Category Archives: In depth

Combating the side-effects of bipolar medication that affects your appearance

This post turned out to be a bit longer than I planned, so if you just want the advice, scroll down and read the italic bits. If you want to understand better, can relate or generally enjoy my self-deprecating humour, please continue. 

It seems that the side-effects of psychiatric medication is something that isn’t discussed enough by medical professionals. In my younger, more naive years I thought that if the doctor didn’t say anything about side-effects, it meant that there weren’t any. Until weird things started happening to my body and I eventually had to take to Google. What you learn very quickly is that everyone experiences side-effects differently, and something that I can’t possibly imagine is true, happens to you.

There are a few side-effects that are relatively common across most psychiatric meds: weight gain, serious fatigue, skin conditions, nausea, gastrointestinal issues to name a few. For some people, most if not all of these symptoms disappear after a while, but weight gain and fatigue usually lasts (especially with anti-psychotics). When I started Lithium almost exactly a year ago, my family couldn’t understand why my doctor hadn’t put me on it a long time ago. Neither could I really, until my doctor warned me about possible kidney failure, thyroid disease, blood tests, dehydration, balancing my salt intake and possible Lithium toxicity. She left out the ‘smaller, less important’ side-effects that I first thought was in my head until it became completely abnormal: hair loss and acne. Along with weight gain, these are the side-effects I want to talk about.

I guess that doctors don’t consider discussing the side-effects that affect your physical appearance as important since they don’t happen to everyone, and aren’t life threatening, but they definitely have a big impact on your already fragile and depressed self-confidence.

1. Weight gain

Of the three, this side-effect is the most common, and caused by most anti-psychotics (except Geodon), some anti-depressants, and most mood stabilisers (like Lithium) except for Lamotrigine. For more info about specific meds and weight gain, go check out Mayo clinic.

Get support

I can only tell you what worked and didn’t work for me. When I was first put on Seroquel (anti-psychotic), I picked up 8kg in a very short time. I didn’t even realise how much I’d picked up before it was too late. I tried going off Seroquel but I could feel myself slipping badly. Later I tried switching to Geodon, but it was extremely expensive and my dose was probably not high enough, so I had the most wonderful hypomanic episode followed by and epic crash that landed me in the hospital again with a new psychiatrist. I had to accept that Seroquel was here to stay. I joined a weigh-loss programme that conveniently had a branch at my offices. It took me a YEAR of mostly being hangry and wanting to cry when I walked past chocolates, but I lost 10kg. I did cheat over weekends, otherwise I would have died. So I was finally on my goal weight; not skinny, but not overweight. I should have continued with the programme but didn’t, and so picked up 5kg again. It was okay though, I had learned a lot and could monitor my eating better.

So my advice is, join some sort of weight support group where someone can help you plan meals, where people keep each other accountable, where you are forced to weigh yourself once a week, and where people keep each other motivated. You don’t have to tell your bipolar story to everyone, but at least tell the person leading the group what medication you are on and how it causes (in my case) sugar and carb cravings and makes you feel like you are ALWAYS hungry. And STICK with it once you’ve reached your goal weight to stay there. 

Consider a possible medical intervention

And NO, I am not talking about diet pills. That shit is bad for you. I am talking about the anti-depressant Wellbutrin. Wellbutrin is also sold as Zyban and helps people to quit smoking. It is also known for making people lose weight. Lithium causes weight gain too, but I started Wellbutrin at the same time and since then I have lost, and kept off, about 6kg in a relatively short time without consciously trying. It is only now that I have lost the weight and am back on my goal weight, that I am making an effort to keep it off. I’ve experienced it as pretty miraculous. Word of warning though, Wellburin doesn’t work for everyone. It either works or it doesn’t. It is also known to bring on (hypo)mania, which is why I am currently only on 150mg and not 300mg. It is also pretty expensive and not all health insurances cover it. Unfortunately there also isn’t a generic at the moment. So seriously discuss it with your doctor first, especially if your are taking a combination of other stuff. To me and others I know it’s been well worth it.

Exercise

I put it here because I feel I have to, not because I practise what I preach. Personally I am not a fan and apart from occasionally walking my dog a block or 2, I haven’t exercised in months. BUT it does help with weigh-loss and general health etc. There is loads of info out there if this is your thing. Just remember weight-loss is more diet than exercise and just because you exercise doesn’t mean you can eat what you want if you want to lose weight.

2. Acne 

I had problems with my skin all through my younger years, so I was pretty happy to grow up and have that stop, mostly. And then it just flared up like crazy! Especially along my jaw line where I never use to get spots before. I couldn’t understand it. I’d been on birth control to help me with moods and hormones for many years, but even on that my skin looked like crap. So I changed brands, and changed again. It was only after a few months that I looked at Lithium side-effects again, and there it was. Acne.

I didn’t want to go on antibiotics unnecessarily and there was NO WAY I was going on Accutane. Not that I can now that I have a mental illness diagnosis anyway, but that shit is BAD. Thinking about it, no medication side-effects has ever been as bad as that. So anyway, no matter how desperate you are, don’t use Accutane.

Once I moved back to my sleepy town, my mom suggested that I go for a chemical peel. She did it when she was in her 30s and swears that’s why she looks younger than all her friends who are younger than her, and it is much cheaper here than in the city. Problem was I really hate facials. The minute they put a warm cloth or steam machine over your face I  feel like I’m drowning. I was also scared that it was going to look like someone threw acid in my face. But desperate times… I wasn’t going out because even thick make-up couldn’t cover up how hideous I looked. Something had to be done.

