Tag Archives: depression

How mental illness is good for the environment

Let’s face it, in recent years, and maybe not so recent, us humans have been abusing and destroying our beautiful planet. My country is classified as a ‘developing’ one, and our government is incompetent at best. So when it comes to all things environmental, despite having brilliant scientists, I would say that we are generally a bit behind.

So when we had electricity shortages a few years ago, and then again a few years after that, no one was prepared. And when we went into a massive drought, where some areas have now been declared as disaster areas, no one was prepared. ‘Yeah, so what?’ I hear you thinking. ‘What has this got to do with bipolar or mental health?’

It’s simple. In trying to be more vigilant by finding ways I can save resources, I have found that due to my mental illness, I already do! Let’s look at saving water, for example: when I’m depressed I save loads of water from not showering or washing my hair. I’m not proud of this, but if you’ve been depressed you’d know that personal hygiene is really too much of an effort. I mostly just swap one pair of pajamas for another pair, so I very rarely have to do laundry. And even when I do, I just don’t. I certainly don’t touch the dishes (if I even eat), and my mushy brain completely forgets to water my few pot plants. The only water I really use, is for drinking, brushing my teeth (the one thing I always do) and flushing the toilet.

As for electricity, no need to turn the lights on when you’re sleeping most of the time. I don’t use much hot water, or big appliances. My food intake is normally restricted to pizza delivery, ramen noodles, bread and cheese or a meal replacement shake. And lots of chocolate. So no using stoves and ovens here!

And my carbon footprint? Well as we know many people with mental illness are unemployed or work from home. I now fall in the second category, which means I might leave the house once a day to buy groceries or see family (I would love to add ‘and go to the gym’ but that’s not exactly happening right now, or when I’m depressed).

So there you go. If your depression, anxiety, medication side-effects or whatever your brain problem is makes you behave in a similar way that I do, always remind yourself that even though you feel like trash, you are helping mother earth to survive. Who knows, maybe that is our collective goal as the mentally ill. When the planet is in trouble, we get sick so lighten its burden and help it get better, if that makes sense. That’s what I’m going to tell myself the next time I’m horribly depressed, anyway: The planet needs me!

 

*This post is meant to be a bit tongue in the cheek-ish, so if you are an environmentalist reading here, please don’t be mean and bury me under links to piles of scientific research. I might have a panic attack and slip into a deep depression. Or get mad and go into bipolar rage, and you really wouldn’t want that.*

Big wave, little wave

*trigger warning* This post contains mentions of suicide.

Greetings  blogosphere and interwebs in general. I’ve delayed writing a bit because you see, a lot can happen in a year. Also because bipolar folk are notoriously unreliable when we hit an episode. It’s really not our fault.

As for me, I won’t share all the details because it will be much too long and I don’t think it will necessarily be helpful to anyone. So just in short, in the past roughly 10 months, I did a stint in clinic because I was suicidal, then thought I was fine. Then, mostly unbeknown to myself, depression became a mixed episode and my life and my brain became all kinds of fucked-up (I will gladly share details if someone wants to PM me), then I did actually try to commit suicide, failed/was stopped, spent 5 days in ICU, went through the aftermath with the people in my life (this was by far worse than anything else). If you want to kill yourself you better make damn sure you die. That being said, now I’m kinda glad I didn’t. Most of the time.

Anyway, then my life fell apart. I had to take unpaid leave from work and left the city to stay with my parents in my home town and receive intense therapy. My doc also put me, and here is the important part of the post, Lithium. It took some time and a whole lot of blood tests to get the dose right, but it pulled me out of my very deep hole. I won’t lie, Lithium has its stigma for a reason and its side effects are horrendous. Apart from the common shakes and dry mouth, there is hair loss, stomach cramps, vertigo, unbearable thirst, acne, possibility of kidney and thyroid problems and probably some others. But how does it look on a practical level? It means if I don’t carry water with me all the time, I get incredibly agitated from thirst. I can’t apply eyeliner or do any detailed kind of work with my hands. My writing is even worse than it was. Some days my stomach cramps so much or I get such bad vertigo that I have to lie down. No matter what I do, my skin looks terrible. But to me the worse is probably the hair loss. I have thick and long hair and it’s EVERYWHERE. I shed worse than my cats and it frustrates me to no end. These side effects make me feel very sorry for myself.

