Cycling: You can cycle a few times a day to once every other year. I was hypomanic for at least a year—maybe two—before things started getting bad. Then I had cycles that lasted a month, and finally, in the last weeks before I was diagnosed, I was “mixed.” All over the place. Manic and depressed at the same time. I wasn’t really cycling, just purely in misery.
When I got diagnosed, they started me on Lithium, and things continued to get worse. I was using love as a means to try to make myself feel better, but that was pretty problematic since this society frowns on cheaters. My mood would go up and down with each affair. My affairs were very intense. So my moods swung drastically. Even when I was high, I was guilty and worried and anxious, and when the relationship tanked (I always made sure it did), I would become suicidal. It was a lot of pain, but it was intense and at least I felt like I was living and that things mattered. I felt like I was trying to save my life.
Treatments: Meds, therapy, group support, self-education. Plus hundreds of other things. Search for bipolar on fluther. You’ll find a lot. But let me tell you a little about the role of each and some common misconceptions.
What is the significance of brain chemistry? Bipolar is a brain chemistry disorder. There are different ways to treat brain chemistry. Meds help by working on the brain chemistry in order to change the way the chemistry work and thereby change the patterns in the brain, thus changing thought patterns. Therapy teaches us to think differently, and this also changes thinking patterns, thus changing brain chemistry. There are other techniques such ect (electro-convulsive therapy) and a therapy that uses magnetism. Both can be very effective. They work to change thought patterns directly, thus also changing brain chemistry. Electro-shock is usually used when meds and therapy don’t work. Magnetic therapy is new, and while effective, is not all that common yet. It may work better than meds or therapy, but people still don’t use it until everything else has been tried.
Meds: Lithium is the gold standard. If you aren’t started on Lithium, you need to find out why. A lot of modern shrinks think they know better and they use modern drugs first, and I’m not sure they get it right as quickly as shrinks that start with Lithium. It usually takes a while to get the meds right. Most drugs won’t kick in until at least a month has passed. I know people who can go through twenty or more different drug combinations before they find something that works. As you might imagine, that can take years. You have to be patient.
There are 276 different combinations of bipolar drug treatments. As you can imagine, that can take a while to go through. Many patients give up long before they’ve given it a chance. Try not to do that. Set your expectations low. It can take a while.
Therapy: meds aren’t enough. Therapy is a good addition. Shrinks and therapists and social workers and a variety of other people are licensed to treat bipolar. You probably won’t find the right therapist the first time, either. Keep on trying. Therapists are like drugs. They don’t all work for you. Identify what style therapy you want. See if you can find someone who is like that. Often you have no choice. You have to take what your insurance pays for, but try to get alternatives. Don’t give up.
Also, join a support group. “DBSA”: www.dbsa.org runs groups across the nation and their website has a directory. There are other mental health organizations that also have support groups. Additionally, there are online support groups. As you see here, there is nothing like talking to people with the condition to get information you can not get anywhere else.
“Therapy dos and don’ts:* Whoever you talk to, it is useless if you aren’t honest. Remember, the therapist works for you. It’s not the other way around. If they give you shit, fire them. You should never be afraid to tell them you drink or do drugs or self-medicate in other ways. One of the members of my group last night was saying she thought her therapist would fire her if she mentioned her drinking. This was because she was “fired” from CBT (cognitive behavioral therapy) because it wasn’t right for her. She took that personally. She shouldn’t have because CBT does not work for certain people—particularly those who are very self-aware. Mindfulness works better, in general, for those who are self-aware and have trouble fooling themselves.
Educate yourself about CBT and mindfulness therapies. Educate yourself about all the different therapies you can find. You have to do your research. There are many sites out there with plenty of information about bipolar and about therapy. Find therapies that you think might work for you. Don’t waste time with the rest.
Coping techniques: There are many coping techniques that people will talk about. Exercise. Get sleep. Do not stay up all night. Tear up your credit cards if you have spending issues. If you have sex and love issues, beating yourself up about them does not help. So-called hyper-sexuality is a form of self-medication, like drinking and smoking pot. It is common among bipolar people. Sexual profligacy is also a hidden symptom. Few are willing to talk about it for obvious reasons. Sex and alcohol are coping techniques, but are not recommended. They create as many problems as they solve.
Volunteer. Help others. Keep yourself busy. Get involved in the arts. Meditate. Do yoga. These are some of the many coping techniques. They work. Like all things, they take time.