Luckily the girl that now does my chemical peels is really sweet and professional and the whole process is not at all what I expected. They start you off with a very light peel and increase the intensity as your face gets more use to it. She also told me to switch to dermatologically recommended wash and cream with no perfumes or funny things as my skin is crazy dry. And it’s working! I’ve gone for 3 peals every 4 weeks and I look like myself again! I’ve always been vigilant about my skin routine, but now I’m SUPER vigilant and will continue to go for the treatments as long as I can afford it. The place I go to uses Placecol products, but I’m sure there are other good products out there too.

My doctor also lowered my Lithium dose a bit because my blood levels were too high, and that probably helped too.

3. Hair loss

I’m sure you could gather that the acne situation was really bad. And it was horrible. But the hair loss! Nothing could have prepared me for that.

I’ve had a beautiful, glossy, wavy mane of hair for the largest part of my life. I love my hair. It has been every colour and style under the sun (except blue and pink), but now that I qualify as an adult, I’ve kept it pretty long. I don’t have to style or use product or even blow dry my hair, and I barely comb or was it. I LOVE my hair.

Obviously long hair falls out a lot, so I’m use to that, but then I started noticing that the hairballs from my brush and the shower were getting larger and larger. I thought it was all in my head at first (no pun intended), but it got worse and worse. Making a ponytail I could actually feel a marked difference. It made no sense, this sudden hair loss problem. And then I went back to the Lithium booklet. It was the only thing that made sense and it pissed me off severely. The worse part is, there isn’t really anything you can do about it, except lower you Lithium dose and cross your fingers that it stops.

And luckily it did. Surprisingly, it also started growing back! The only stupid thing now is that I have these little Alfalfa hairs sticking up all over my head, and what my hairdresser recently referred to as ‘bum fluff’ (ridiculous little corkscrew curls) that are frizzing on either side of my forehead.

I haven’t been to hairdresser in almost a year, because I didn’t want to explain why it looks like a child got to my hair with a razor, but then I made friends with a friend of my brother’s who I didn’t mind telling the bipolar Lithium hair loss story to. Once you’ve gotten your hair to grow back, there isn’t much you can do about it, but she basically recommends:

  • Don’t touch your hair at all, because the baby hair is fine and by trying to get it flat or uncurled you just pull the hair out again.
  • After you’ve blow dried your hair, you can set it with cold air (didn’t last long for me).
  • Don’t straighten the baby hair (in my case my bum fluff) because the flat iron will also damage it and pull it out.

Someone also recommended that I use horse shampoo, but I haven’t found any yet, and I have also started using folic acid but not long enough to know if it makes any difference.

 

I hope that there is someone somewhere who has looked long and hard for some answers on how to just look like yourself again and who will find them here. If you have any other tips on psych med weight, acne and hair loss PLEASE share. The struggle is real people and I don’t want to have to choose between looking good and feeling good, because that’s just not fair!

*Please discuss any and all medication adjustments with your doctor. Don’t be stupid and make things worse for yourself. NEVER just stop your meds cold turkey on your own. You think taking meds have bad side-effects? You don’t want to go through withdrawal!

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Dealing with loss AND bipolar disorder

I’ve been meaning to write this post for a while now, but I didn’t really know how. I wanted to write something that would be relatable, but not just a story of what I’ve been going through. Something that makes to others and hopefully prepare them a little bit. I apologise if I didn’t achieve this, but I’m sure you’ll bear with me.

Today, four weeks ago, a very dear friend of mine passed away at the age of 32. She died from natural causes, but in unnatural circumstances. She still had all this potential to unleash on the world, and now she’s gone. We’d been friends since university days, but it was only really in the last 2 or 3 years, where both of us went through some very unpleasant life experiences that we grew really close. And when I say really close, I mean talk on the phone every 2 or 3 days for at least an hour, and sending texts almost every day in between. I still spoke to her on the Monday, and when I wanted to text her about something we had spoken about on the Thursday, I thought that I would wait until the evening before sending it because she had an important day at work. I didn’t know she was already dead.

Most of us know about the stages of grief: denial, anger, bargaining, depression and acceptance. I have lost loved ones before, I’ve been through them. But it being a person so young, with whom I shared so much with, somehow makes it very different. The good news, if there can be good news in a situation like this, is that I have not completely fallen apart. I’m devastated, I cry basically every night, reality hits me in the face over and over again when I don’t expect it. And yes, I was more or less unable to do anything productive for about five days, but somehow I’ve gone on with my life. At first it felt like a massive betrayal, moving on without her. But then the reality of ‘if I don’t work, I don’t get paid’ set in, and I had to get moving. I cycle between denial, anger and depression (I’ve never really understood the bargaining part), but I manage to come up for air every now and then. It’s true though, you don’t get over losing someone. You just learn how to live with it. I’m definitely not there yet, but I want to share what has helped me in the meantime.