So why take it if it’s so horrible? Because the 1 pro far outweighs the many cons: It keeps me from wanting to kill myself. It’s as simple as that, and the no. 1 reasons doctors prescribe Lithium despite its side effects. I’m still not on ‘normal’ between hypomanic and depressed, but I’ve only have little waves, not big waves. And this has been with a whole bunch of crap happening in between. I quit my job, left the city to move back home, had to find my own place, my father passed away and I’m starting my own business. It hasn’t always been easy, and there has been plenty of days spent in bed or in front of the TV, but I’m managing.

While most of this is largely thanks to Lithium, I am also on Wellbutrin, Venlor and a very small dose of Seroquel. I’ve also basically stopped drinking and have a good exercise routine. I’m not under big city stress (like traffic), and I am not in an extremely deadline driven industry. I try to at least do one big task/errand a day. All these things help too. I still need to get into a better routine and do something about my diet (currently I have only bread, cheese and a bunch of sauces in my fridge).

I curse the fact that I have to live with these side-effects every single day. I get very angry that people don’t see it and therefore don’t know what I’m going through. I feel embarrassed when someone sees my food fall off my fork because my tremour is so bad. But then I get over it and remember where I could have been. How I almost drowned in the storm of my own mind. And I ride my little waves, that no one even sees, like a pro.

 

*If you or someone you know need support, please call the suicide prevention hotline in your area immediately, or reach out to someone you trust. Threats of suicide should ALWAYS be take seriously.*

Admitting when you need help

Earlier this week I went to see a new psychiatrist. Naturally I was sceptical but it didn’t take her long to win my trust. Her assessment of me was very thorough, she is open to new treatment options and seems to care (or at least pretends convincingly that she does). Her suggestion was that I go to a clinic to receive in-patient treatment while we adjust medication and to give me some space to just be without having to manage myself in the world, as this is more exhausting than most people would think. I agreed and will be going in next week.

Some people I have spoken to seem to confuse the reason I’m going, as I am not suicidally depressed or running around hypomanic off my rocker. They think I’m going in for a little rest, or a nice vacation funded by medical aid. While that is true, I will be doing a lot of resting and sleeping and switching off from society, that’s not the whole point. The reason I’m going is exactly because I am not suicidally depressed or hypomanic. Not yet, at least. Or rather, not at the moment. The reason I agreed to in-patient treatment is because I want to PREVENT things going too far.

For the first time since I was diagnose I’m actually pre-empting this thing. I can do that now, because I am more self-aware than I use to be. I can recognise a crisis creeping closer before it actually bitch slaps me through the face. I might be feeling fine right now. Right now going to a hospital and putting my life on hold feels like such a silly idea. I clearly don’t need it. But the reality is that I don’t know how I’m going to feel tomorrow. Or this evening for that matter. It’s become clear to me that I probably have some rapid cycling going on and that is part of what I want to figure out while I’m in the clinic. I can have my meds adjusted without having to worry about whether or not I’ll be able to make it through a day at work. I can talk to a psychologist every day if I want to. I can get focussed treatment and don’t have to drag it out for months.

It doesn’t mean that it’s not scary. And I think that’s what people who think I’m going on vacation don’t understand. There will be intense group therapy, one on one therapy, new drug regimes, routine, all in a foreign environment where I will likely be sharing a room with strangers who snore. But it’s not my first rodeo, so I know I’ll be fine.

I’ve taken the first steps; admitting I need help and accepting it. It can only get better from here.

Celebrating small victories in the midst of depression

When I’m depressed, I become obsessed about being depressed. So instead of actually doing my job, I spent the day on bipolar blogs and forums, finding comfort in shared pain.

I read a post somewhere (wish I could link to that blog, but I really can’t remember where I read it) about ‘how to get out of bed in the morning when you’re depressed’ and the person talked about a technique that I thought could be very useful: taking life one baby step at a time, while giving yourself the freedom to back out at any time. The person talked about how, when she woke up, she would convince herself that life is better once she’s had coffee, so she might as well get up and have coffee. Then she would tell herself that she doesn’t have to go to work, but that having a shower will make her feel refreshed. And then that she doesn’t have to go to work, but she likes to listen to music while she’s taking a drive. And so on until she would eventually get herself to work. The trick is to stay in motion. For someone going through paralysing depression, just getting to work is actually a huge accomplishment.

Today I was suppose to go to a Pilates class; one I know is pretty intense; but I felt so crap all day that I didn’t want to move, never mind do Pilates. I so badly wanted to be alone on my couch eating chocolate and staring at the ceiling. Under normal circumstances it takes a huge amount of effort to get myself to exercise. When I’m depressed it’s practically impossible. If I can’t get myself to go dance, I am certainly not able to get myself inside a gym. So I approached the situation with the same mindset. After work just get yourself to the gym. Just take your card and swipe your access card. Turn right around if you want to. So I did that. Once inside, I said to myself, just put on your gym clothes. You’ve got your bag here, just get dressed and leave. By the time I was dressed I thought, might as well spend 5mins on the bike (the only form of gym cardio I actually enjoy). Five minutes turned into 20 and I was actually disappointed that my time was up just as I was half way through my second game of solitaire (machines these days, incredible).

