by Amy Stringer
TW/CW: bipolar disorder, depression, mania, medication
I started writing this and realised it was getting quite long, so I’ve split it up into two parts. Part 1 will be a little bit of an intro, some of the stigma around bipolar and my journey to a diagnosis. Part 2 will then be a detailed explanation of my experience with bipolar, with a little at the end on how family and friends may be able offer support.
“Without medication I would not be able to function in this world. Medication has made me a good mother, a good friend, a good daughter.”Carrie Fisher – on bipolar medication
In this entry, I speak briefly about various medications and side effects of these, but I do not really linger on the drug itself. That is, I might mention something is an SSRI but I don’t talk about what this means. This is mainly because I am not a psychiatric professional and I do not want to pretend I know what all of this stuff means, and so I speak primarily from my own experience. If you would like a separate post about the types of psychiatric drugs I’ve taken and side effects one may experience, feel free to get in touch and I will possibly do one down the track after extensive research.
This image is pretty accurate, except that you yourself don’t get to do the choosing. It’s some underlying process inside your head that you have little to no control over. One day (and perhaps every day for weeks) you might feel pretty great, like REALLY great. You might suddenly be super productive (or at least feel productive), like you can work on 4 different things at once. Then, one day down the track you’ll be very low. You start running at half speed, and you have have this unexplainable sadness looming over you. A few months of this and then you might be back to “normal”, whatever that is, and you may not be able to really recall the high or the low, and you may wonder whether they ever happened at all.
Po is unpredictable, Po is ruthless and Po has firm grip on my life.
Bipolar in the Media
Bipolar disorder is classed in the same group of illnesses as schizophrenia and personality disorders, which to most people are considered “dangerous” disorders. Now, I’ve already mentioned that I have my own reservations about untreated schizophrenia, but it is a known fact, that with the correct treatment and/or mix of medications, someone with any one of these disorders can live a healthy and fulfilled life. This, however, it not often portrayed in the media. People with bipolar disorder are often seen flushing their lithium, being violent, destroying relationships or turning to illicit drugs and alcohol. It’s often believed that the mood swings of someone with bipolar are something sufferers can just “get over”, like they should just get a hold of themselves and get on with life.
The truth is, bipolar is a pretty dangerous disorder. These things that are often represented in the media can happen and do happen on what is probably a semi-regular basis, but what I disagree with is the image that you can’t be successful, hold a stable relationship or live a relatively balanced life if you are bipolar. In reality, you probably know someone, perhaps even multiple people, who suffer from bipolar and you may not even realise. People are often surprised when I tell them I have it because from the outside I look like I have it altogether, I don’t appear to be “crazy”. This is something I can achieve and, in general, maintain because I am medicated. Getting a diagnosis and in turn getting the correct treatment drastically decreases the danger associated with bipolar and, for some (lucky bastards), medication stops their episodes altogether.
When I say I am medicated, I want to be clear, medication is the ONLY way to adequately manage bipolar disorder. You cannot get over it, it is incurable, and you DEFINITELY cannot just think your way out of an episode. Some try to live their lives without medication, and personally, I think that is ludicrous. If you are one of those people and you want to tell me your secret, please do, because I despise the fact that I have to take 5 pills a day, possibly for the rest of my life, just to appear normal.
I could talk for hours about how you can’t just get over Po, but I think Stephen Fry does a great job at explaining both this, and the illness itself, so please check out the video below.
And to anyone who thinks you can’t be successful or normal with bipolar, let me tell you a little bit about what I’ve achieved since my diagnosis.
- I gained 2 bachelors degrees. One in mathematics and one in physics
- I presented at a conference while I was still an undergraduate
- I started my masters of philosophy in mathematics, where I study the brain, and am on track to publish in the number 1 journal in my field by the end of this year (fingers crossed!).
- I teach at least two units at a university level every semester
- Last semester I scored my first job as an Associate Lecturer
- I’ve been in a stable and happy relationship for the past 3 and half years
- I currently have 3 part time/casual jobs in the academic field, which along with my masters, means I work full time
I don’t know what normal is, but I feel like this must be getting pretty close.
Diagnosis and Medicine
The journey to Po’s diagnosis was a little different, a little more drawn out than Pete. I mentioned in my post about Pete that I reached a very low point about 3-4 months after the attack. I already had a diagnosis for Pete, and so my psychiatrist turned to treating the resulting depression. This is where the Po journey begins.
