I was having a very annoyed/angry day. This was annoying me and then that was pissing me off. And I realized this was a thread through my day and thought to myself, “Yup, I have days like that. It’s a bipolar thing.” And then I wondered, “Do normal people have days where they’re mad at everything?”
And then I realized I had no idea. I have no idea if normal people have irrationally angry days. I’ve forgotten what it is to be normal.
[And before someone has a hissy fit because I’m saying that people with bipolar disorder aren’t normal, please read the linked article.]
Last year, I wrote an article on psychomotor agitation at HealthyPlace. Psychomotor agitation (or retardation) is a symptom of bipolar (and unipolar) depression as well as hypomania/mania and very little information about it is available (in spite of the fact that it is listed in the Diagnostic and Statistical Manual of Mental Illness (DSM-5)).
Most definitions for psychomotor agitation include the words, “inner restlessness.” I don’t know about you, but “inner restlessness” reminds me of a 22-year-old who can’t find himself and so is backpacking across the country. It really doesn’t sound like a mental illness symptom – let alone like a serious one.
Last time I wrote about missing the signs of improving bipolar disorder but today’s question is, if your bipolar is improving, how do you know what you’re doing right that’s driving that improvement? In my case, the answer to that question was easy – it was a bipolar medication change. But things are not always so simple.
It’s easy to tell when your bipolar is getting worse. At least, it sure the heck is for me. I spend my nights crying and trying desperately not to kill myself. It’s a notable thing that you really wouldn’t miss.
But how do you know if your bipolar is improving? Is it actually possible that you might miss the signs of your bipolar getting better?
You know what I hate? I hate the concept of “having fun.” I hate the pressure to “have fun.” I hate the notion that so much of what we do is to “have fun.” Now, don’t get me wrong, I don’t begrudge others their fun. They should have as much of it as they like. But for me, trying to have fun is just a big chore (or a big lie).
So I’m here, in Parma, Italy and I’m supposed to be chill-axing and “having fun.” Italy is a fun place, after all. All you need to do is stumble from gelato stand to pizza bar to have a good time.
But here’s the thing: I don’t have fun.
It’s not that I don’t want it, or that I wouldn’t have it if I could, it’s just that I can’t.
In my life depression is the worst thing in the world. Depression takes away everything from me. It tends to destroy love, life, work, everything.
And while this is due to the symptoms of depression like, “depressed mood,” it’s also due to something not mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM, the manual that defines mental illnesses) – apathy. Apathy basically means that you don’t care about anything. And when you do a “care-ectcomy” on a life, it makes it seem not worth living at all.
Don’t Believe Everything You Think
Recently, a commenter was here and she was frustrated because her doctor told her to separate herself from her bipolar thoughts. And the commenter remarked,
How am I supposed to separate myself from my thoughts? I AM MY THOUGHTS. Everything I do, everything I say, everything I am, started with a thought.
This is true and it isn’t. I understand this commenter’s frustration and I understand how illogical it seems to suggest that you can separate yourself from your thoughts. After all, don’t you have to think about the separation? And how does that work, exactly?
What this commenter’s doctor failed to mention is probably the most confusing part of any mental illness. The mentally ill thoughts come from the brain while the ability to separate from those bipolar thoughts come from your mind. And you brain and your mind are not the same thing.
For weeks people have been asking me my opinion of ABC’s new show Black Box. According to Wikipedia, about 6.9 million people watched Black Box’s series opener and it seems like about half of them have contacted me about it.
People are wondering about this show because Black Box’s lead, Catherine Black, (played by Kelly Reilly) is a neuroscientist who has bipolar disorder. In fact, the first episode of Black Box details the Black’s descent (ascent?) into mania after she stops taking her medication (which includes lithium, an anticonvulsant, and an antipsychotic).
In short, I think Black Box tries for accuracy and they hit it here and there but, as with all television shows, it’s dramatized and so bipolar disorder isn’t terribly accurately, or fairly, portrayed.
Earlier I wrote about the realities involved in bipolar relapse and now I want to address the question as to how to plan for a future when relapse of bipolar disorder tends to hang over your head.
I understand this question and this uncertainty. It’s very hard to live with a disease like bipolar that you know can bite you any day, any time and often without any provocation. And it can be very hard to see yourself as a serious professional, with a 24/7 career, when you know that relapse is almost a certainty, at some point.
It’s trite to say that, “no one knows what the future holds for any of us.” It’s true, but it’s hardly helpful, and it’s unfair to compare the uncertainty that the average person faces (ie, I might be hit by a bus tomorrow) to the uncertainty that a person with bipolar faces when, in his case, bipolar relapse is very likely.
So how does one plan, or even make big life decisions, when bipolar relapse means an uncertain future?
Recently, I was asked about planning for the future with bipolar disorder considering the threat of immanent relapse. This individual was in the last year of medical school and wanted to know how to plan the rest of his life, knowing that, at any moment, he might have a bipolar relapse. He was on meds, and they kept him functional, most of the time, but the bipolar medication didn’t prevent two major relapses in the past.
So the questions in this scenario are: How likely is a bipolar relapse? How can I avoid a bipolar relapse? How can I plan a life with such uncertainty?
Some people with bipolar disorder are lucky in that when they get treatment, they find something that works for them within some reasonable period of time (and this might be in a year or two, maybe not altogether reasonable, but on the whole, good). However, not all people sick with bipolar are so lucky. Some people with acute bipolar symptoms don’t find anything that works for them for prolonged periods of time. In fact, for many people sick with bipolar, it seems like they will never find any treatment that will work.
So if you’re in this latter group (and I am) what keeps you going? If you still suffer from acute bipolar symptoms and the treatment isn’t working, how do you keep trying to get better, day after day?