While lying in the fetus position bawling my eyes out not a few hours ago (what is it with the fetus position that it is so comforting?), feeling pain take over my whole body and soul, I reflected on this. Look, I barely broke a sweat. I wasn’t even out of breath. I didn’t make it to Pilates. But I was there. I showed up. I kept moving and for 20mins of my day, I actually felt a bit better. In my brain I know that it was actually a victory. In my brain I know that I should be proud of myself, because putting one foot in front of the other is an achievement when you’re depressed. I rewarded myself with that chocolate I was waiting for all day.

I still feel like shite. What it feels like when your emotional pain is so intense that you actually feel it in your whole body is something I can’t explain. I don’t know if the same technique is going to work to get myself to work tomorrow. Maybe I’ll be fine by tomorrow (I’m starting to suspect that I might be the rapid cycling kind). At least I know that today I did something. And that’s a small victory worth celebrating.

Getting over it and back: The first (practical) signs of depression

Happy belated new year to the troopers actually still willing to read my sporadic ramblings.

For me it’s mostly been a good one. I’ve realised that blogging, for me, is like praying (which is wrong on so many levels); when life is good, there really isn’t much to say (except for the occasional ‘thank you’), but it’s when things start going pear shaped that we (I) feel the need to reach out, express what I’m feeling or not feeling, look for understanding and kindness and someone to say that it will all be okay.

The last two weeks of December I found myself in a remote location on holiday with no working electronics to speak of, and no electricity for the most part. This recharged me like I couldn’t have imagined. It really put life into perspective and brought about peace that I had not felt in a long time. But then we get back to reality and have to face the world and we fall back into old habits and hangups.

As I mentioned in my last post, my psychiatrist told me to just ‘get over’ this little, ‘mild’ bipolar problem of mine. So I decided, skrew you, I will do exactly that. Which also means that I won’t see you again and not that it really matters, but you will lose my money so HA. I did give it an actual try though. My meds were working in their higher doses and I felt fine. So I decided no psychiatrists, support groups, blogs, forums, no nothing. Just taking my pills morning and night without thinking about it. And it actually worked, sort of. I really wasn’t giving much thought to this little ‘like high blood pressure’ problem of mine. I would talk about it freely with those who asked, but in a detached manner, like it was just something part of my past.

So I was almost two months in with this and it worked pretty well. In the meantime I met a very nice man, who it then didn’t work out with (men hey…). But shame, it’s not his fault that I’m depressed now. Maybe just a little bit. But I think it started a week or so before we broke up. Today I was extremely irritated and even a bit bitchy. I had one of those days where you just want to lash out and scream. And while I was lying in the bath tonight, while I was actually suppose to be at a dance lesson, it hit me. I am depressed. Not suicidally depressed, but it’s definitely there lurking underneath the surface. And I realised it’s been 3 to 4 weeks. And I wasn’t surprised as it seems like my period of calm is two months. It never lasts longer than that. Being older and wiser and being better at recognising things for what they are, instead of thinking it’s all in my head, I can now see some of my early signs of depression, which I will gladly share with y’alls.

The conversations in my head sound roughly like this:

  • ‘I am so bored. My work is so totally unstimulating, I can do it in my sleep.’ Followed by job searches.
  • ‘Once <insert event here> is over, I’m going to start tapering off my meds. I don’t FEEL anything anymore’.
  • ‘I have become such a boring person. Where is my sense of humour?’ (misses hypomania)
  • ‘Why bother getting up early when no one even cares if I’m an hour late for work.’
  • ‘There is a fat man standing on my chest.’
  • ‘I know it’s not really true but today it feels like life isn’t worth living’.
  • ‘Chocolate! I need chocolate!’
  • ‘I’m so fat!’
  • ‘Fuck I hate pms! This is the worse in my entire life!’ Followed by the realisation that I will only be having pms in a week or two.
  • ‘Take me back to the clinic where I can sleep all day and people feed me.’ Followed by looking at the clinic’s website and reminiscing.