Suffering from bipolar disorder, my first thought was that this was going to completely derail me and be a huge setback. I knew that I couldn’t deal with that too. I didn’t want to make this about me, and I think I managed to achieve this more or less:

  1. Be with people. I found this to be very important. Because I don’t live near the city, I couldn’t be with any of my friends who were also grieving, but I moved back to my home town exactly for a situation like this. I immediately packed my bags and went to stay with my parents until after the funeral. I didn’t necessarily interact with them, but it was good to have people around to distract me, to just check up on me and to make sure that I at least ate.
  2. Withstand the urge to numb the pain. Not surprisingly the first thing we want to do when we get sad news like this is reach for the bottle, or take a pill to numb the pain. I know from experience that drinking makes me more depressed, so when I did have a drink, it was just one glass. Another advantage of staying with my parents during that time; I didn’t exactly want to get completely trashed in front of them. I was also relieved that I didn’t have any benzos left, and felt to awkward to ask my new psych, so in the end I left it. It was a kind of bitter sweet, I almost didn’t make it through the memorial service, but I’m glad I didn’t numb myself. I also owed it to my friend to really feel my loss.
  3. Don’t go it alone. Whether it is making arrangements or going to the service or whatever you need to face, don’t go it alone. A friend of mine drove me to the memorial and back, handed me tissues, held my hand and just generally checked that I kept breathing. She knew the friend who passed from university also, but they weren’t really friends and she was much less emotional and more rational than I was at that point. There were so many old, familiar faces and so much emotion, it really helped to have my own little beacon who was there just for me.
  4. Share stories. The first week or so I was terrified that everything about our bond was going to fade away and that I would completely forget the small little things and moments that made her who she was. I post stories, memories and photos on social media. Whether it’s the ‘right’ way to do it or not, I don’t really know. But other people have commented that they appreciate it and that it keeps her memory alive. Some may feel and prefer to keep their grief private. In that case, write stuff down. I don’t think there really is a right or wrong way to do it. It just helps to keep the memories alive.
  5. Try sticking to your routine and med regime. This is a ‘basic bipolar rule’, but even more applicable when you are dealing with a loss. I forgot to fill prescriptions or just couldn’t bother getting myself to a pharmacy (not sticking to routine), so I missed more than one dose of more than one medication at different times, and it really isn’t ideal. It just causes side effects and more of an emotional roller coaster. I did take something to help me sleep (25mg Seroquel) for about 2 weeks which I don’t do anymore, but I check it with my doctor and realised I really needed it. My sleep was okay-ish after 2 weeks.
  6. Sleep as much as you need if you can. This isn’t exactly something ‘prescribed’ for bipolar, but necessary under the circumstances. Once the dust had settled, I realised that I was (am) extremely tired ALL the time. I’m busy with a big project so I can’t exactly afford to sleep a lot, but luckily I make my own hours. I basically work until I can’t anymore, power nap, rinse and repeat. I spoke to a few people who have also lost loved ones and they reassured me that it wasn’t my body giving in, but that grieving is hard work and so you have to rest as much as you can.

 

I’ve been feeling like I’ll never NOT be sad in my life ever again. At least the sadness has become a bit less intense, but I will always miss my friend terribly. So often I want to tell her something and can’t. I’ve become slightly obsessed with finding every photo, text, email, anything that we shared in the past 10 years. It is incredible and also ridiculous what reminds me of her. Silly things will spark a memory and have me in tears. But I am very grateful that I’ve somehow managed to focus on my loss without my bipolar interfering. I definitely wouldn’t have been able to deal with both.

 

If you have any advice, please share. I will take any help I can get!

The benefits of support groups

Like most, I found being diagnosed with Bipolar Disorder completely bewildering. On the one hand it was a relief to finally find out that my life was coming apart at the seams not because I was a weak person who couldn’t cope with everyday life, but because I had an illness that had become unmanageable. But even though I had the diagnoses, and read everything I could lay my hands on, I felt that there was a key piece of the puzzle missing that made it impossible for me to really understand how it all fitted together. At the time it felt like I had to somehow fit my ‘self’ into the illness, instead of the illness into my ‘self’. I tried to discuss it with my psychologist, but to me it didn’t feel like he thought that I really had Bipolar Disorder. I might have only imagined that, but regardless I couldn’t talk about it. I eventually stopped seeing him because I didn’t feel like we had anything left to discuss. I felt lost, alone and unable to communicate or figure out what it meant to have Bipolar Disorder.

I had heard about the support group in my area, but hadn’t had the courage to attend. I was anxious about going by myself, but had no one to go with me. My family lives very far away and at the time I didn’t have any other support, so I had to talk to someone. Walking into my first meeting was absolutely terrifying. I wasn’t at the point where I openly discussed my illness yet, and I felt embarrassed and way too vulnerable. I didn’t know what to expect and was sure that the people were going to judge me. Luckily I was wrong.

These days I actually look forward to going to group and even when I don’t really feel like it, I go anyway (that’s usually when you need it the most). I have met some amazing and inspirational people and have made great friends that I meet with outside the meetings. Being able to talk to people who can identify with what I go through, think the way I do and have experienced the same frustrations I have has really made life easier. Although I believe that Psychologists have their place, and I still see my Psychiatrist monthly, attending a support group has helped me a lot more than therapy (in terms of understanding and dealing with my illness). I know that I now have people I can call on who will understand and a place to go where I can share my load, get help and advice and even laugh at myself. I also find it very rewarding to be able to pass what I have learned on to others.

Research has proven over and over  again that support groups have many benefits for their participants, whether it is for mental health issues, weight loss, addiction, chronic illness etc. These groups don’t have to be led by professionals in psychology or psychiatry and are more often led by ‘regular’ people who share the condition and therefore know what other participants go through. I found this quotation that sums it up:

“Mutual support groups, involving little or no cost to participants, have a powerful effect on mental and physical health… The psychological and physical health importance of this diffuse community is striking. The self-help movement, both in face-to-face and virtual arenas, has tremendous therapeutic potential.” (from American Psychologist feature article “Who Talks?: The Social Psychology of Illness Support Groups” by K. P. Davison, J. W. Pennebaker, & S.S. Dickerson, (55) 2, pp. 205-217, 2000.)

