Learning to ride the bipolar roller coaster

Posted on May 21, 2021August 26, 2022 by content_ly0hqz

What’s it like living with bipolar disorder? Learning to ride the bipolar roller coaster

by Tina Phillips, MSW

What is bipolar disorder?

Bipolar disorder is a psychiatric condition which causes intense mood swings, often between depression, or low mood, and mania, high mood. Most of us are familiar with depression, but may not be as familiar with mania.

Mania can cause different kinds of behavior including grandiosity or inflated self-esteem, pressured speech or talking fast, racing thoughts or flights of ideas, impulsivity or taking risks that put one in danger, and decreased need for sleep, among some other symptoms.

Some people with bipolar disorder experience paranoia, hallucinations, and delusions, among other psychotic symptoms. Not every person will experience all of these symptoms, but to be diagnosed with bipolar disorder a person must experience at least three of the diagnostic criteria. There are varying symptoms and it can be hard to recognize if one is not aware of how it manifests. It is important to be aware of what bipolar disorder looks like so one can seek diagnosis and treatment or help a loved one in need.

There are several subtypes of bipolar disorder and some consider bipolar disorder to be a spectrum disorder. Bipolar disorder is largely considered a serious psychiatric disorder and around 2.8 percent of the population has it. Bipolar disorder is considered one of the more stigmatized forms of mental illness, making it particularly hard for those who have it to recognize, acknowledge, seek treatment for it, and stick with treatment the rest of their lives in order to manage it.

Types of bipolar disorder

Bipolar I

Bipolar I disorder is a mental illness comprising episodes of mania. Many have both episodes of mania and depression. To receive a Bipolar I diagnosis a person must have a mania last at least a week or be so profound that it requires hospitalization.

Bipolar II

Bipolar II disorder is a type of bipolar disorder where a person experiences depression with episodes of hypomania, which is not a full blown version of mania, but shares some features.

Cyclothymic disorder or cyclothymia

Cyclothymic disorder or cyclothymia encompasses a period of unstable mood in which a person experiences both hypomania and mild depression. This must last for at least two years to meet the criteria and sometimes one can experience leveling off periods of normal mood, but this usually lasts less than eight weeks.

Bipolar disorder, “other specified” and “unspecified”

Bipolar disorder, “other specified” or “unspecified” is when a person doesn’t meet the criteria for bipolar I, II, or cyclothymia, but does experience periods of abnormally elevated mood.

What causes bipolar disorder?

Scientists are still studying the cause of bipolar disorder, and it appears there are several complex factors at play. These include genetics, brain structure and chemical makeup, and stress/triggers. While each of these plays a part, there isn’t one reason scientists can pinpoint or say every person with bipolar disorder developed it because of something specific. Bipolar disorder is known to run in families, but there is no one gene responsible, and there is no direct connection between one family member to the next. There is some evidence that disruptions in a protein called Akt can lead to brain changes that can contribute to developing bipolar disorder. Also stressful events in our lives can sometimes be a trigger for an underlying condition to express itself. It is most common to see bipolar disorder develop in one’s late teens or early 20s. However, some people don’t get diagnosed until later years, and unfortunately many experience misdiagnosis, leading to many years of suffering without proper treatment.

What’s it like living with bipolar disorder?

I can speak from my own experience of living with bipolar disorder. Diagnosed at age 14, I have lived with bipolar disorder for a little over 25 years, more than half my life. I have Bipolar I, which means I have the most severe type of bipolar disorder. For me this includes manic episodes with psychotic features, such as hallucinations, delusions, paranoia, and complete black outs, in addition to most of the symptoms from the basic diagnostic criteria list.

It always starts out as feeling good, and ends with feeling bad. I develop a lot of energy and creative ideas, I come up with grand projects, I start to believe I have special powers, I start talking fast, I have a decreased need for food and sleep, I talk to complete strangers and become flirty, my inhibitions go away, but then my behavior becomes stranger as time goes on. I end up becoming so irritating to those around me, and I cannot believe it when they say there is something wrong with me. To me I am more than fine, I am great. It adds to my stress when others don’t believe what I am saying. My paranoia picks up and then the darkness takes over.

In the early part of my life I had been on and off several different medications trying to find the right medication for me, working with different psychiatrists. I experienced three major manic episodes, and was hospitalized in a psychiatric ward twice. I stabilized on Carbamazepine in my early 20s and have been on it ever since. However I suffer from traumatic memories of those manic episodes even now. I also recently had an aggravation of my symptoms due to life stressors and had to add medication to treat bipolar depression.

