As people who read this bipolar blog know, I’m on medication, lots of it, actually. Nevertheless, many people (philosophically, even me) wish to be medication-free. I’m the first one to say this usually isn’t possible; however, today I’m talking with CEO and Medical Director Dr. Kim Dennis from Timberline Knolls (a sponsor) about bipolar disorder without medication.
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Don’t get me wrong, most of the feedback I receive for writing the Bipolar Burble blog and elsewhere is positive. People, mostly, appreciate what I do and how I do it.
Nevertheless, some people, not so much. Today I received this regarding my writing:
I hope this individual kills herself for writing this bullshit.
Go fuck yourself you ugly bitch.
This comment never made it online, for obvious reasons, but as I’m the moderator, I see it nonetheless.
This comment was in regards to this post I wrote on the intelligence of people with bipolar disorder.
In the post, I point out that people with bipolar disorder are not, in fact, more intelligent than the average person and, actually, exhibit cognitive deficits. You can go read the post for details, but basically, people with bipolar disorder suffer from a variety of cognitive deficits which may factor into your definition of intelligence. (You’ll note that, in the article, each cognitive deficit contains a link to the source for the information. You’ll also note that I never said anything about creativity. It may be the case that people with bipolar disorder do show more creativity.)
And boy, do people take offence to that fact. There is this prevalent myth out there that people with bipolar disorder are somehow brilliant and that’s a good part of having bipolar disorder.
Um, no.
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Bipolar disorder is an inescapable mistress. No matter what you do, no matter how hard you work, no matter how many medications you take, she is always there, ready to hit you over the head with a 2 X 4. True, some people are lucky enough be experiencing remission. In that case, the mistress is forced to take a few steps back. But for people not in remission, people in full-blown bipolar disorder, that mistress is relentless. Every minute of every day she steals your brain and makes life unbearably painful.
And I have found that if you also happen to be bipolar and anhedonic, almost nothing allows you escape from that reality. Anhedonia is the inability to feel pleasure and when truly anhedonic, no matter what you do, no matter how theoretically pleasurable that activity is, you will not feel that pleasure – no matter what. This is a concept that most people cannot fathom but believe me, an inability to feel pleasure is real.
I have, however, found one tiny escape. It’s something I do all the time. It’s a little embarrassing, actually. I manipulate physical sensations and responses. Yes, I have orgasms.
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Do you feel broken? I sometimes do. I sometimes feel very broken. I sometimes feel like the bipolar disorder has damaged me beyond repair. I sometimes feel like the bipolar disorder has damaged me beyond reason.
I sometimes feel like it would be impossible for another human being with a functioning brain to want me.
And this is too bad because it can lead to some very bad decisions regarding relationships. I’ve seen people with bipolar who feel this way stay with people who were entirely beneath them because they feel like that broken toy. The person with bipolar disorder feels like she/he doesn’t deserve any better.
This may be wrong. This definitely is wrong. But it doesn’t mean that some part of our brains doesn’t still believe it.
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As I’ve mentioned before, people with bipolar disorder, statistically, spend more time depressed than they do manic or hypomanic. People with bipolar II have it the worst. People with bipolar II can spend up to 35 times more time depressed than hypomanic. This means that if you’re a symptomatic bipolar II, you’re probably feeling depressed right now.
And, of course, depression is a big problem in bipolar disorder as there are only two Food and Drug Administration-approved treatments for bipolar depression (although other treatments are prescribed off label).
While that picture is dark, I would argue there is one aspect of depression that’s more within our control but is equally debilitating. It’s (often obsessively) feeling bad about feeling bad.
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Many of us hear condescending, stigmatizing and prejudicial remarks about bipolar disorder in the workplace – a place where everyone should be treated with respect and as an equal. This lead one reader to ask me this question (reprinted with permission):
I’m not sure how to deal with an incident at work. The company brought in a trainer who when talking about difficult coworkers said “for example have you ever worked with someone who is bipolar.” I spoke with him afterwards and he said he meant to say when unmedicated. I’m disturbed because that seemed very stigmatizing and prejudiced either way yet it was accepted as appropriate . . . I hear how difficult people with bipolar are frequently, like we are 10 to 100 times more difficult than other people just because of our illness. Can you please offer any insight so I can stop feeling like a plague on humanity?
I read this question and I was pretty much incensed.
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I was driving in my car yesterday morning, groceries in the back, a freshly frothed latte in the front, when I flipped to a radio station, heard one line of a song and started crying. The song lyric is inconsequential; I knew that then and know it now. What is consequential is that my bipolar disorder heard the song and used it as an excuse to be upset. My depression, my loathing, creeping, squirming depression, popped its fucking head up and made me burst into tears for no reason on a perfectly functional Wednesday morning. I had a breakthrough bipolar event.
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The Diagnostic and Statistical Manual of Mental Disorders (the DSM) is frequently called psychiatry’s “bible.” I, however, would not pen it that way. I would suggest that the DSM is simply a guideline for the diagnosis of mental illness. It lists the criteria one has to have in order to be diagnosed with a mental illness.
And, as the name of this post suggests, the DSM is releasing its fifth major version – the DSM-5 – in just a couple of weeks.
Now, the DSM-5 has been controversial from the get-go and I have said that much of this controversy is overstated, but some of the changes do have fundamental nosological implications. In other words, some of the changes in the DSM-5 can change how people fundamentally think of certain mental illnesses.
And one of the changes in the DSM-5 is the separation of major depression and bipolar disorder into their own chapters. No longer is there a chapter called “Mood Disorders” with both disorder types listed (Can we still call them mood disorders?). Now they each represent a separate category.
This may seem like a small change, and I’m not going to have a fit over it, but I will say that I think it was the wrong move.
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If you know my story of bipolar disorder treatment, you know that it hasn’t been a pleasant one. Doctors have fired me and given up on me. I have tried a host of treatments that didn’t work. I have experienced almost every side effect under the sun. I have bumped into holes in the healthcare system that have denied me access to a psychiatrist. I’ve spent years wanting to die. I have seen, and lived through, it all. And I would say there are many unmet needs in the treatment of bipolar disorder. I would say these unmet needs are part of bipolar treatment and part of the system in which treatment is delivered. I don’t blame psychiatrists or psychiatry, specifically. I would say there is plenty of blame to go around.
So when I think about unmet needs in bipolar disorder treatment, there seems to me to be many.
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