Other signs include:

  • Easily sleeping 12 hours, being awake for about 7, and then sleeping another 12.
  • Drinking to get drunk.
  • Throwing all my good quit smoking resolutions out the door.
  • Being permanently irritated with my colleagues (but in my defense, some of them are chronically annoying)
  • Spending most of my time either watching series or staring at the roof.
  • Feeling like I have achieved nothing in my life and that I will die alone.
  • Guiltily stuffing my face, in a way that feels like I’m punishing myself.
  • Not showering over weekends.
  • Having unreasonable fits of rage or feeling like a friend/family member is out to get me or hurting me on purpose.
  • Obsessively worrying about something or someone.
  • Being totally unreasonable in general.

You get all those websites that list a bunch of symptoms about sleep and appetite and not enjoying things, but what I have listed above is what it FEELS like. The practicalities of it.

Luckily I have caught myself before things got out of hand. As always when I go through some kind of mood episode, I’m almost crippled by the thought that it isn’t the first and it won’t be the last. And frustrated that the medication that worked so well a few weeks ago has seemingly stopped working. And of course the horror of imagining riding out a depressive episode.

But chin up! This is still quite manageable. I compiled a shortlist of psychiatrists to research and luckily there is a support group next week. I don’t feel it, because I feel nothing but dread and horror, but cognitively I know that I can be proud of myself for spotting the signs early.

Getting over my ‘mild bipolar’

After having my meds adjusted last week, I went to see the pdoc again today. Changing from Geodon to Seroquel was not so easy, despite the fact that the pdoc said there should be no problem. For two days I was shaky, dizzy, anxious, couldn’t work and could barely sit up straight. (As an aside, no matter who says what, cold turkey is never a good idea. Taper taper taper.) This little experience has taught me to always listen to my own body before listening to the voices around me. Also that Seroquel is the unfortunate answer to my little hypomanic problems.

So back to today, bawling my eyes out because I am just too tired to face another day and then being told by my pdoc that I really focus too much on this whole bipolar thing. Mine is only mild and more on the depressive side (like depression is not excruciating) and at least I don’t have bipolar 1. And he sees loads of fucked people (his words), and I am not one of them. I am actually doing well. Now I can’t really argue with that, because I am not locked up in a state mental health facility chained to a bed. So yes, life could be a lot worse. But does that make what I am experiencing here, now, any less real, or earth shattering for me? No. In my frame of reference, this might not be the worse it’s been, but it’s getting pretty close. I’m not necessarily as depressed (touch wood), but my little trip into hypomania was almost as bad as it was when I was first diagnosed. So for me I’m pretty close to rock bottom. A more self-aware semi-rock bottom, but still. And maybe my rock bottom might not be as low as someone else’s, but it’s still pretty shitty.

Look, the man makes valid points. I know he says it to me like it is and not what I want to hear. And I know I can be a bit neurotic. But on the one hand you have people telling you to be kind to yourself, love yourself, take it easy, and on the other hand you have people telling you to put on your big girl panties and get over it. Life is hard and it’s unfair. I think this is what makes the journey so lonely; you can’t really win either way. People will always give you contradictory messages. You can’t compare experiences. And in the end you go back to it just being you. Not sharing what’s going on in your head and heart. You are still isolated, because none of us can truly understand what another person is going through, whatever it is. So we’re all lonely little beings wondering this planet by ourselves. Life is all we have, says the doc. Nothing, and no one else, really. Thanks for the good cheer, doc. That’s exactly what a depressed person wants to hear.

Yes, I have a lot to be grateful for. But that’s the problem with depression, isn’t is? There are no feelings of joy. Cognitively, yes, I get it. A part of my brain tells me what these emotions should be. But on the inside? I don’t feel it with my soul. There I feel only apathy, with bouts of anger. Mostly, I’m just tired.

What to do when in bipolar crisis?

*warning, slightly ‘disturbing’ content. Don’t go do this at home. Get help before it’s too late*

There is a reason that there is a question mark after that heading, because I don’t know. I feel that saying I’m in crisis is a good way to sum it up. Last night I had an amazing eve at a concert, but about half way through I couldn’t wait to get home to cut myself. I don’t do it very often, but after going through very stressful events over the last couple of weeks, I have become slightly unhinged. I don’t cut deep, but I cut lots. I vowed to not do it again, but last night I decided, skrew it. My main issue that I don’t know how to let go of the feelings in me that I have no way of verbalising. So I cut, because it distracts me and makes physical a pain that I don’t know how to process emotionally. It’s not like something hectic happened yesterday, I was just feeling strange on the inside. I took something to calm me down but it had the weird effect of making me completely rational and calm about what I was doing. Luckily I couldn’t find a knife sharp enough in my house to do damage, but usually a razor blade does the trick. Please note that I was not trying to commit suicide and know that what I do is not a healthy way to come. At the moment it feels like I’m only coping in unhealthy ways.