Suicide: Bipolar is a very dangerous condition. 20% don’t survive. Suicide is the means of death.
Having said that, I have found it very helpful to realize that suicide is absurd. Ridiculous. Funny. I don’t think it is painless, as the MASH theme suggests.
No one wants to die. We all want the pain to stop. But we do not want_ to die. The problem is that with bipolar, if left untreated, it seems like the pain will never end, and it is the worst pain most of us have ever experienced. Most, given a choice, would rather be physically tortured than be depressed. In fact, that’s why so many engage in self-harm. Physical pain actually relieves mental pain.
If, somehow, we can feel some hope, we will hang around to see if something will make us feel better. My shrink said that he advises his patients to not make any big decisions (such as divorce, quitting jobs or suicide) for three months. You just aren’t thinking properly when you’re depressed and if you get some relief, you will probably reconsider. So wait three months to see if anything will work before you make any decisions.
When I was diagnosed, I was ready for divorce, job quitting, leaving my family and ending up in the gutter. I hoped that one of my lovers would take me in, but I didn’t expect that. I fully thought I only deserved to be in a gutter full of piss and rotten fish guts until I died. I didn’t even think I deserved to end it soon. I still think that’s where I should be, even if I am one hundred times better, but that’s just a…. I don’t know.
When I write about this stuff, it starts to come back, like a kind of ptsd and then it gets to the point where I start falling back into it. I can’t do this much longer…. I’m feeling really sad… maybe it’s just for the pain I was in and others are in. I wish I could do something. I know now it is possible to get out. There is hope. I can help. But I can’t be with everyone. I love you all. Yes, it’s not personal, but I feel for you and… I wish I could help.
In any case, one night I was talking to a friend who was depressed. She was the only person I knew at the time who understood. I spoke to her because I had had enough. I was ready to go, but I didn’t think I could do it alone. I knew she was just about ready to go, too, so I thought if we did it together, we could do it.
So we had to figure out how to do it. We started brainstorming. Well, I don’t know if people who haven’t been here can understand, but brainstorming about suicide is hilarious! It’s totally absurd to be trying to come up with ways to kill yourself. We started tossing ideas around, and there seemed to be reasons to reject them all. Some weren’t doable—couldn’t pull trigger or couldn’t step off the edge of the skyscraper. Some were too scary. Some were inartistic. Every once in a while, an idea would seem totally ridiculous and we’d laugh. Gradually, all the ideas became absurd and we were laughing more and more, and then we were laughing so hard, we couldn’t breathe. And I serious mean couldn’t breathe. To the point of blackout, almost. Ironic, wouldn’t it have been, had we actually died of laughter.
So trying to figure out how to kill myself was the funniest thing I’ve ever experienced in my life. Laughter is so healing. My friend and I saved each other’s lives that night by trying to commit suicide. I should patent it, don’t you think? I could run suicide workshops. Gallows humor, to the nth degree.
Ok. I had a point somewhere in all that. Oh. I guess we shouldn’t be afraid of suicide talk. We certainly shouldn’t steer away from it. I think most people are afraid to deal with it for any number of reasons. But it doesn’t help to avoid it. I think we can’t afford to be afraid of it. I also think that what most people do doesn’t help too much. Guilt-tripping us may work for people with children, but to tell folks that they will hurt others isn’t very sympathetic and makes us feel even more misunderstood. We are almost never doing this to hurt others, and if we are, it is only because we didn’t get the help we needed earlier on. Anger is a weapon against pain, although in this case it is self-destructive. Guild tripping people may work, but it isn’t a good way to deal with the problem.
So talk about it. Be sympathetic. Don’t try to argue us out of it. Yes, express your concern and care and love, especially love, but don’t try to make us believe any loves us. It’s not possible to see. Be real, for god’s sake! Understand that suicide is about pain. We don’t want to feel pain any more, and you wouldn’t either if you knew what it was like. Trust me. We need hope and we need help. We need love. Help us get help. Let us know you will help. ASAP. Get us to a shrink. Talk to us. Love us. Help us feel connected to the universe, the world, to you. Don’t fake it either. Just be honest.
Sorry for writing so much. I’m sure I could write a damn book about it. Maybe I will one day, but I doubt it. I don’t have any stick-to-it-iveness. But I hope this has been helpful to someone, even if you only read the first few paragraphs. Good luck. There is help is you want. Oh yeah. The support groups are for family members, too.
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