Although I am medicated I also experience some depression and a lot of anxiety, which I only recently learned is often a large part of bipolar disorder. Even after this long I am still discovering things about the disorder and how it manifests for me. It’s very complex, not every person experiences the exact same symptoms, and it can also shift throughout time. I am starting to look at my emotional patterns and seeing how my mood swings despite being on medication, which is frustrating, but part of the reality with living with bipolar disorder.

I am still learning about what my triggers are, how to manage my bipolar disorder, and what about me is because of my bipolar disorder. Some of the things other people dislike about me are because of my bipolar disorder, and they aren’t things that can be medicated away. Things like my sensitivity, intense emotions such as anger, how fast and dramatically my mood can change, my anxiety, my loudness, my sleep schedule/being a night owl, my bluntness, and my bossiness. I have to remind myself that I don’t have control over what others think of me, and I need to learn to love myself, even the challenging parts of me.

Many people with bipolar disorder experience isolation and many lose family, friends, jobs, and romantic partners in part due to their bipolar disorder. This can make people feel ashamed for having it and it can lead to further depression. Despite the challenges and heart breaks bipolar disorder can bring to our lives, it’s not something we should be ashamed of. There is nothing we did to deserve having it, and there’s only so much we can do about it. It takes a lot of work to manage our moods and all the parts of life impacted by our disorder.

Sometimes bipolar disorder is like riding a roller coaster we cannot get off, but that doesn’t mean there is nothing we can do to improve the quality of our lives, learn to cope, and find treatments that work for us. There are many other experiences of bipolar disorder, and no two stories are exactly alike.

Bipolar emotions: Intense and sensitive

Many people with bipolar disorder are accused of being overly “intense” or “sensitive.” In fact, these are common traits and there’s not much one can do about this, as this is the person they are. Medications can stabilize moods to some degree, but some traits cannot be medicated away. People need to try to adjust to their loved ones, friends, or co-workers who display sensitivity and emotionality. When people in a persons’ life don’t try to accept their differences, it can leave a person with bipolar disorder feeling isolated, depressed, anxious, and misunderstood. Often stresses in life and mistreatment can lead to trauma and other disorders.

There are several common co-occurring disorders with bipolar disorder. These include ADHD, OCD, substance abuse disorders, anxiety, and eating disorders. Some of these may come along the same genetic line as bipolar disorder, but also could be triggered by stress in a person’s life. Some people use substances to self-medicate, and eating disorders are often a way for people gain control when they feel their lives are out of their control. In addition, suicide attempts and completed suicides are more common in people with bipolar disorder. In fact, “up to 20% of (mostly untreated) bipolar disorder subjects end their life by suicide, and 20–60% of them attempt suicide at least one in their lifetime.” Given such alarming rates, it’s vitally important we take a look at what can prevent people with bipolar disorder from attempting to take their own lives. Important factors in reducing suicide attempts include early diagnosis, effective treatment, and clinical interventions.

Treatment for bipolar disorder

Medication

psychiatry

One of the main treatments for bipolar disorder is psychiatric medication. Medication can be very effective in helping to manage symptoms. There are a range of medications that treat mood disorders, mania, psychotic symptoms, anxiety, and depression. Many people with bipolar disorder see a psychiatrist regularly to help manage medications and make adjustments as needed. Some people require multiple medications to effectively manage their symptoms.

Many people with bipolar disorder struggle to take their medications or do not stay on their medications. Reasons behind this vary. Many experience side effects that become intolerable or they don’t like how the medication dulls their personality. Some people like the way mania makes them feel and are used to living life with mania, and go off of their medication to gain back what they feel like they lost. Some people start to feel better on their medications, and think they no longer need their medication. However, it’s often the medication that is making them feel better and once off the medication they can backslide.

Some people feel the pressure of the stigma of being dependent on medications, or worry about what other people think of them and cave to pressure of wanting to appear “normal.” This is ironic because medication actually stabilizes mood and can help people manage their condition, making them more functional. Some people worry being on medication for life will affect their long-term physical health or even shorten their lifespan.

It’s important not to judge people for their decision not to take medications because we don’t walk in their shoes. Respecting the self-determination of people with mental illness is key. We should work towards research that will develop new therapies that have less side effects. People with bipolar disorder should work closely with their healthcare team to address any concerns and adjust medications as needed.

Therapy

Psychotherapy can also help people manage moods, learn their triggers, develop and practice coping skills, and find creative ways to regulate their mood. Several types of therapy have been shown effective in treating bipolar disorder including Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Family Focused Therapy, Interpersonal and Social Rhythm Therapy, and Group Psychoeducation. Group therapy also helps some people as they can talk with peers experiencing similar struggles, feel validation, and share social support.