According to the Mayo Clinic, support groups hold the following benefits for its members:

  • Feeling less lonely, isolated or judged
  • Gaining a sense of empowerment and control
  • Improving coping skills and sense of adjustment
  • Talking openly and honestly about your feelings
  • Reducing distress, depression or anxiety
  • Developing a clearer understanding of what to expect with your situation
  • Getting practical advice or information about treatment options
  • Comparing notes about resources, such as doctors and alternative options.

For more information read this article. It’s about stress management, but I think the principles are the same.

Thanks to the Internet we don’t have to only rely on face-to-face support groups. Some people don’t have groups in their areas, some prefer to stay anonymous and others would rather express themselves in writing or to strangers. You can even belong to a few different groups if you want. The point is that these days it is easier to find a support group or forum that will suit your particular needs.

I’m sure support groups don’t work for anyone and it might take a few tries before you find something that works for you, but I would definitely recommend that you give it a try.

I only have a few support groups listed under Useful Resources, but please share yours and I will add it to the list.

Bipolar Disorder: The ‘flu’ of mental health?

I recently read something about celebrities and Bipolar Disorder where Bipolar Disorder was being described as a ‘fashionable diagnosis’ and ‘the flu of mental health’. I practically blew my top. This after hearing people say things like ‘everyone is bipolar these days’, ‘the weather is so bipolar’, ‘I think being bipolar is awesome’.

Generally, I have learned to keep my cool when I am faced with ignorant statements like these. Sometimes I would come out of my Bipolar closet and take time to educate the uneducated, but often I just don’t respond to a statement like that. However, hearing the chronic mental illness that my broken mind cannot get rid of being compared to the flu (I mean, FLU), really hit a nerve. But before I turn this post into a rant against those who I deem to be the ignorant and uneducated, it is worth looking at WHY a statement like that would even be made.

In this article about myths about Bipolar Disorder, the myth right at the top reads:’ Bipolar Disorder is a rare condition.’ A survey that  was done found that at least 2.4% of the world’s population  have been diagnosed with Bipolar Disorder, (245 million people) with less than half of those diagnosed actually receiving treatment. Although the percentage is actually higher than one would think, the reality is that about 4% of the world population suffers from Depression, which is also the second-leading cause of disability worldwide. We should also keep in mind that these statistics don’t include populations that still deny the very existence of Depression. What about Schizophrenia? 1.1% of the population. If you look at how many people are affected worldwide by these and other mental illnesses, it’s clear that it’s a much bigger problem than most people realise. I can’t help but wonder why there is still so much stigma attached to these illnesses.

Those who say that Bipolar Disorder is the flu of mental health are obviously not referring to statistics, and they might be snarky about it, but in a way they are not wrong. It is true that more people have Bipolar Disorder now than ever before. This is simply because the illness cannot be cured. So it makes sense that not as many people with Bipolar Disorder die as are being diagnosed daily, especially since the general public is now more aware than before and health professionals have become better at diagnosing it. Personally I’m a word person, but to me this sounds like simple mathematics.

Thanks to celebrities like Catherine Zeta-Jones and more recently Demi Lovato coming out of the bipolar closet, the illness has received more media coverage in recent years. You just have to search ‘Celebrities with Bipolar Disorder’ to find a whole list. What we ‘regular people’ have to keep in mind is the kind of lifestyle that celebrities lead. With this I don’t mean drugs and parties and alcohol (although that is part of the lifestyle in many cases). The typical lifestyle of an entertainer includes a lot of travelling across different time zones, lack of sleep, high stress, high pressure, ridiculous work hours, sporadic eating and other things that would cause problems to the most stable person’s mental health. Place someone with just the smallest predisposition to Bipolar Disorder in a life like that and chances are they’ll get it, and struggle immensely with recovery and becoming stable. An unstructured and unhealthy lifestyle like that is a recipe for disaster if you suffer from Bipolar Disorder.

One of the big and pressing questions is whether Bipolar Disorder was previously under-diagnosed or is now over-diagnosed. Since it took me, doctors and psychologists about ten years to figure out what was actually wrong with me, my personal opinion is that the illness is still under-diagnosed. Until there are blood tests or a brain scan that can conclusively diagnosed mental illnesses, correct diagnosis will always be a problem. After what I came to know as an ‘episode’ that landed me in the hospital, the psychiatrist assigned to me immediately thought that I had Bipolar Disorder, but since I couldn’t give him the information and history he needed, mostly because I didn’t really understand what he wanted to know, the official diagnoses took a month of hospitalisation, loads of talking an playing around with different medications. It was more a case of ‘since all this bipolar medication has made you better, you must be Bipolar’. I think that is often the case. It is still very much a diagnosis of exclusion.

But getting back to the issue of over- or under-diagnosis, there are mental health professionals that have done studies and reached the conclusion that psychiatrists might have become a bit overly enthusiastic with their diagnosis. On the flipside though, is it better to treat someone with mood stabilisers when you suspect that they have Bipolar Disorder, or to treat them with anti-depressants and risk them becoming manic (which is what happened to me, btw)?

The term ‘bipolar’ is also thrown around very easily to describe any state or being that is not seen as ‘unipolar’. Perhaps Manic Depression is then still a better name for it. I think people are much more likely to describe the weather as bipolar than as having Manic Depression.

