Saturday, 20 February 2010

Being Bipolar Part Three – Day to Day Living

As I come to this subject, I wonder if I haven’t bitten off too much. I wonder if it is too vague. I keep saying that there should be more written about the mundane day to day experiences of being bipolar or maybe the experiences of having any long term mental illness. I only have experience of Bipolar Disorder but I am sure there are similar struggles or even worse struggles with illnesses such as schizophrenia.

I have asked myself what my life would be like if I wasn’t Bipolar. It is very hard to know because my experience spans almost 28 years. If I am honest, I was suffering symptoms way before that. I have effectively been bipolar for ever, at least as long as I remember. I think that there maybe too much emphasis is placed on first symptoms and diagnosis. First symptoms only come to light when they are severe enough to require treatment. In my case, it was a long journey to diagnosis from the first severe symptoms, in my case a manic episode.

I am trying to write about how it is to be a “stable” bipolar sufferer. I know this term is not generally liked. It is liked as much as “normal”. I talk about “stable” as living with good self management skills and medication that takes away the extreme symptoms. It may mean you can pursue a career but more likely it means you can get on with your life with limited intervention. I know some sufferers will continue to have episodes of depression or mania.

Being Bipolar means that you have to live with a regime of medication and psychiatric support. My psychiatric support is four-monthly appointments with a psychiatrist. Most times I could manage without but it is probably best not too drop off the radar completely. My GP handles prescriptions of psychiatric meds but they only do what the psychiatrist tells them. Even though I take meds every bedtime and every morning, I still sometimes forget. Things happen to distract you I guess. The best laid plans sometimes fail. Prescriptions in my case are monthly. This means I have to order my new month’s supply at the appropriate time. Here again I have a system. It works well but I can still occasionally forget and leave it a little late.

We sometimes do travel like “normal” people, although some people suggest that we shouldn’t travel. We might have a manic episode and do something illegal (I am joking!). If we do travel, we have the additional stress of making sure we have enough meds. We might have to arrange to get a new month’s supply early. Stress is the last thing that bipolar sufferers need and travelling becomes difficult. There is also the issue of pre-conditions on travel insurance. Most vanilla insurances would probably exclude treatment for bipolar disorder. There are specialist companies that offer insurance for people with long term illnesses. I’m sure it is normally more expensive. Charities like MDF help with such matters.

Very few bipolar sufferers continue a meaningful career. As in my case, the illness eventually gets the better of you and you end up on disability. Eventually you might leave a job or several jobs, sometimes with no warning. The result is that your resume or CV is trashed. It doesn’t need a brain surgeon to realize that you have problems. It probably wouldn’t matter that you hadn’t declared your illness. Whether or not you declare your illness on job applications is another major stress for bipolar sufferers. This dilemma also applies to other life situations. Do you declare your illness to new people or groups that you encounter in life? I have tried to be particularly open about my illness but I sometimes wonder what the cost is. I am beginning to think that I should be more selective in who I tell. We are in danger of stigmatizing ourselves if we are totally open. I will try to address stigma in a future part of this blog.

I have talked about social isolation. A lot of bipolar people live in isolation and tend to isolate them self even more. This leads to extreme loneliness. Even the best of friends will back off. No one wants to socialize with a crazy person. Maybe I am generalising too much. My social diary is not exactly overflowing with activities. I admit that it is very much due to the fact that I don’t reach out myself. Maybe fear of rejection or agoraphobia. Sufferers do lose a lot of friends or at best they become acquaintances. They become tired of apologising or trying to mend bridges. I constantly try to work out why I am so reluctant to leave the safety of my small flat. I don’t think I suffer from agoraphobia. I am not talking about major socialisation, just the odd person coming round for coffee or meeting you in town for coffee. The only people who might drop in at my flat are fellow sufferers. I “never” drop in at anyone else’s place. My slimming world meetings are my only social outlet. I also meet other sufferers at mental health related meetings or events.