Learning coping skills and having a wellness action recovery plan can really help people navigate the bipolar journey. Different techniques work for different people and so it’s important to be open to trying various tools and strategies to find which ones fit best for you. Some people also use apps to manage their symptoms or keep track of their moods.

Finding balance: ways to manage bipolar disorder

There are many ways to manage bipolar disorder outside of traditional methods. These include exercise and other coping mechanisms such as art, journaling, and mindfulness/meditation, among other activities. Other important factors are proper nutrition, getting enough sleep, keeping a schedule/routine, and avoiding drugs and alcohol. Disruptions in these key factors can lead to mood destabilization or lead to medications being less effective.

Furthermore, managing stress and triggers, relaxation and rest, and having social support are very important in managing bipolar disorder. Having places to go and community that is inclusive decreases stigma, gives people hope, and builds skills that help people recover. One such place is a clubhouse for those with mental illness. Putting together the right plan for each individual to successfully manage bipolar disorder may take some trial and error, but it’s worth the journey of exploration. It takes a lot of adjustment and readjustment throughout the lifespan to learn to ride the waves of bipolar disorder. It is not an easy life, but it is a life that can be worth living. Seeking help to manage the mood swings and creating a good quality of life through various coping skills and strategies is how we thrive through the ups and downs of life.

Further resources and recommended reading

https://www.bphope.com/

https://www.dbsalliance.org/

https://www.dbsalliance.org/support/chapters-and-support-groups/find-a-support-group/

https://www.verywellmind.com/best-online-bipolar-disorder-support-groups-4802211

https://www.nami.org/

https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961

https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml

https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders

https://www.rethink.org/advice-and-information/about-mental-illness/learn-more-about-conditions/bipolar-disorder/

https://www.psycom.net/what-i-wish-people-knew-about-bipolar-one-disorder

https://www.helpguide.org/articles/bipolar-disorder/living-with-bipolar-disorder.htm

https://www.helpguide.org/articles/bipolar-disorder/bipolar-disorder-treatment.htm

https://www.helpguide.org/articles/bipolar-disorder/helping-someone-with-bipolar-disorder.HTML

Accessing treatment in a deteriorating system

Posted on May 18, 2021June 29, 2022 by content_ly0hqz

city budget cuts and mental health services

Accessing treatment in a deteriorating system

By Angel V.

I was diagnosed with Borderline Personality Disorder about six months ago. Before that I’d had a diagnosis of bipolar one, a severe form of bipolar where rapid cycling and suicidal ideation are particularly common. Borderline personality disorder, or BPD, makes it difficult for someone to control and regulate their emotions, affecting interpersonal relationships, basic day to day functioning, and employment.

Finding treatment and therapy for both of these diagnoses is difficult. Even under the best of circumstances.

Before covid, my options were limited. Most people choose to go on a waitlist and wait for the type of therapy that is known to work best with borderline personality disorder, Dialectical Behavior Therapy, to become available. This type of therapy works best in a group setting and takes the form of a course wherein a person is taught better coping mechanisms, based on a practice of mindfulness.

I’ve been waitlisted for almost a year now.

Covid made treatments like this near impossible. People can meet in Zoom chat rooms, but scheduling can be difficult. And it requires a full group doing the full 6 to 12 week program in order to work.

mental health budget cuts

Cutting mental health budgets, militarizing the police

Part of the problem lies with state funding. Without people who are experienced in this type of treatment, who can facilitate the group, the number of groups that are available dwindles.

Funding for programs in Chicago and throughout Illinois was cut years ago.

Under Republican Governor Bruce Rauner, the state decided to allow mental health services to receive little or no funding during sweeping budget cuts. True to form, it was the most at need that received the least assistance under the new budget.

Psychiatric care for many programs were reduced drastically or eliminated completely as a result. In Chicago, a city of over eight million people, these budget cuts, and the reduction in services that they cause, have had deep and lasting effects.

Under Democratic Mayor Rahm Emanuel, many of the city’s major providers were shuttered because of lack of funding. Unsurprisingly, the first providers to go were the ones in predominantly Black and Latino neighborhoods.

The money that should be going to mental health services and clinics is going instead toward policing and prisons.

The 2021 budget allocates nearly $1.7 billion dollars toward police spending. This is nearly 40% of the corporate fund, the largest of funds of the city’s spending plan.