I’m of the opinion that all the reasons mentioned above and the fact that more people are being correctly diagnosed now creates the illusion that it has become an illness that is no worse than the flu. A larger percentage of those living with mental illness have been diagnosed with Bipolar Disorder, yes, but I still find the statement offensive; like people think that I can just take a few pills, rest and get over it.

I’d love to hear your thoughts.

Does Bipolar Disorder exist in children and teens?

From a very young age I knew that something about me was different from other people. I was very sensitive and frustrated. I can remember how, at a very young age, I would cry without knowing why, and make up excuses to my parents. Apart from that I don’t remember too much about my childhood moods, but what I do know is that I was an extremely depressed adolescent. I had always been a confident child, but my anxiety become so bad that, where once I was an award winning public speaker, I suddenly couldn’t stand in front of a crowd without shaking and sweating uncontrollably. I was forever obsessing about things and people. Especially people. I felt like I had no one to talk to and was absolutely alone. When I did try to reach out to people, I became obsessed with them. I couldn’t control it and I couldn’t understand it. I just wanted someone to talk to, but could not burden them with my problems. I started contemplating suicide when I was about 15, and started writing teenage angst poems about death. Most of the time I either felt suicidal, or trapped and frustrated. Before I left high school, I had seen about 6 different therapists; no one can say that I didn’t try to find help. Strangely enough, I was never referred to a psychiatrist. In the small town that I grew up in, and especially in my family, people just didn’t do that.

My situation was also complicated by the fact that my parents were going through a divorce at the same time and all my emotional baggage was put down to trauma from divorce. I won’t lie, it was traumatic, but no one thought to look further or deeper. I read all about depression, but as a 15 year old I couldn’t quite grasp it, and I didn’t understand what it was. Depression wasn’t really the problem though; it was the obsessions, compulsive racing thoughts, frustrations, sudden bursts of anger, irritability and anxiety that I didn’t not understand and didn’t have the vocabulary to identify. Now I look at my family and I clearly see a history of mental illness, but 15 years ago no one thought of or wanted to go there. Plus it can be difficult to distinguish between just being hormonal and being clinically depressed when dealing with teenagers.

Diagnosing most people with Bipolar Disorder is difficult, but diagnosing kids and teenagers are even more difficult, since their bodies and brains are still going through so many changes. To further complicate things, children and teens with Bipolar Disorder don’t display the same symptoms as adults. It is said that they generally experience more irritability and rapid cycling than adults, and the cycles might not be as ‘visible’. They do not exhibit the manic behaviour described in the DSM and their shifts in mood are not as clearly defined. This causes a lot of controversy around the topic. Some experts believe that Bipolar Disorder can appear in children as young as six years, while others believe that it does not exist in children. This is because the symptoms can easily be confused with that of ADHD or depression. Being treated for these illnesses when children actually have Bipolar Disorder can make the condition worse and trigger mania.

An Italian psychiatrist, Dr Franco Benazzi, explains it very well:

“Misdiagnosis of bipolar disorder as attention deficit hyperactivity disorder [ADHD] and major depressive disorder is common, leading to the use of stimulants and antidepressants, which might worsen the course instead of mood-stabilizing agents,” he notes.

When Bipolar Disorder runs in the family and other members of the family have been diagnosed, it at least gives doctors a bit more to work with, and they know to consider this. Like with adults, Bipolar Disorder can only be treated effectively if correctly diagnosed. At some point I read that if a child displays symptoms of depression it is more likely that he or she has Bipolar Disorder and therefore some psychiatrists would rather treat them with mood stabilisers first and antidepressants second. Even though I’m sure this is not false information I can’t find the original information and wouldn’t want you to just take my word for it, so if you are in this kind of situation with your child or teen, ask you psychiatrist about it. Here is some other advice about how to help your child with Bipolar Disorder. Also have a look at this article from a Psychiatry journal about the misdiagnosis of Bipolar Disorder, that I have also added on my resources page. The article says the following:

“Research supports frequent onset of bipolar illness prior to age 20. Pediatric bipolar disorder, unlike in adults, has been reported to present as nonepisodic, chronic, and mostly mixed manic states. The unique presentation of bipolar disorder in children and adolescents and its frequent comorbidity with ADHD, anxiety disorders, oppositional defiant disorder, and conduct disorder might be a significant contributor to the difficulties in accurate diagnosis.”

Doing research on this topic was much more difficult than I thought it would be. Clearly research is divided into two camps and although there is a lot of information out there, it all says the same things. From personal experience I can definitely say two things: 1) No matter what the DSM says about criteria, my Bipolar Disorder definitely started in my teenage or even childhood years, and 2) Antidepressants made my condition worse. Parents and doctors have to be more sensitive to these conditions in children and teenagers instead of just treating them for ADHD or Depression and worsening their symptoms. Kids should not have to experience the suicidal lows, excruciating mixed states or uncontrollable highs of Bipolar Disorder. It scars you for life.

Please share your own childhood stories or the stories of your children. It’s usually not the research in books by scientists that help us understand, but the real stories of real people.

*Small update: I spoke to my psychiatrist about this today. In his opinion Bipolar Disorder definitely exists in children, but is almost impossible to diagnose.