For me personally, the worse thing about day to day living with bipolar is the uncertainty of how you will wake up each morning. Before this is the uncertainty of how you will sleep. Will you sleep 6 hours or 12 hours? Will you have weird and maybe lucid dreams due to the medication? Will you be able to carry out the plans you have made for the upcoming day? It is very tempting not to make plans because you may not be able to make it on the day. You might worry as I did about making it to your own birthday party. How do you explain that you are not up to it and your friends should carry on without you? Do you invite other sufferers to such occasions, even if you doubt whether they will make it? You might be stigmatising them either way.

Apart from the trouble of waking up in a difficult mood, there is sometimes the thing called rapid mood swings, where your mood can switch suddenly several times in a day for no apparent reason. Even worse is the mixed state, where you can experience up and down moods at the same time. You might start a day quite well and suddenly be unable to function. The reverse can happen when you start a day down and suddenly be fine for no reason. The danger here is that you make plans based on the morning mood. The afternoon mood maybe better or worse but you have already made the plans. It makes you seem very unreliable.

A lot of time is spent on self management, keeping well if you like. When any kind of extreme mood is experienced, we do our best to handle it. It is relatively easy to handle the upswings if you can spot them in the first place. I think that having years of experience gives you the insight to spot and handle the swings. This is best done at the early hypomania stage. When you hit full blown mania, you have pretty well lost control and you are away with the fairies. Depression or depressive episodes are notoriously hard to handle. Everything can seem so hopeless and it is hard to carry out a plan. I have not suffered much from depression and I can’t say whether insight improves. I can’t say if it gets any easier to handle. I defer to others who suffer more depression.

7 comments:

  1. Don't you think that many BP diagnoses begin with a manic episode? And I know what you mean about travel. I visit my boyfriend every weekend, and since it's been snowing, I'm always afraid I'll get stuck there longer than I have medication for, even though I bring plenty I still worry about it.

    I'm one of those that seems to be stuck in a never ending depressive episode. My mania seems to be under control but so far no matter what meds I try, I still struggle with depression.

    Before I write a more lengthy comment, I'd like to say that I can really relate to this post. You have an excellent way of expressing yourself and the aspects of this disorder.

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  2. Hey Clive. Great Post! Day to Day living is the hardest thing to deal with in bipolar and one that doctors never understand. You expressed the difficulties perfectly. If someone asks me to do something on a specific date, I never feel comfortable saying "yes." I'm always afraid of what mood I will be in and if I will be up to doing whatever needs to be done. I was recently asked on a Friday to do an errand on Sunday. I cried for 2 days worried that I wouldn't be able to do it. In the end, the person requesting the favor ended up doing it themselves. Every day things seem so difficult sometimes. Thanks for the post.

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  3. Sounds like me to a T

    Thanks

    Good luck and life

    (-:

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  4. I can relate to this all to well in times when I am not doing well. which had seemed like all the time. I still do not go out a lot. But Iam open about my illness. It is no t a bother to me. Lucky for me it has been a positive response that I have gotten from being open. Not everyone had that experience. well written and keep it coming.

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  5. Good post. I've been learning all I can about bipolar since my friend was diagnosed with it. She has been through some rough times but now things are better. I picked up a memoir called "bipolar bare" at the bookstore. It really opened my eyes to what life with this disorder can be like...the extreme high and lows. It's interesting that the author concludes that in his life it is a blessing from God.

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  6. I am currently in a depressed mood of my bipolar state, wanting to die. I sometimes get on the computer when I start to feel this way to try and find what others are doing to help themselves. I appreciate what you wrote! It has helped me feel better and to see things more clearly. I guess I just have to keep realizing that sometimes how I am feeling is not necessarily "reality." God it sucks to be bipolar!!!

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  7. God it sucks to be bipolar!!! I agree , Graham. Sorry you are struggling so much. I was very much in the same state earlier this year. I am not much better. Just plodding along and I get those negative thoughts regularly. I feel stuck. I think I have to have a picture of the future before I can go there. Until I find that picture, I am in limbo. I don't come here often now but I am notified of comments by email. My Being Bipolar blog posts were a major project but I was feeling a lot better. Take Care.
    Clive

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