Bipolar Disorder ask a question/discussion thread

bptoo wrote: »

I started to feel something was not right 8 years ago and this was first diagnosed as depression but later when I attended a psychiatrist bipolar disorder. I never had real highs although I always made big purchases like a new car when I was up but I sometimes think this was just because I was too lethargic to do anything significant when I was down. Now I feel my medication keeps me at an even level but a lot lower than I would like to be.

My biggest problem is sleep and having a regular sleep pattern - usually I cannot get to sleep and then I oversleep the next day. It's a viscious circle. Recently I have started using Melatonin I got in America and it has been the biggest help to me since I was diagnosed. I get to sleep in under an hour now but I still cannot get up early in the morning although now I get up at 11 instead of 1-2pm. I have been of work for a long time now and worry that I am becoming used to this. I also feel embarrassed about this because outwardly I appear fine to people and so I hide the fact that I do not work from most people and I think this puts extra pressure on me to "cover my tracks".

I just wonder if anyone has any tips on how to get a consistent night's sleep?

I've similar problems with making large purchases when even just slightly up. I lose whatever bit of sense I have about restraint. I don't necessarily buy stupid things but I definitely am too quick to spend and buy.

Regular sleep is extremely hard to pin down with bipolar. Sometimes you can get decent results by being very strict with "sleep hygiene." This entails setting a time to try and get to sleep and then ensuring that you are in bed with very little or no light on for a half an hour to an hour beforehand as well as avoiding caffeine and other stimulants like nicotine during this period. Some people get great results with this, some (like myself) don't. It'd definitely worth trying and completely safe.

I'd strongly suggest bringing up your sleep issues with your psychiatrist and well as bringing up that you're feeling a bit flat/low on your meds despite being stable.

tbh wrote: »

how about when you're in a low cycle nesf - is it something you can recognise as something transitory, or does each time feel like the first?

Again a bit of both. Your mind slows down, literally. You don't "solve puzzles" as easily. So when you do go down you might not put two and two together and spot that you're down. Especially if you have the kind of depressions that involve loss of interest/enjoyment rather than classical low emotions i.e. "feeling depressed."

galah wrote: »

I have been exposed to bipolar episodes as a family member-in-law, and I have a question (first of all, thanks for providing this medium!).

When you're high, and you say things (either really 'out there' things like 'I'm the worlds' greatest rockstar' or personal things, such as insults) - do you remember these when you are coming down? Would you remember the "crazy" things you talked about, and the nasty things you may have said in your high phase? Are they part of your long-term memory?
(for example, do you realise that it's always the same stuff you talk about when you're high?)

Cheers!

Sometimes I remember them. Sometimes I don't. I definitely have poor memory when it comes to remembering details of a mania. I forget a lot of stuff. There are a variety of reasons for this, mostly I blame higher adrenaline levels during mania for my memory loss over the period but that's just a baseless theory. I think the problem is in the formation of memories rather than losses of long term memories, as in, if I remember something I don't lose that memory. It's a binary situation I just remember stuff or I don't, I don't seem to remember stuff and then lose that memory later on any more than with memories from non-manic periods.

tbh wrote: »

that's really interesting, I didn't know about that.

There are two clinical symptoms where one (or both) need to be there for someone to be diagnosable as having depression. Plus a bunch of other symptoms but one of the two of these is mandatory (plus these need to be there for at least two weeks, just feeling sad for a few days is perfectly normal mentally!):


(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

You can be clinically depressed and very rarely actually feel sad. This is something practically unknown outside of those in the profession or sufferers with primarily (2) type of depression (I'm one of those people, I don't really feel sad very often, I just lose interest in pretty much everything and just find ways to kill time between periods of sleep).

sam34 wrote: »

yep, i remember one consultant saying to me that "11 out of 10 schizophrenics smoke"

i think most people think of it as self-medication, an attempt to calm the nerves (for want of a better phrase)

also, it may be partly caused by teh fact that if someone is admitted to hospital, the smoking room is the happening place to be! i'd imagine a lot of people start smoking during a psychiatric admission.

