I’m writing this to help you all understand what I’m dealing with and to help myself process.
Characteristic of Bipolar type II are episodes of deep depression and, other times, episodes of hypomania, which are less extreme versions of the full-blown manic episodes that manifest themselves in people who live with Bipolar type I. I feel lucky to not have developed type I. I cannot even begin to imagine how difficult it must be to live with mania. My friend Wolfgang shared with me an incredibly raw poem by a man who lives with manic episodes – check it out. I can’t wait to earn the title of LCSW so that I can competently work in a treatment center with people living with mental illness, especially Bipolar disorder. Episodes, both manic and depressive, can last for hours, days, weeks, or months, but they are so intense that they interfere with an individual’s ability to function.
Every person who lives with Bipolar can be placed on a spectrum based on the frequency, intensity, and duration of their moods. My experience with Bipolar II has been one marked by ultradian cycling and it seems to be most difficult to live with during the Autumn months and during February. It’s looked like dozens of long periods of severe bipolar depression, which is different from standard clinical depression, followed by periods of intense emotionality and mood instability. Sometimes, I can be mid-conversation and my mood will shift from stable to severely depressed for no reason. However, I have very rarely experienced legit hypomania. It’s been years since my last hypomanic episode and I’ve definitely not had more than 5 in my life. The last time I experienced hypomania I hadn’t even been diagnosed yet and so I thought it was totally normal to stay up for 3 days straight while feeling on top of the world. Growing up, my parents would yell at me for not sleeping or for crying at inappropriate times or for feeling too much.
Turns out, it wasn’t even my fault.
I just cycled out of a depressive episode and I started a hypomanic episode on Friday.
I’ve slept 3 hours in the past two days and I’m not tired. My appetite is non-existent, my thoughts and words are moving at the speed of light, I’m extremely giddy, I’ve been overly-productive, and at times I feel dissociated from my own actions–they don’t feel like mine. I don’t know how to handle this, because I’ve never really had to.
Hypomania is not normal or something that I can just snap out of. If I could sleep or eat, I would. If I could slow down, I would. If I could take a few moments out of my day to rest and breathe, I would.
But I don’t know how.
Here are the criteria required for symptoms to be considered abnormal:
(1) They cause the individual to feel extreme distress
(2) They negatively impact the individual’s ability to function
(3) They cause the individual to deviate from social norms
Now, add a comorbid diagnosis of Borderline Personality Disorder (BPD) to the mixture and you get me.
Fortunately, I resume therapy on Wednesday and by next week I will finally be taking the target dose of my mood stabilizer, Lamictal. My medication’s purpose is to neutralize the extremes of Bipolar and keep my mood balanced. We’re hoping that medication, coupled with Dialectical Behavior Therapy (DBT), which was developed to specifically treat people with BPD and has proven to be an effective form of therapy for a lot of the other issues I deal with (generalized anxiety, binge eating), will be exactly what I need.
Now, because I experience a lot more of the severe bipolar depression, you would think that an antidepressant would be the answer, right? Actually, no. Antidepressants can be incredibly dangerous for someone with Bipolar disorder, because the job of an antidepressant is to bring the lows of depression back up to baseline. However, they tend to push the highs of hypomania up, as well.
Okay. Deep breath.
Today is Sunday.
If I still feel this way on Tuesday, I’ll more than likely head to the hospital even though I’m already in the process of doing all that I can to get better. If I broke my arm, I wouldn’t just learn to live with a broken arm and the pain it causes–I would seek treatment and help, because I’m not qualified to fix a broken arm on my own. I don’t deserve to live with a broken arm.
I’m not qualified to fix a broken heart and mind. I don’t deserve to live with untreated mental illness. Everyone is worthy of hope and help. Even me.
In addition to having not yet been taught the skills that I need in order to sit with hypomania, I haven’t been on medication long enough to experience its neutralizing effects. I haven’t even reached the therapeutic dose yet.
I hate that I have to live like this. I’m embarrassed to even try and hold a normal conversation in this state. I think what scares me the most is that hypomania can take one of two routes:
(1) it can grow into full-blown mania (which isn’t characteristic of Bipolar II, so I really don’t have to worry about that), or
(2) it’s followed by a major depressive episode.
I don’t want to have to go through another one after barely making it out of the last one. This last month has been incredibly difficult and if I hadn’t cycled out of it towards the end of last week, I would’ve probably ended back up in rehab. That’s how bad it got, because it’s not just depression that I’m dealing with. The symptoms of my BPD, especially the constant, irrational fear of abandonment, have been thriving off the feelings caused by my recent breakup and family situation. My BPD had a heyday, which not only made my depressive episode worse, but increased the extremes in which I was willing to go to not have to feel.
Lastly, you may be wondering what triggered my brain to enter hypomania. I can’t give you a definite answer, but this gives us some insight on common triggers (and I’ve experienced more than half of them recently), but as someone who studies psychology, I also have a theory. Friday was one of the first days in weeks where I felt genuinely excited, loved, and happy. It was enough positive emotion to cause me to cycle out of my depressive episode. Simultaneously, though, I feel like my chemically-imbalanced brain and unstable emotion-regulation systems were like, “Oh, we like this feeling and we haven’t felt it in a while, so we’re going to make you feel like this for as long as we possibly can, no matter the costs. We run the show now.”
Friends, if you want to hang out with me later tonight, that’d be fantastic, because I’m probably not sleeping. I could use the company, but please be gracious with me. None of you have seen this side of my illness and experiencing it in this way is fairly new to me, too.
I do want to express how grateful I am for having access to effective treatment and that I know what I’m dealing with. There are so many people living with and suffering from untreated mental illness and they don’t even know it. Or they do know it and treatment isn’t accessible.
This post has taken me 5 hours to write, because I can’t really stay focused on one idea long enough to write about it. Here I am, though, at the end and hopefully this was cohesive and helpful.
I know that it’s helped me.