If you’re planning on listening to the Bipolar Disorder podcast, you may want to skip ahead to the resources section as I read this blog in its entirety as part of the podcast this week.
1 in 3 try, 1 in 5 die.
Those are the statistics for people with my illness. 1 in 3 up to 50% of people with Bipolar Disorder will attempt suicide and as many as 1 in 5 will successfully complete suicide. Here’s another super fun fact, Bipolar Disorder results in about a 9.2 year reduction in expected life span. So a woman in the U.S.A. with Bipolar Disorder can expect to live to be about 69.5 years old. My original diagnosis was Major Depressive Disorder, but that was changed to Bipolar II after my first hypomanic episode. That hypomanic episode morphed into a mixed episode with full blown mania and my diagnosis changed again to Bipolar I with mixed features. I have also had, over the past three years, the specifiers “with rapid cycling” and “with anxious distress.”
This, believe it or not, is a very brief overview. If you wish to learn more about Bipolar Disorder or specific types of Bipolar Disorder, I suggest you go to the References section at the end of this blog or use trusty old Google. This is the blog post that I am most qualified to write but that is giving me the most trouble because it is a topic so near to my heart. I suppose I should just start with what Bipolar Disorder is. Bipolar Disorder is an incurable mood disorder in which a person’s moods cycle between extreme highs and extreme lows. But even that explanation is too simplistic since there are different types of Bipolar Disorder. There are Bipolar I, Bipolar II, Bipolar With Rapid Cycling, Cyclothymic Disorder, Bipolar with Mixed Features, Bipolar With Anxious Distress, and Bipolar NOS (Not Otherwise Specified).
Terms to Know
Manic Episodes (Mania) for me are a time when my mood is elevated, I feel invincible, I act out of character, my decision-making skills are impaired, I spend a lot of money that I really don’t have to spend, and I often experience psychosis (delusions or hallucinations). I’m very lucky in that my hallucinations tend to be very beautiful music like music box music, classical music, or, one time, the soundtrack from the movie Titanic. I tend to move around a lot more than is normal for me (I’m a manic pacer) and I don’t need as much sleep as usual. My thoughts tumble around in my head so fast and so many that it’s hard to pick just one out to focus on. I speak extra quickly and tend to feel the need to keep speaking even over other people. I become hypomanic before I become manic, which means that I experience extreme irritability for that time period. Mania can also cause reckless behavior and increased sexual drive.
Hypomanic Episodes (Hypomania) for me are the time between stable and manic where I’m almost manic but not quite. Hypomanic episodes are similar to manic episodes but aren’t as extreme and don’t last as long. Hypomanic episodes are generally less destructive than manic episodes. They are a defining characteristic of Bipolar II but they also happen in Bipolar I.
Mixed Episodes (Mixed States) are when someone experiences hypomania or mania and depression at the same time. They are the most dangerous time for people with Bipolar Disorder because the person may have the desire to commit suicide and the energy to do it, as opposed to a depressive episode when they may have the desire but not the energy for follow through. Mixed Episodes (Sometimes called Mixed States) are my least favorite part of having Bipolar Disorder. At least with the mania and the depression, I know what to expect. To me, mixed episodes are almost constant emotional pain. There will be a whole post on them soon.
Depressive Episodes (Depressed States) are when I feel hopeless, useless, and full of despair. They are when I just don’t feel like I can physically make another move or take another step. I feel sad and sometimes cry randomly. I may eat a lot more or a lot less than is normal for me. I may feel guilty, unworthy, and be unable to concentrate or make decisions. I may see a photo of myself and go into a tailspin down the rabbit hole with body image issues. I may move and speak more slowly than is normal for me and I may have recurring thoughts of death or suicide.
Types of Bipolar Disorder (As described in the DSM 5)
Bipolar I is characterized by one or more episodes of mania or mixed episodes and periods of depression. People who have Bipolar I experience full blown mania as opposed to the hypomania of Bipolar II. The manic episode must last at least a week or require a hospitalization.
Bipolar II is characterized by at least one major depressive episode and one episode of hypomania. For people with Bipolar II who end up in the hospital, it is usually because of the depression. The hypomania may just feel like really great times to them.
Cyclothymia (Cyclothymic Disorder) is a milder form of Bipolar Disorder that consists of several hypomanic episodes and less severe episodes of depression than those with Bipolar II experience.
Bipolar NOS (Not Otherwise Specified) is the diagnosis used when someone meets some of the diagnostic criteria for having Bipolar Disorder but not all of them. For example, they may have the required depressive episodes but only experience a few days of hypomania.
“With Mixed Features” is a specifier that can be added to the end of Bipolar I or Bipolar II and means that the person is experiencing both depression and mania or hypomania at the same time.
“With Rapid Cycling” is a specifier that can be added to the end of Bipolar I or Bipolar II when four or more distinct episodes of depression, mania, or hypomania occur during a one-year period.
“With Anxious Distress” is a specifier that can be added to the end of Bipolar I or Bipolar II when a person has noticeable symptoms of nervousness/anxiety during a related mood episode.
Resources About Bipolar Disorder
Depression and Bipolar Support Alliance This has information on the types of bipolar disorder. (You can use this website to search for a support group near you. I go to a DBSA support group here in our town once a week but they offer meetings twice a week. There’s also a DBSA Wellness Tracker App (can be found in the app store under that name) that is tremendously helpful. I used to fill it out each day and take it to all of my psychiatrist’s and therapist’s visits and they loved it.)
BP Hope Magazine (This is honestly a really fantastic resource. I used to get it delivered to my house, but now I just read it at my therapist’s office and at my support group and/or on their website)
National Alliance on Mental Illness (NAMI also has support groups you can join if you or a loved one has a mental illness, but I have never been to one so I can’t speak to their quality)
Of Two Minds Documentary (This is our movie of the month. I’m not sure how long it will be available on Youtube but it’s an excellent documentary and you should definitely watch it)