I started smoking at 18. Just tried it when out and found it relieved my anxiety because it gave me something to do with my hands. It was a really stupid thing to do but still hooked 11 years later and having extreme difficulty quitting. I can get off them when manic and then end up back on them as soon as I get depressed (I don't get remission periods of normal mood, I just go from mania to depression and back again constantly, well it's more complex than that, I might go into it at some point).

ntlbell wrote: »

When you say this, do you mean if you didn't medicate?

Or is this a constant state for you medication or no medication?

I was under the impression that with the vast majority of cases that once the right synergy with the medication was found that's the end of the ups and downs? is this not the case?

does the medication only make each of them less concentrated or?

I still cycle through mania and depression when medicated. The manias and depressions are far less severe. We're still working on my medication but I'd be unusual in this respect. Most people find a drug or combination of drugs that works fairly quickly, a small enough minority don't. I'm one of said minority.

Undoubtedly though, without medication I'd be a lot worse. They might only at this point be a partial treatment but untreated my life would be a lot worse.

Pernickity wrote: »

Fair play Nesf for making the thread. It's very generous of you to share your experience like this.

I was just wondering when you said that you were suffering from bipolar for 15 years and treated for 10, what was life like for the other 5 years where you weren't treated or diagnosed? Was the 5 delay in getting treated because the onset of the illness was gradual and was diagnosed late ?

I received treatment early on when I was 17 about the time my illness was seriously disrupting my life and my quality of life was quite poor. For various reasons I didn't continue with treatment and only ended up taking treatment very seriously when I was 21 and had a very severe mania. Prior to this I was having a lot of difficulty with my illness but I was lying to myself about my need to get help.

My symptoms first started (I think) when anxiety started becoming a problem between 13-14. Prior to that there probably were symptoms but my quality of life wasn't being strongly effected so treatment/diagnosis wasn't necessary. The issue was when I was 13/14 I had no idea what anxiety was or that what I was going through wasn't normal. I was convinced that everyone else had the same issues and just dealt with them better for a good number of years.

I was originally diagnosed with depression at 17 and again 21 until I got a referral to a "second line" psychiatrist who corrected the diagnosis to bipolar. Though to be fair this was mostly because I tend towards having dysphoric manias which means my ups tend to feel like lows a lot of the time.

Life off medication for me was very difficult. Mostly because I had no idea what was wrong with me and no idea that I shouldn't automatically trust my instincts/thoughts (i.e. I used to get paranoid and believe it and then in retrospect afterwards not spot that this thinking was aberrant in nature). I only started to make real progress once I accepted that I had a mental illness and that my mind wasn't something solely in my control. This took a long time to really sink in.

Pernickity wrote: »

You are very well able to articulate yourself in a way that lots of people are not. Do you feel that you can explain to friends and family in a way that they can understand what you go through? Do you feel understood?

I can explain it fairly well. Part of that is introspection, part of it is the ability to clearly express complex thoughts from years of study in academics. The only people who truly understand are those who also have a mental illness though. Someone who is used to being around someone with a mental illness has some degree of insight definitely but they don't have the same instant recognition that you'll find in other sufferers.

That said, I've never really yearned for understanding so much as acceptance. I don't really mind if someone can't really grasp what psychosis is like so long as they are able to accept that sometimes I go through it and sometimes you can't take everything I say at face value. My wife doesn't understand what it's like to be depressed but she accepts that sometimes I'm depressed and have little energy and other times I'll be high and have too much energy. That's all I need/want really.

Queen-Mise wrote: »

Nesf - any chance would you answer two questions for me. Are you able to work?
did you find counselling or psychotherapy helped at all? Have you ever went for help like that?

I can work part-time but very irregular hours. I'm a bit of a house husband at the moment though, so that complicates things.

