I live in a world of extremes. Sometimes I am drowning; I am sinking and waves crash by as I catch my breath between each one. Other times I’m the wave; I am a force and my mind runs at a mile a minute.
This may sound like a cycle where the positive outweighs or at least matches the negative, but both extremes are just as dangerous. The lows, bipolar depression, are characterized by much of the same symptoms as depression. The low point of the bipolar cycle brings on feelings of intense sadness, worthlessness and hopelessness. Often I lose interest in the things I once loved, I isolate myself, and I am consistently tired. It sometimes comes along with suicidal thoughts and ideations.
The highs, called mania, bring about an extremely elevated mood. I am wary of using the word “happiness” here as mania is not real, nor it is sustainable. When I am manic I am dialed up in every way. I drive recklessly fast, I make rash and risky decisions, I undertake a dozen projects and am pulled in every direction. Mania may feel great at first, but it quickly becomes uncomfortable. It is not unlike a constant buzz at the back of your head or like your skin crawling. It can sometimes be accompanied by irritability and anger. It is too much. And I always realize it will be followed by a crash.
Bipolar disorder looks a bit different for everyone but these two poles are present in every diagnosis. For some the cycle is quicker, for others each period lasts longer. Some people will experience bipolar depression often with only one or two episodes of mania in their lifetime. Regardless of the cycle someone lives through, untreated bipolar disorder can be extremely disruptive to someone’s life. It is believed to be a chemical imbalance in the brain and is diagnosed in one of three ways. Bipolar I requires the presence of at least one manic episode. Bipolar II is used when there are hypomanic episodes but not necessarily full-blown mania. Cycles that do not fit within these criteria are diagnosed as bipolar NOS (Not Otherwise Specified).
With years of treatment, self-awareness and hard work I have learned to manage my symptoms. For the most part my mania is in check though I occasionally experience hypomanic moments. My depression recurs regularly at the low point of my cycle but treatment and medication have also helped me manage this. I have tried a myriad of medication and I have found the combination that works for me. I have also been in therapy for years. The medication tempers my highs and lows and brings me back to something closer to the middle, to neutral. From that foundation, I can do the work on myself to manage my symptoms and be self-aware.
Bipolar disorder is not the same as changing your mind often or unexpectedly. It is not having a mood shift within the same day. It does not mean being unstable. The language we use surrounding mental illness dictates the viewpoint we perpetuate and it is important to be accurate and non-judgmental. Using a diagnosis as a punch line or a superlative can help reinforce stigma and foster a misunderstanding of the illness.
Like with any other mental illness, someone struggling with bipolar disorder faces challenges that a mentally healthy person does not. If someone trusts you enough to open up and disclose that they have bipolar disorder, it is important to respond with compassion and kindness. The more we reduce the stigma surrounding bipolar disorder, the more we break down barriers to people seeking out help and support.