As seen during the Black Lives Matter Protests, the city’s police force is better equipped than some military forces. In addition to full riot gear, tear gas, batons, rubber bullets, police have availed themselves the use of the Long Range Acoustic Device, or LRAD, a sonic weapon intended to disperse protesters using an ear splitting deterrent tone, capable of causing permanent hearing damage. Use and operation of these weapons is not cheap. Spending suggests the city would rather deal with the problems that having an unhealthy population cause then preventing the problems by providing services.

A history of cuts to mental health services

Cutting health services is a hallmark of Republican budget strategies: As soon as he took office as governor of California, Reagan decided to slash funding for health services. The number of people suffering from mental health issues in the prison system effectively doubled as a direct result of this action.

Private board and care facility operators capitalized on former patients who needed assistance. There was money to be made providing spaces and services for the mentally ill. Those who didn’t end up in prison ended up in one of these facilities, or eventually on the street if their symptoms were severe enough and they were not receiving proper treatment and medication.

Later as president, Reagan decided to cut funding for health services again, reducing federal spending for mental health and pushing the responsibility for funding services onto the states.

This fiscal strategy of intentional neglect continues today. As recent as last year, 45’s proposed budget for 2021 included $2.9 billion in cuts to the National Institute of Health and another $708 million to the CDC, this during a pandemic.

In January, the senate overrode a veto to pass a $740 billion defense budget while denying us our $2,000 survival checks. The Democrats still haven’t delivered.

National policy affects people who are suffering from mental illness personally.

Shortly after I was diagnosed with bipolar one, I was prescribed lithium to help with manic episodes and to regulate depressive cycles. I was on lithium for a year before switching to depakote after finding out lithium can damage the liver and kidneys.

Under the Affordable Care Act, also known as Obamacare, I qualify for Medicaid.

Without insurance, I would be paying hundreds of dollars for my medication.

Even with medication, day to day functioning is a challenge. Trying to explain the necessity of taking medication to someone who doesn’t struggle with mental health issues is difficult and adds to the challenges that neurodivergent people face.

I am in constant fear of losing my insurance because of a change in the administration.

Change is possible: cities making progress

Forward-thinking cities have taken matters into their own hands. In 2018, Denver residents passed a measure that would allow for a .25% tax increase that earmarked funds for mental health treatment. Among a rash of suicides and overdoses, Denver wanted to see its citizens receive access to better mental health services.

Other parts of the country have taken similar steps with positive results. In 2008, King County Washington saw a .1% increase in funding for behavioral health services. Within three years, they witnessed a drop in psychiatric hospital admissions of 29%, with a 35% drop in jail bookings.

The major problem with programs like this is how people access them. A lack of standards means that people might have trouble finding them, and without regulation there is a good chance that those most in need will slip through the cracks.

In Chicago, this has been a big part of the problem as well as limited services. People who are computer literate and who understand how to navigate bureaucratic systems are still left daunted by a confusing and complicated, time consuming, frustrating system.

For those who do not have the time, patience, and wherewithal, it’s easier to find other ways of coping with mental health issues.

10 fun things to do if you’re depressed

Posted on May 9, 2021August 21, 2022 by content_ly0hqz

10 fun things to do if you’re depressed

By Cane Kelly

The past year has driven most of us to live like angry tigers pacing tiny cages. Isolation isn’t natural and has serious side effects, but one can also cultivate a healthy solitude. Knowing yourself isn’t an easy process and it’s easy to get intimidated by the outside world and its standards and materialistic focus.

This article is for anyone. Even if you have a partner, invest in yourself. Trying new things alone is key to keeping your independence and understanding emotions as they pop up in your life. We learn through new experiences, and this helps to keep our brain young and happy. Living with purpose and open-mindedness makes life a lot more interesting than following someone else’s lead.

If your’re depressed, try dating yourself. Dating yourself is fun. There’s no compromising – you get to choose what you do. It’s healthy for people in relationships too. Being in the constant company of your partner can be overwhelming and creates a dependence that’s bad for your mental health.

Before I got married, I spent a lot of time by myself. I made continual efforts to entertain myself and explore who I am. I still date myself. Covid-19 changed my normal patterns. I try to visit a new place alone a few times a year. I haven’t been anywhere this year, and I’ve got a bad case of cabin fever.

traveling alone

While I’m eager to explore places like Romania and Greece, we have to be careful because the crisis isn’t over yet. A few of these suggestions require a little investment but rediscovering and reconnecting with yourself is worth every cent.

Go to the movies alone

This seems like a no–brainer. People watch television by themselves all the time but taking a weekday trip to the movies is fun. Most people don’t show up for the first showing of any film. Some theaters won’t care if you slip into a second movie if you buy concessions. I’ve spent entire days lost watching movies.

go to the movies alone

Learn how to bake

I have mixed feelings about baking because it is technical. The quality of your tools, like measuring cups, scales, and other items will determine how well your efforts turn out. I’ve made some real stinkers because I wasn’t precise with the measurements.

