Living with Bipolar Disorder - My Story

I am Bipolar and I don't know if I've mentioned it here before but I'm Bipolar Type 1 sub category unipolar. Unipolar in mood disorders usually means depression but in my case as a bipolar it means I invariably go up or 'high' in my mood.



The fact that I am at the tail end of my fifteenth admission since I was 17 (21 years ago) and was first diagnosed means I am still slightly elated which is safe but would explain the last few days here and in another forum. I feel great and full of energy and optimistic and positive which to my consultant means I'm still a bit high. [This was written a few weeks ago; I have since been discharged, my medication changed successfully i.e. in a way that my consultant and I both like and I feel fine and back to level]



I have experienced the full spectrum of mood in the high range of mood disorder - elation, hypomania, mania and even a few times psychosis which is a very scary place to be. Mental health is defined by the excellent support group Grow as 'the vigour and peace of a person who is wholly attuned to reality.' Psychosis is where you lose your grip on reality, sometimes altogether but just temporarily - you will come down or you will be brought down by professionals in a unit over time but once I remember thinking quite reasonably to myself, I must be completely insane - that's scary when reality is, for example, perceived wrong and imaginings creep in. You think you're in hell for example or the world is a matrix type world or everyone in the world is telepathically linked up except you, this was known from your birth and in a giant conspiracy I am being studied globally but from a safe distance because I’m so odd and am being monitored without me knowing it and ‘safely’, etc, etc



I've had delusions and paranoia before but many bipolars flatten out in their 40's and I'm now 38. I'm ok at present and my consultant says I'm nearly there just about two more sessions to monitor me and then I'll be officially discharged after seven weeks. [This has since happened]I've done longer in the 90's and in worse places but I think this time I've made a breakthrough.



The problem from my consultant's point of view is that I'm a tough case. I don't drink or do drugs, I'm compliant with my medication, I have insight but I still get ill every year or two usually because I haven't slept in a few days and I self-refer or just sign myself into the local psychiatric unit which is actually the acute unit for the Cork area in a university hospital that is the biggest outside Dublin and has virtually every specialty on one campus. It's also ten minutes walk from my home so signing myself in is not hard. Others in Kerry for example may have to travel 80 miles in an ambulance if their suffering a manic episode which is much more common than psychosis and represents the upper limit of mood for many bipolars.



They go manic, act out, destroy property, run naked around the block, etc and they're taken against their will to hospital and involuntarily admitted because they don't have the insight to know they're sick something that not every bipolar has especially at the onset of a mood change. Some love the elation and go with it, 'surf' the mood but it always escalates through hypomania into mania at which point they lose control of their thoughts and actions and are basically chaotic and very difficult to be around even in hypomania. If the illness just stayed at elation it wouldn't be an illness just a natural high that some people get. Bipolar Disorder can occur in 1% to 2% of the population.



The illness is genetic and results from a chemical imbalance in my brain which can be dealt with by medication notably lithium usually accompanied by one or two mood stabilisers or sometimes anti-psychotics, a sleeper and a relaxer like Ativan or Zanex (Valium family) and a drug for side effects like Akineton. The naturally-occurring chemical, serotonin is leaking out of a part of my brain and interacting with other parts causing a bit of neural chaos like a literal 'brainstorm' or maybe like splashing some water on some circuitry in a large connected system and the damage that could do if you want a rough analogy.



Stress is the main trigger for us and may spark off the first episode and indeed subsequent ones. It's usually family, relationships or career-related but whatever the cause we find it difficult to deal with, lose a night's sleep, maybe two or three, start obsessing about some matter become hard to be around and either then know you're sick even if elated and immediately get admitted and get out after say four weeks i.e. self admit/self-refer or don't know or don't want to know, go with the elation and enjoying ‘surfing’ for a few days before the following week or the week after you end up crashing and burning in a manic episode and may require 3 or 4 months to be treated because first the psychiatrist has to spend weeks bringing you down.



I've had insight for a long time now but even with that I still get sick because you can't control life and any crisis will set you off. All I can do basically is minimise stress and stressful situations especially relationships in my case or new, complex experiences - foreign travel, starting a new course or college or a new job, etc. and avoid any potential crisis like the plague. The others are givens for me but not for every bipolar: don't drink, don't do drugs, take your meds. The last one some of us question because of the side effects like substantial weight gain/loss, restlessness, the shakes, headaches, etc.



Consultants would say do a cost/benefit analysis - you have your mental health and can get on in life but you're two stone overweight. It's unfortunate but is the price you have to pay.



We all have to pay for our wellbeing and happiness in some way, not every day is a good one and that's just life. With bipolars their mood fluctuates like a wave over a larger range of mood and some have to suffer both highs and lows or rapid cycling mood disorder where they can be up and down several times in a short period of emotional distress and chaos.



My pattern is that I'm well all year but go into hospital about once a year/I8 months for five or six weeks maybe less. That's the way it has been the last five years and I hope I stabilise out now or soon with few if any further admissions.