I’d never had psychiatric medicine before, but I had heard things; terrible things. Apparently there was an abundance of side effects, and often the drugs didn’t even work. This is the mind set I had going in to treatment.
At this point in my recovery (if you could call it that at this stage), I wasn’t really eating, I had lost a little bit (okay, maybe a lot) of weight, and so my psych put me on a drug, an anti-depressant, called mirtazapine. He said it’s what they usually give eating disorder patients with depression to help them put weight back on. I thought “okay, a little bit of weight, that shouldn’t be too bad if it makes me feel better,” but I was still a little skeptical. Within a month, I had gained 10kg. I was not happy, and I felt worse than ever before.
I went back in tears (perhaps some foreshadowing) and asked him to find something else and from this point on, he only prescribed me medicines that had no weight signal. What this means is that clinical trials of these medicines have not found them to result in either weight gain or weight loss. There are not a lot of psychiatric drugs that have no weight signal, so this really limited what he could give me.
Medicines. The was just the beginning.
Next up was a medicine called Sertraline, you might know it as Zoloft, an SSRI. This one I had heard of but the experience wasn’t as bad as I expected. The only real side effect I had in the first few weeks was a slight facial twitch; whenever I would yawn my eyes would take a little longer to open, like they would get glued shut. Again, I was willing to deal with this if it made me feel better, and BOY did it. After a few weeks, maybe a month, I entered into my very first hypo-manic state.
Apparently anti-depressants, particularly SSRI’s, typically only trigger a manic or hypo-manic episode in people with bipolar disorder, so from here on out that’s what I was being monitored for. For those wondering what hypo-mania is, I’ll talk about it in part 2, but it’s kind of like “mini mania.” (I know, I know, “what’s mania?” We’ll get there).
Since I was no longer depressed, I had to stop the Zoloft, ride out the hypo-mania and wait to see if I got depressed again. I did a few months later, and this time I got a new medicine, escitalopram (lexapro, SSRI), which I had to take until I maybe went manic again. This one gave me a facial twitch too, only this time when I yawned I couldn’t close my mouth right away, my jaw chattered. Again, this I could cope with if I was going to feel better and surprise, surprise, within a month there it was, hypo-mania.
It was then that I got diagnosed with the disorder I now call Po. Usually for a bipolar diagnosis, you only need one episode of major depression and one episode of mania or hypo-mania, but since the only hypo-manic states I had were a result of medication, the process took a little longer and we had to trial a couple of drugs to make sure it wasn’t just a reaction to one of them.
My relationship with medication has been a long one, and I’ve stopped and re-started a number of times, taken a total of four different anti-depressants, two different anti-psychotics and a whole lotta lithium, a mood stabilser. Lithium is the go to drug for bipolar, it’s been around for decades and it seems to work for most people. One of the hardest things to come to terms with after a Po diagnosis is that I may never (or, according to my psychiatrist, I shouldn’t ever choose to) live without the support of medication.
Apparently if bipolar is left untreated, each “episode” (mania or depression) is worse than the last and it can get really bad, often leading to suicide or psychosis (the parts that are commonly portrayed in the media).
Fortunately, after a trial and error period, I’ve found a pretty good balance of medications; a mood stabiliser, and an anti-psychotic to counteract the manic swing when I need the antidepressants. The antidepressants I don’t take all the time, due to them triggering mania, but the other two I take every day, like clockwork at 9am and 7pm. They don’t do all the work, and I still have episodes but the episodes are relatively mild (still a little more than your usual ups and downs though).
Could I have always had it?
Well, yes, I could have, but I’m at least 80% sure I didn’t. I mean, I had been sad before, but I had never experienced depression and definitely never experienced mania or hypo mania, at least not as I know it now.
My psychiatrist thinks that severe mental trauma flicked a switch in my brain, a switch that not everyone has, that triggered my bipolar, as if it had been laying dormant… waiting. Apparently this can happen, but apparently, if you have the switch, it also often onsets naturally in your early 20s anyway and I was 21 at the time. Whether it was the trauma or not, I don’t really care. Either way, I now have what is essentially a life sentence, and I’m still not happy about it 3 and a half years later.
In part 2 of Po I will talk through my experiences with hypo-mania and depression, stay tuned.
If you are seeking help, follow the link below for a list of Australian resources