A few years ago, I tried to make Red Velvet Cup Cakes, but I was sloppy with the chemistry and they turned out as dense as baseballs. My poor husband ate one with a smile on his face. That’s true love.

Meet a new city alone

I must admit traveling alone is my favorite thing in the whole world. You may want to wait a little while as the pandemic finally comes to an end but exploring a new place – even the next town closest to you might have something unexpected to find. The United States is an enormous place with people as different as Europe. It takes an estimated 40 hours of driving to get from one coast to the other. The drive is scenic particularly if you skip the big highways and take the smaller roads. Don’t freak out if you get lost. That is part of the adventure.

visit a city on your own

Check out your local cemetary

I’m from Lexington, Kentucky and our city cemetery is the most beautiful part of the entire city. There are mean ducks that might try to run you off if you get too close to the water or forget to bring grapes or other types of fruit. Bread is bad for ducks and other wildlife. I love cemeteries and I make visiting these monuments to past generations a priority when I visit a new city.

Volunteer

There are endless opportunities to help others. The United States has a serious issue with homeless cats and dogs. Thousands are put to sleep every week because they aren’t enough homes for them all. Volunteering at an animal rescue will make you feel good about yourself and you will be helping creatures that could die without you.

If helping animals isn’t your thing, then try volunteering at a homeless shelter or any number of organizations that desperately need your help. From spending quality time with kids to digging in and helping feed those who sleep on the streets, there are endless opportunities to help out and you get a big dose of serotonin for your efforts.

Take yourself out to dinner

You might have to sit at the bar if the restaurant is full, but most bartenders are excellent listeners and offer advice and understanding. Alternatively, bringing a novel to dig your teeth into as you try a flight of beer or wines is a great way to spend an evening. You end up making new friends or at the very least hear some juicy details about someone else and their experience. You might feel a little uncomfortable at first but try to embrace the discomfort and watch the adventure unfold as you try something new.

Go to an aquarium

You must check out the ratings for any animal attraction. Don’t spend your hard-earned money on places that mistreat any creature. Ethical animal attractions might cost more than their less reputable counterparts, but do you want to see dolphins in tiny tanks living like prisoners? No. Do your research before visiting any animal attraction.

Learn to grow veggies from table scraps

As the climate crisis rages forward it is crucial to embrace a circular economy. Green onions, potatoes, leeks, and herbs are foods you can grow on a window ledge. All you need to do for potatoes has cut them in half after they have grown a few eyes. Cut them in half and deposit them in deep soil. You will have potatoes by winter!

This is easy and quick to do, but if you have more time on your hands, you can start a larger veggie garden. Gardening reduces stress and negative emotions, it gives you a sense of responsibility and you get to nurture something and see it grow and thrive.

Treat yourself to a spa day (or organize one at home)

A spa day is a luxury and if you do a little internet digging you might be able to grab a deal that makes the treatment more affordable. Or you could plan a spa day at home. A bath bomb, essential oil, bath salts, and a few candles and a pumice stone can change your bathroom from an ordinary experience into something truly relaxing, and you can add a face mask or even mix brown sugar and coconut oil for a more natural approach to getting a glow to your skin.

Take your time and pay attention to your feet. A proper foot rub is an easy way to improve your health and help you sleep. Magnesium flakes also can offer an extra element making bedtime a breeze. Magnesium is best absorbed through the skin which means if you have a deficiency, this is a great way to resolve the issue.

Get naked, paint your toenails, do yoga. Go crazy taking care of yourself. A full day dedicated to relaxation is a great way to get in touch with yourself and renew your mind and body.

Go to a show or a musical performance

Did you know you are more likely to make new friends and acquaintances when you’re all by yourself? Don’t be afraid to push to the front of the crowd and dance your pants off. This is another exhilarating situation, particularly if you are passionate about the music or play you are watching!

take yourself out

Bonus tip! Take a long walk!

Self reflection should shadow selfies. Understanding yourself and your emotions can be a complex issue to tackle and take hours or days to process. Being human is hard! Taking time to breathe and think. If people made it common practice to be careful with their words and intentions even when speaking to themselves is becoming a focus throughout many health and wellness experts.

Compassion for others is important, but compassion for yourself is more crucial than anything you can do for others because if you’re bullying yourself, then you need to readjust and pull that focus of care on you’re on well-being.

take a walk