i wrote this and posted it in my blog. i feel, however, that it would be useful here as well. it doesn't touch on the spiritual aspects, so don't look for that; i'm trying to objectively describe what's going on in a bp mind/brain/body:
bipolar, what is it? bipolar disorder is a mood disorder, which is a mental illness. let's just get that out of the way. after hearing what i have to say, you might be tempted to label or limit me, but i would strongly advise you not to as i'm not bound to live up to, or rather, to live down to your expectations. illnesses of the body generate sympathy and acceptance, but those of the mind are only stereotyped and maligned through art, culture, and in society in general. however, both are real illnesses and both deserve understanding.
first, let's understand what a normal mood is. moods are normal. you feel the highs and lows of life. happiness instills you with a sense of well-being and confidence, you feel good and optimistic. sadness brings you the opposite. you turn inward and are preoccupied with your low thoughts. energy's low, self-doubt takes over. these are healthy reactions to life's stresses. your reaction is connected to your environment.
what makes the mood abnormal, giving rise to a mood disorder, is the regulation of mood. imagine if you started shivering on a warm day, or you're drenched in sweat. your body's temperature regulation system doesn't work correctly. so it is with mood disorders, our emotional temperature regulation. your mood is disconnected with your environment. your feelings of happiness or sadness take on rhythms and fluctuations of their own. sometimes these fluctuations are mild, and you only appear to have more ups and downs than the average person. other times, they are so extreme and maladaptive that your ability to judge reality is shattered.
i am bipolar 1. this is when my mood is able to escalate into either one of its two polar extremes, mania or depression. note two things. one, it's predominantly about the mind, but this illness will also affect your body and behaviour. and two, you need to exhibit a lot of these symptoms all day for an extended period of time to be diagnosed.
mania
mania feels good. "if this is an illness, it's the best illness i've ever had" says one patient, and i agree. i am euphoric, wildly optimistic and hyperactive. it is for this reason that mania is equally as dangerous as depression. it is seductive, i may not want to get well.
mood
- elated, euphoric mood; or irritable mood when it's not positive, which is dysphoric. more on that later
- grandiosity: unrealistic belief in abilities and powers
cognition
- feelings of heightened concentration
- accelerated thinking: racing thoughts because quick → fast → racing until your thoughts are tumbling out, jumbled up, jumping around
- irrational, illogical
- denial that anything is wrong
body
- increased energy
- decreased need for sleep
- erratic appetite (probably eat very little)
behaviour
- increased drive towards normally pleasurable things
- sociable, charismatic, engaging, outgoing
- provocative, intrusive, aggressive
- abuse of drugs and/or alcohol
psychotic features
- grandiose delusions
- hallucinations
- suicide
- delirious: stupefied, confused, bewildered, lose orientation with time and place
depression
depression is the opposite of mania. if mania is like a flower bursting into bloom, depression is those petals painfully curling in. here, i am disconsolate, inwardly turning, negative thinking melancholy. it's the "common cold" of mental illnesses as everyone will experience it at one time; that doesn't make it normal or alright though. we can definitely learn something from whatever the experience, but being depressed isn't a state you should have to live with as normal. it can become very dangerous to not only your mind, but your body and life.
mood
- depressed mood: unworthy, inadequate, loss, regret; you may not actually be able to feel sadness or cry.
- loss of ability to feel pleasure (anhedonia)
- guilty feelings
cognitive
- poor concentration: easily distracted
- poor memory
- indecision
- slowed thinking
body
- hypersomnia (or insomnia)
- erratic appetite
- fatigue, lethargy, feeling "slowed down"
behaviour
- social withdrawal
psychotic features
- delusions of poverty: i'm going to be fired, i just know it!
- hypochondrial delusion: i've cancer, aids, whatever, i'm sick!
- paranoid delusion: i'm in danger! people are mocking me!
- hallucination
- disorientation in time and place
- distortions and misinterpretations
- grandiosity
- catatonia
"patients lie in bed taking no interest in anything. they betray no pronounced emotion; they are mute, inaccessible; [...] they stare straight in front of them with [a] vacant expression of countenance like a mask and with wide open eyes." (mondimore, 25)
- depressive stupor
"i had now reached that phase of the disorder where all sense of hope had vanished, along with the idea of futurity; my brain ... had become less an organ of thought than an instrument of registering, minute by minute, varying degrees of its own suffering ... i'd feel the horror, like some poisonous fog bank, roll in upon my mind, forcing me to bed. there i would lie for as long as six hours, stuporous and virtually paralyzed, gazing at the ceiling" (see before)
- suicide !!!!
mixed states (dysphoric mania)
i can mix it up. i can have a mixed state where the negativity of depression is combined with the hyperactivity of mania.
comments
the breadth of this illness makes hospitalization nothing to be ashamed of. there, beside the free meals, you're in a safe environment, monitored by psychiatrists, nurses, social workers, and occupational therapists. this is an incredibly hard illness to diagnose as it can appear like other illnesses. for example, the weakened memory in older patients can be mistaken for dementia, and the mania in young kids, hyperactivity.
like any illness, there are times when i'm sick and there are times when i'm well. untreated, mania can last a few weeks, and depression months. recovery can vary between individuals, but it can be days to months depending on the severity of the illness. when i'm well, i'm said to be in remission. stable.
treatment
there are various forms of treatment that are effective:
- medication (mood stabilizers, antipsychotic, anticonvulsant, antidepressant, etc.)
- no alcohol or drugs
- psychiatric appointments
- support groups
- cognitive behavioural therapy
- interpersonal and social rhythm therapy
- develop and stick to a personal schedule
- family therapy
- art therapy
- physical exercise
- balanced diet
- good sleep
- avoid stress, or develop ways to cope with it. (don't procrastinate)
- develop a support system
- family support
- psychoeducation (i.e. study and understand bipolar)
- plan what to do in case of an episode while well
- mood charts
- make it a point to engage in activity, especially if in depression
- avoid over-stimulation if manic
- avoid triggers
- vitamin supplements, like omega-3 fatty acids found in fish oil
- prayer
- don't be a victim!
references:
mondimore, francis. (md). bipolar disorder, a guide for patients and families. john hopkins press health book. baltimore: 1999.
national institute of mental health booklet
other mood disorders:
- bipolar II: hypomania (literally "under-mania": mild mania) and major depression
- rapid cycling: cycle through, ie. go through, your episodes of mania and depression quickly.
- ultra-rapid cycling
- cyclothymmia: hypomania, mild depression
- major depression
- dysthymia: chronic low mood (minor depression)
and Amen!!! This is an incredible post, vibrant 