Surviving hypomanic episodes

Most of us don’t realise when we are in the midst of a hypomanic episode. Only in retrospect from the depths of depression do we realise that are behaviour was ‘of’ or ‘not normal’. I use to think that because I am stable on my medication, I wouldn’t experience symptoms of hypomania or depression again. Of course this assumption was wrong. People more knowledgeable than I have told me that it takes a lot of self-awareness and experience to realise before it’s too late that you are being pulled into depression or hypomania. Personally I have not reached this level of awareness yet, but I have found a few things that help me when I realise that my mind is spinning out of control. These are only my personal ways of coping and what works for one person might not work for someone else. I have found that the only way I can pull myself out of myself is by distracting my mind and focusing on the things I do rather than the things I think. That is what we are doing anyway when we are behaving in self-destructive ways. Shopping, 100s of projects, speeding, taking risks, drinking excessively, doing drugs, cutting, random sex and yelling at your boss are mechanisms, I think, of distraction. Why we have to turn to the self-destructive is beyond me. Although it is also where intense creativity comes from in some of us.

Most importantly though, you have to contact your psychiatrist immediately when you realise that things are going haywire and that you can’t keep it under control yourself. I usually only realise this too late, but as I’m going along I am getting better at recognising the signs in myself.

Below are a few other things that I have found helpful when I feel the hypomania coming on and I can’t see my doctor or am waiting for the new drugs to kick in.

Do something with your hands.

The best way for me to get out of my head is by doing things that distracts myself from my thoughts and focus me on something I’m doing with my hands. My go-to is doing mosaics, which I learned while I was hospitalised (gotta love art therapy). I can do it for hours and just focus on fitting the different piece into each other. The fact that I get to break stuff is a bonus. I also do puzzles. It’s the same concept and completely distracts me. Of course I need to make sure that the puzzle is big enough to keep me busy for some time.

Another thing that really works for me is origami. Learning how to fold some of the more complicated designs can be frustrating and infuriating, but otherwise you could just see if you could get to a 1000 tiny cranes (the Chinese believe that if you can do it within a year, you get to make a wish). You can do anything where you make something, really. Beading, pottery, wood work, baking, whatever works for you. I know some people go into a complete frenzy about cleaning and I don’t think it’s a bad thing. You distract yourself and have a nice clean house after!

Be artistic

To me there is a definite difference between being artistic and being creative. In certain areas I am very creative, but I am not artistic at all! The other day I said to someone, “I can’t draw!” His reply was, “Of course you can! Anyone can draw. You don’t necessarily have to be good at it.” I realised that he was right. I don’t have to be a brilliant artist to have fun with shapes and colours. So I bought myself some oil pastels and a sketchpad. Even though I’m pretty sure that I suck, I find drawing simple shapes therapeutic and the bright colours make me happy. You don’t have to be Picasso (although that might be a bad example), you just have to do it for yourself and enjoy what you’re doing.

Get active

I’m not big on doing exercise. I’m actually embarrassingly lazy like that. What I have found works for me during especially frustrating and angry times is playing tennis against a wall. I don’t play against anyone else as that will just frustrating and irritate me more, but hitting balls gets rid of a lot of nervous energy and anxiety. I also go for really long walks or especially dancing. That can conveniently be done in your house in your underwear too. Doctors always say that exercise is good for you because of endorphins and all that, and you can’t really argue with that. But more importantly when you have Bipolar Disorder, it distracts you and will hopefully make you tired so you can sleep. Speaking of…

Sleep

This is a tricky one, since during hypomania you can’t and don’t want to sleep. During ‘happy hypomania’ it’s easy to just let this one go without thinking of the consequences, but during dysphoria it’s just that you can’t sleep, even though you badly want to. Being awake is too painful. When I feel like this, the only thing that gets me to sleep is a sleeping pill. Of course only ones prescribed to me by my doctor and only the prescribed dose.

Write

Even though I love writing and write all the time and would write for a living if I could, but it doesn’t work for me when I’m hypomanic or depressed. My thoughts reach very dark and scary places and drag me down further into an abyss. On the flipside, I have these amazing epiphanies where the world and the afterlife suddenly become so clear, which isn’t a bad things, but these thoughts and pieces of writing are of course to important and life changing to keep to myself, so I email them to everyone I think might be touched by my revelations. At the time my friends humour me, but when looking back at what I wrote later, I realise every time that I probably sound absolutely insane. So for me writing is actually a bit destructive when I’m hypomanic or depressed, but many people find it very therapeutic.

Use music

Music can be used as a distraction in two ways, either by playing an instrument or listening to music. I can barely call myself a beginner on the acoustic guitar, but practicing the chords I know, learning new ones or trying to work out the chords for my favourite songs can keep me busy for hours. All I think about then is the music. Learning a new instrument is both fun and much more constructive (and cheaper) than shopping. Again what doesn’t work for me is listening to music. I’m very sensitive to sound and the world gets too loud very quickly. Depending on whether I’m in a euphoric or dysphoric state of hypomania, music will either make me angry and depress or let my mind go wild. I can get so into the music that it feels like I disconnect from the outside world.

Watch TV

Now this one is not necessarily the healthiest one, but when my mind can’t stop spinning often then only thing that works for me is focusing my mind on the lives of characters in TV shows. I can’t watch movies because they are too long and boring and I don’t watch documentaries because I find them boring, but I love stories, so I can easily go through 2 seasons of a show without stopping. This is not what I mean with using it to cope with hypomania though. When an activity hinders instead of helps you, breaks your routine and deprives you of sleep, it because destructive. Therefore when I’m hypomanic I try to avoid falling into this ‘addiction’.

I realised while I was writing the above; and you might have picked it up too; that there is a very fine line between distractions and destruction. The same activity can have opposite effects in different people or even in the same person at different times. The key is to figure out what works for you. I am sure that there are many other distractions and coping mechanisms out there and the ones mentioned here are just the ones I know work or don’t work for me.