I never found counselling helpful but bipolar is a very different illness than depression when it comes to counselling and many people find it very useful/helpful.

Queen-Mise wrote: »

Oh no - I am not diagnosing myself from nesf - it is something the psychiatrists are considering also at the moment. Nesf is in a very settled (?) place as he knows where he is.

Things for me are a bit more confusing - they haven't nailed down yet what the 'particular' problem is.

Before I ever came across this thread - I was seriously wondering whether I had mild bi-polar rather than depression. But then nevermind all that - my moods have their own issues as well As well as having to deal with depression, I am dealing with moods - I think they are in a parallel universe or something.

In essence - I am really not sure where I stand. It is helpful reading others experiences - as I can see what is similar and what is different.

Honestly. Discussions about possible diagnosis is not suitable discussion for this thread. The only person you should bring up your doubts with is your psychiatrist as only they can help you with this.

sam34 wrote: »

ok, but dont interpret too much from here, thats all im saying

Exactly. It's far too easy to read about someone's experiences and think "that sounds familiar" and not at all have the same illness as that person. My experiences of paranoia would sound very familiar to someone with schizophrenia but we'd have two extremely different conditions etc.

So, in an effort to continue the thread and to give some insight into the illness for those who would be interested in learning more:

Today I'm going through dysphoric mania. Or at least that's what I, and a friend who also has bipolar, have independently come to think. Whether this is a true label or not isn't really that important, with mental illness it's all about symptoms and groups of symptoms and these vary between individuals to a rather large extent. I was out and met a load of friends that I don't get to see very often. I just couldn't summon much of a will to enjoy myself. I can crack jokes and smile but don't really feel the humour and just smile etc because I know someone is telling a joke or funny story and that they expect me to smile. I'm having some mild grade psychosis, hearing my voice almost as another person's, thinking that friends don't actually like me and so on but nothing major. Mood wise I'm low yet energetic, agitated yet feel like doing nothing. It's very hard to describe the combination of anxiety and suspicion coupled with agitation and a lack of a will to do anything other than stand and observe others. From the outside I appear (to others) to vary between manic energy and depressed silence and stillness. It feels odd, a friend gave me a good expression for it, there seems to be a sheet of glass separating me from the world. Outside the glass there are emotions, happiness and people interacting but I can only observe not partake in this and they feel somewhat alien to me. The strangest sensation is one of almost feeling like you're watching yourself react to social cues, almost a sense of watching a puppet reacting to its strings being pulled. Not a true out of body experience in the true sense but more of one feeling like I'm inside watching my body doing things for brief periods. Decidedly odd to be honest about it.

From a medical PoV, this is all fine, seeing my psychiatrist soon etc to discuss this stuff but I thought some description of very mild psychosis might prove interesting to people given that the normal examples are of quite severe bizarre psychosis like believing the CIA are spying on you and similar.

MUSEIST wrote: »

Can I just ask for you does mania manifest itself as extreme anxiety with you .

Anxiety plays a large part in my depressions and dysphoric manias but doesn't play a large part in normal manias. Especially with the latter it manifests as extreme agitation + anxiety which is highly unpleasant. With meds my anxiety isn't as bad, without meds it's crippling really and I couldn't get through a night out without a large amount of alcohol to calm myself down which for obvious reasons isn't a great idea as a habit.

Pernickity wrote: »

I think it's very impressive that you can be so objective about it and recognize your feelings as low grade psychosis rather than fully belief them and give way to them completely.

Honestly a combination of years of psychosis + medication makes it possible. I'm not sure if I could maintain such a sense of perspective without medication. Plus low-grade psychosis is much easier to keep your head with than full blown psychosis though one could potentially argue that the ability to maintain perspective during mild psychosis helps prevent a fall into full blown psychosis for bipolar patients based on personal past experiences of mild becoming somewhat more serious psychosis in the past (I've no idea about schizophrenia and whether it works like this for sufferers of the illness).

I have that book somewhere, though I haven't gotten around to reading it yet.