'm trying to adhere to a primal lifestyle/diet (I've celiacs), which has been incredibly helpful when I can actually stick with it. Walking (even when I don't want to), Yoga, DDR (Dance Dance Revolution) and meditation have also been useful. Mindfulness is also increasingly helpful, though it takes some practice. YMMV, but I vape cannabis to help with sleep or on bad days to help slow the rumination. I've been off of meds for almost a year now and it seems to be working out OK, though I fear I may some day have to return to the doctor and start the search for a new med all over again.

Even the vague stability I seem to have acquired now is something I constantly question.
posted by stubbehtail at 11:40 PM on January 17, 2015 [2 favorites]

Response by poster: Thank you all so much for these informative, honest and heartfelt answers. I really appreciate your opening up and sharing your experiences and advice on how to compassionately understand someone struggling with this. It means a lot to me; I thank you all sincerely.
posted by Punctual at 5:02 AM on January 18, 2015

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