This is an interesting question that was recently posed to me by a reader: Am I feeling better, or am I feeling hypomanic? Feeling better, of course, is the goal. Feeling hypomanic, of course, is not. One can be something to celebrate while the other can be something to be afraid of. So how does one tell the difference between plain wellness (or happiness) and hypomania?
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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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Today, the Bipolar Burble blog welcomes guest author Kevin Hines, a fellow mental health advocate. Kevin is one of only 33 people who have survived a jump from the Golden Gate Bridge. I met Kevin recently at a conference and I can tell you, his story is incredible and he uses it to help others.
I always try to remember that life is but a state of mind and if that state of mind can be altered by an imbalance of chemicals, it becomes extremely hard to function. After all, I was diagnosed with bipolar disorder when I was 17 years old. Since that day, I’ve come to learn that life literally is a state of mind, and how, without the love and support of friends and family, life would be a lot more difficult.
I am so thankful for the support of family and friends who have helped me whether the hard times at are inevitable when one has– like I do – a mental illness. With all the years that have passed since I attempted to end my life by suicide, I have learned that we all make mistakes in life, but now it is time to put the past where it belongs, in the rear view mirror. We cannot control the future, but we can help one another – and ourselves – today and every “today” that follows.
After my bipolar diagnosis I struggled, suffered, and attempted to understand the metamorphosis I was going through. I hoped that it was just a phase, maybe I was going to “grow out of it.” I was going through the motions of trying to find the right medications for my particular kind of manic depression. Some days the medication would feel like it was working, but on others, it would not.
This lasted until I was 19-years old when thoughts of suicide unfolded. I wrote a suicide letter and the next day, I prepared for another day of classes at City College in San Francisco. But that was a blatant lie, even to myself. This morning my plan was to go to the Golden Gate Bridge to end my life.
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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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Recently a friend of mine tried to make a change – she tried to stop smoking. Unfortunately, that attempt only lasted a few days.
Many people, of course, have been in that situation. Many people have tried to make a change and have found themselves less than completely successful. But what I told my friend is that she didn’t fail, she simply hadn’t succeeded – yet.
And so, I would consider her attempt a type of success. I would consider it an intention of success. I would consider it an approximation of success. I would consider it to be a step forward that ultimately will lead to success.
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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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I get asked this question quite a bit, “How do I become a mental health advocate.” (Or mental illness advocate, or bipolar advocate, or what have you.)
Mostly I think people fall into mental health advocacy. I did. In fact, I never really considered myself a mental health (mental illness) advocate*, I always just considered myself a writer, but people started calling me a mental health advocate, so, I guess I became one.
I think advocacy comes down to being a loudmouth for what you think is right. That’s about it. So to be a mental health advocate you just have to have some strong opinions on mental health and a good set of lungs.
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I get asked lots of questions, but even more questions are silently asked of Google and one of those is, “Is something wrong with you if you think of killing yourself?” The question as to whether something is “wrong” with you if you think suicidal thoughts often leads people to this blog so I thought it was important to address the question.
I actually think the odd thought of suicide is not unusual. A friend once told me that he was unable to take an acetaminophen without thinking of the number it would take to kill him. This particular friend isn’t remotely suicidal but it’s just one of those thoughts that floats through his mind. I don’t think it means anything, per se, other than the fact that his mind is pretty active.
Of course, there are thoughts of killing yourself and there are thoughts of killing yourself.
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