How do you distract yourself when you are hypomanic?

What is Bipolar Disorder? – Happy hypomania

For this post, I really had to dig deep. I have found that there are two reasons for why I’ve found it so difficult to isolate emotions and experiences from these times of hypomania, or euphoria. The first reason is that when I am hypomanic, I don’t realise that anything could be wrong with me. How could feeling so good be a symptom of an illness? The second reason is that over the past couple of years, I rarely experienced the highs of hypomania. I’ve mostly found myself in mixed states.

What I do clearly remember from being ‘high’ is that it really feels like you are high on something, without having taken anything. High on life, I use to say. It like being tipsy, without having had anything to drink. I haven’t had any experiences with illegal drugs, but I have heard that the feeling is similar to being high on cocaine. People often become addicted to this feeling, which makes them more likely to quit their medication. After being diagnosed I could look back at my life and I instantly knew when I had my first hypomanic episode. I went to a arts festival with friends for 5 days. It was my first one and I was extremely excited. But looking back I realise that it was more than that. In 5 days, I barely slept 10 hours. I didn’t want to sleep. I partied until the sun came up. I was funnier than usual, more excited than usual, more outgoing, drunker, louder, more carefree, taking more risks with my safety. My friends joked about my two personalities that week. See naturally I’m more introverted, like my sleep, get tired of people and generally a bit shy when I meet new people. That week I really felt like the world was my playground. It was great. After the festival though, I cried a lot. I had a sense of impending doom for months. Even though I was still feeling great, or thought I was, I freaked out because I was afraid that life would never feel that good again. I was scared. My moods were dropping at a rapid and uncontrollable speed.

I remember other occasions where I’d bounce out of bed (a huge deal for the anti-morning person) and feel like my life was the best thing that could happen to anyone. I would write long and meaningful emails to everyone I know, sharing my amazing and profound epiphanies about the meaning of life. I would write fiction for days on end, not typing fast enough for my thoughts to become words. Something would amaze and inspire me, and when others weren’t as excited as I was, I would be furious. How could you NOT see the splendor of this thing, this person, this piece of music? How are you no in awe? I could work and study for days at a time and barely take a break. Poems from my English class, in particular when I was studying Emily Dickens for exams, suddenly came to life.  I would listen to a song on repeat for months, hearing every instrument, every beat, individually and as a whole. Songs would conjure up images and stories in my head. I would write on the train, while waiting in queues in stores, while I was suppose to work, at 5am. Stories would fill my head. I would dance in my underwear for hours, stomping my feet and drinking. Even if no music was playing, I’d dance to music in my head, or bounce up and down. I couldn’t sit still. I told people I had ants in my pants. In truth, it felt like I had ants under my skin. The world looked sharper, colours were more vivid, everything inspired and excited me. I didn’t want to eat, couldn’t eat (big deal for a major food lover). My brain would never shut down, I didn’t stop talking because I had so much to say, and the thoughts and ideas were coming so fast. I was animated and charismatic.

Amazing right? Truly fantastic. Exhilarating and inspiring and passionate and so many other wonderful things. So how on earth can anyone call this an illness? Why would trade these bursts of light and colour for a normal and stable life?

Why? Because it doesn’t last.

As I explain about the title of my blog, your wings catch fire and burn out quickly. Then you start falling, and you fall from a dizzy height and crash spectacularly, either into depression or you go into full blown and uncontrollable mania. The problem is that all those amazing thoughts and feelings become too big. No matter what behaviour you engage in, you can’t get rid of whatever is chasing you from the inside. No matter how many risks you take, how creative you are or how much you self-medicate, nothing gets rid of the excessive amounts of energy building up inside you. I’m not really into exercising except for dancing, but not even jogging in the rain or walking for hours until my body felt exhausted could shut my brain down or help me sleep. Whatever is inside of you grows and grows and your body is unable to contain it. In my case, I resorted to a lot of alcohol to numb and relax me, and self-harm to try to physically release what became, like with depression, a physical pain in my chest. Of course that makes everything worse. For me, once I have reached this tipping point, the descend into dysphoria and depression is rapid, all-consuming, painful and extreme.

After going through this cycle a couple of times, especially after realising that it is in reality a cycle, you get to a point where the cons outweigh the pros. I am so terrified of what my happy hypomania morphs into, that I have now gladly sacrificed it for a more stable and predictable life. Sometimes I feel like I am a very boring person now, and that I have lost my special spark, but since being in remission I’ve realised that when I have ideas now, I can actually follow through. This don’t come as easily anymore, my memory is not what it use to be, which is the worse for me. I don’t have life changing epiphanies and being creative is as much about being inspired as it is about working hard and persevering.

Do I miss those magical times? Definitely. Was it worth giving them up? Absolutely. I said to a friend yesterday that really reflecting on my past made one thing abundantly clear: There was a point in my life that I was stark raving mad. Bonkers. Insane. It’s not as glamorous as it sounds. Having split depression, dysphoria and euphoria into three separate entities might make them sound manageable. They might be, when experienced in isolation. But all three in a never-ending cycle? Often with symptoms overlapping and an absolute inability to have normal relationships, function in society and keep a normal job? No. Definitely not.

How do you experience hypomania? Have you had to deal with a loved one in a hypomanic state? 

Next post…. How to manage early stages of hypomania.