On my admission form this time when the nurse wanted an answer to the question ‘Reasons for admission’ I listed out the following: ‘no leaving cert, no degree, no career, no car, no apartment, no marriage, no kids.’ I should have added, to sum up – ‘no life’ but not ‘no hope’ – I always believed in a better tomorrow and that somehow my illness would become manageable with few if any further admissions. The way I look at it realistically, I will be back in one year, two years, five years, ten years or never. These are the milestones I have set myself and will celebrate each one. For a lot of my life I was functioning and not in hospital obviously but against a background of unresolved frustration with my life and long periods of boredom – I was living an unhealthy, dysfunctional lifestyle in many fundamental ways.



As for my life as a whole I look at it this way and see it every time I look at my friends or hear significant news about them. The normal path, put simply for many (leaving aside their own ups and downs and crises) is Leaving Cert (second level certificate and entry into college), university degree for four years (maybe further study) Job 1, Job 2, Job 3, etc (career) Marriage, child one, child two, child three, etc. This is the way life has worked out for many of my friends but not for me. My 20's and 30's had long periods of unemployment punctuated by short term courses that didn't suit me and low grade jobs - cleaning, stacking shelves which a lot of students do part time for an income and they're fine – I believe as a Christian that all work is noble but I wasn't even a student and I didn't like the work. I was lazy with my head in the clouds. My dream degree would have been Theoretical Physics in Trinity College Dublin or a Joint honours degree in Maths and Physics in University College Cork, my home town and accessible for me in 15 minutes by bike. Because I had my first episode in 5th year and was doing the leaving cert at the time I missed out on six weeks and was lost when I returned. From being one of the best maths students in the top stream of my year I now couldn't follow it then which dented my confidence and affected everything else. I screwed up the leaving that year had to repeat it, made a mess of that and subsequently seven years later tried again but messed up again so I never got started on my own 'normal' path but I did have friends and interests, I discovered writing three years ago, I've had a few girlfriends, not many and none worked out until the present one where things are very promising and I'm currently in good shape. I'm in two high IQ societies and post regularly in one and I'm writing away so I have a good mind-just have to apply it now. I've signed up for software engineering in October and that course will run for a year. If you're good enough based on the final exam you can link in directly to the Computer Science Degree the following October in U.C.C. and from that go into the equivalent in the Microsoft Certified Learning program get another qualification and work anywhere with that. That's my own five year plan or so and I'm determined to make it work by taking it one step and one day at a time.



Anyway, enough about me, the main message if you're bipolar and struggling or newly diagnosed say in the last year or two is to learn about your illness and develop insight - knowing your sick when you're feeling energetic, positive, really happy etc. is strange I know, the paradox of our illness but that initial stage of the illness - elation, will almost certainly escalate if not dealt with and treated. Don't just go with it, get help, go to your G.P. and tell them.



What I've also learned is that it's a hard illness to have and live with but there is hope and support groups out there and you can have a normal life. Hopefully I won't see the inside of a hospital for a long time and will flatten out as happens many my age but I will be careful too and that's how I will maintain my mental health. And don't believe some of the conspiracy theories you hear - the pharmaceutical companies and psychiatrists are all in league to keep us ill because it's in their interest, etc., etc... In fact they're just dealing with sick people and trying to help. It is incurable in that you will have it for life and were born with it i.e. it's genetic - the predisposition but your environment and circumstances at any given time can trigger an episode - but the great hope for our children and grandchildren is gene therapy instead of the current chemical intervention which is a blunt tool by comparison but we live in 2012 not 2112 or even 2062 so we have to get on with it. Like so many things in life you have to play the cards you're dealt and you have to play a good game.



PS: For a concise medical treatment of the illness the reader should look up ‘Bipolar Disorder’ in Wikipedia which will give the reader a reasonably comprehensive look at the illness as it can manifest itself generally. What I have given is a personal account which is individual and most obviously for example I only had one admission that could be characterised as a ‘depressive low’. That was my first and the understandable reaction of a teenager put into an acute unit when, as my friends and I say who have been in and out themselves, it was ‘dead’. This means there are a lot of older people, or just people who are quite sick – often depressives and some schizophrenics and there is no life in the unit because there are few people your age and few bipolars. As my consultant knows, when I come in elated I treat the unit like a ‘funhouse’ if there is any craic there and interact on a familiar level with fellow patients as well as nurses, doctors, consultants and even the Head of the unit. I joke around and say to some that I am the unit ‘monitor’ looking out for flaws and inefficiencies  in everything from empty water coolers and ‘system errors’ right up to the medical model itself and the underlying philosophy and future of psychiatry with my consultant. The mental health system in this country is deeply flawed and underfunded for one thing but as my consultant says they’re doing the best they can given the constraints and limitations they’re working with and the medical model itself which needs to be looked at by experts and reassessed as a whole as a matter of urgency. The tragedy of mental illness; suicide is going up and is now more than 500 people per year and rising. In my own case, why has it taken me 15 admissions over 20 years to get where I am now?

I just hope I have demonstrated the ‘problem’ that is bipolar disorder and more generally mental illness but also the hope that you can eventually get well and get on with your life. Some are lucky and have only one or two admissions but I’m just lucky that I’m still in my thirties and because there is longevity in my family, might live a good life to a ripe old age. Finally I must credit my strong faith as a major unrecognised part of my recovery and any future success.



Thank you for your attention, I hope the article was interesting and somewhat informative.



M.