I then did something strange that I hadn’t done before. I pulled out a notebook and started drawing and writing with my blood. It didn’t seem so weird at the time, I mean it’s something that artsy people would totally do. I’m still not so sure if it’s really that weird. But I thought about my friends and I know that none of them would ever do something like that, so maybe it’s not such a cool thing to do. Like I say I was really calm, and then I started panicking. I was also fondly thinking of the time I was hospitalised because I’m tired, not of living but of putting effort into life. So I phoned the emergency room, where the very nice nurse on call told me that they cannot admit psychiatric patient without referral but I can gladly come sit with her for the rest of the night. Since I was in no state to drive, she phoned me every two hours for the rest of the night to check that I was okay. There are still good, caring people in this world.

I wish I could say the same of my pdoc. He knows I never bother him and this was the first time I felt that I had a real emergency on my hands, and he always says to call him any time, until I do. Granted in the middle of the night is not a good time, but the nurse insisted that I phone him for a referral but he was very pissed off. This morning I tried to get an appointment or at least a call. He eventually phoned me back and said ‘I don’t know what you want me to do, it doesn’t sound medical, I’m fully booked. You were never on that high a dose of anti-psychs anyway (I recently changed medication, enter fuckup). So I said I was going to increase my dose and hung up. I’ve decided to now, with the help of a more experienced friend, take matters into my own hands, because what am I suppose to do? We literally pay these people R1 000s for consultations and anywhere from R2 000 for meds, and they’re just not there when we need them. Like having an illness all the time isn’t bad enough. I’ve reached a level of maturity where I can (sometimes) recognise that I am sick and try to get help, and then there is no help to be given. Luckily I have a good support system or I don’t know what I’d do.

What do you do when the crazies hit (which seems to always happen in the middle of the night) to get you to day break?

Accepting your Bipolar diagnosis. Again and again and again.

Initially my diagnosis didn’t come as much of a shock to me. It was more of a relief. I did show up at the emergency room in the middle of the night exclaiming “Something is wrong with me!” after all. I was just too happy to finally find out what that “something” was.

As I got better and changed back into something that resembled a “fully functioning” human being, there have been times that I wondered if I was really ill. It usually only takes about two weeks for my mood to shift, as if to say “Ha! And there you thought you were well and health. Mwhuhahaha!” So I haven’t wondered whether or not I was really Bipolar very often. But that doesn’t mean I like it one bit, or that I don’t become frustrated and even enraged by it.

As of today I am, very reluctantly, back on Seroquel (anti-psychotics), and I don’t like it one bit. I worked really hard to get off it a few months ago, and it feels like I’m taking a step back. Unfortunately it’s become very clear, even to me, that my emotional reactions are disproportionate to what triggers it. And sometimes life happens and you can’t have a meltdown and become suicidal every time something upsets you. Speaking of suicide, I said to my psychiatrist: “Surely every person thinks about how it would be to kill themselves at least once in their lives. In my mind it’s a normal thought.” He looked at my wide eyed: “You might be surprised, but it’s actually not. People don’t just think about killing themselves.” Being depressed for roughly two weeks every month is not working out so well and with a stressful time at work ahead Seroquel seemed to be the only answer. I am mad and it sucks and I am going to get fat again and only start functioning after 11 if I’m lucky. Even though I know that Seroquel basically saved my life, I stopped in the first place because it feels like I have to navigate my whole life around it.

To come back to accepting your diagnosis. Taking my pills have become a habit and mostly I try not to think about it. It’s only when it gets mixed up again and I have to remember what dose of what and break pills in half (I am the proud owner of a pill cutter…) etc that I really become conscious of it again, like today. Somehow it becomes more real again and I go back to being pissed off, frustrated and feeling rebellious about it. I go back to hating myself, my life, my illness, the world, everything. I become acutely aware of the fact that I will be struggling to manage this thing for the rest of my life. And then I get overwhelmed with feelings of guilt and self-loathing for acting like my life is so much worse than everyone else’s. Of course all these emotions make my condition even worse. I have to get use to the idea all over again. I have Bipolar Disorder. It is chronic. It will never go away. I will spend the rest of my life struggling with mental illness. I will get better but at some point it will get worse again. Life goes on. Until I finally, again, accept that this is my reality.

On that note, with the Seroquel kicking in and the letters starting to swim on my screen, I bid you good night.

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.