 

What is Bipolar Disorder? – The dark side of hypomania

In my pervious post I explored what it feels like to have depression. As we know, that is only one side of Bipolar Disorder. What makes this illness different from ‘regular’ unipolar depression is that you have the lows and the highs.

As with my previous post, I am not going to list the typical symptoms of hypomania and mania; you can find more information about that here. A note on the two though: Mania and hypomania are not the same thing. Even with all the reading that I’ve done, I sill haven’t found a proper comparison between the two. It is generally said that hypomania is a less severe form of mania. Mania is usually experienced as an episode that lasts for a few days or weeks. As far as I know it does not last as long as a hypomanic episode. Hallucinations, delusions, psychosis and severe paranoia  are experienced during manic episodes. This is not the case with hypomania, although I know from personal experience that paranoia and delusional thinking should not be excluded when talking about hypomania (or I might just be more manic than I realise…). Mania greatly impairs the sufferer’s functioning up to a point where hospitalisation is usually necessary. People who experience mania are classified as Bipolar I, whereas people who experience hypomania are classified as Bipolar II. Suffering from Bipolar I is probably much worse than Bipolar II, but don’t think that if you ‘only’ have bipolar II, it is not serious.

My diagnosis is Bipolar II, which is why will only share my experiences of hypomania and not go into further detail about mania. Various levels of manic states are, in my opinion, largely misunderstood and the part of the illness that intrigue people and lead to their misconceptions. When someone joking refers to themselves as Bipolar because they experience a couple of mood swings, or feel really happy, I have to work very hard to keep myself from flying into a state of extreme rage. That is when I have to remind myself that people are just uninformed and ignorant, and that my talking about it is part of the solution. As the title says, this post describes the dark side of hypomania. Most people think that hypomania is flying on a cloud of endless euphoric energy and creativity. A fun feeling. Even though that is often the shape that hypomania takes (and I’ll cover that in my next post), there is a dark side to hypomania that in my opinion does not get nearly enough exposure.

Dysphoric hypomania (mixed state)

My process of being diagnosed with Bipolar Disorder started 15 months ago. I had been on antidepressants for about a year before that. I wasn’t depressed anymore, but I was something that wasn’t normal. Turns out being only on antidepressants is very dangerous if you have Bipolar Disorder. I didn’t realise it at the time, since I couldn’t recognise my thoughts and behaviour as faulty. When I look back now I don’t know how I didn’t realise earlier that something was very wrong. I had been going through a very stressful time for about a year, and I thought that what was going on with me was severe anxiety. I didn’t feel the happy, ecstatic states mostly described as hypomania. Not then. What I did feel was a sense of being stuck inside myself. It felt like I had ants crawling under my skin and that I had to keep moving. I was usually tapping my foot or standing up when everyone was sitting down. At home I put my headphones in and I would dance non-stop for hours, giving myself over to the music completely. Colours looked brighter, sounds were louder. I couldn’t sleep#. I only ate because I had to (even though I love food) and most of the time I would just feel nauseous when I ate anyway. It felt like the world was closing in on me.  I needed to get out, but  there was nothing physical to get out of. I still had a painful feeling on my chest, like when I was depressed, but I was pumped up. Frantic. My thoughts were obsessive. I obsessed over people. I drove people away. I was completely irrational and often delusional in my thinking. It felt like everyone was against me, even the people in my life who love me the most. The intensity of my emotions were almost unbearable, and I didn’t understand how people can experience something with me and not have the same reaction. I was unreasonable. I was aggressive and frustrated all the time. I had fantasies about bashing annoying people’s heads against walls. I was angry about everything all the time.

I think that my behaviour resulting from all this was a kind of attempt to get away from myself. Describing my feelings are not embarrassing to me. I felt things that I had no control over. My behaviour because of these feelings I do still feel very embarrassed about. I have to share some of the things I did to let this information make sense, but I do want to say that I deeply regret most of it. I spent much more money that I had and made debt that I am still struggling to pay off. I almost bought a flat! It was only thanks to a small admin error that the deal thankfully didn’t go through. It would have completely bankrupted me. I got traffic fines in the double digits. I drove drunk, late at night and to secluded places. When I wasn’t home, I was drinking. I took whatever pills I could find, just to try to shut down my head. I would go jogging in the icy pouring rain (and I don’t jog!). I sent out messages and emails and didn’t think about the consequences. There were things that I said and did that I had no control over. The obsessions and compulsions took over my mind. Once I established a routine or pattern, I couldn’t break it. Eg, if I got into a habit of texting one person every day and I realised that, I couldn’t break the habit, I just couldn’t. Even if I had nothing to say. Come to think of it, it might actually be what real OCD feels like (not the kind where people think you have to arrange your books alphabetically or clean a lot, the actual misunderstood disease). Even though I’m not promiscuous and not one to kiss and tell, my sex drive definitely went haywire. Theoretically it’s a small miracle that I didn’t sleep around and contract a disease or something. All of these crazy thoughts, feelings and behaviour eventually led to very bad physical and emotional self-harm.

This was an awful time in my life. I now know that it wasn’t my first hypomanic episode, but it was certainly my worse so far and landed me in the hospital. I really is only by the grace of God that I survived it. Personally I’m not sure how I didn’t commit suicide. This state of mind went on for months. I was completely lost in it. I look back with such relief and gratitude. Now that I look back, I know that I was severely ill and that has made it easier for me. I don’t blame it all on myself anymore.

Learn more about dysphoria/mixed states.

Can you better explain the difference between mania and hypomania? Have you or anyone you know experienced dysphoric hypomania? How has it affected you as a sufferer or a supporter?