Sunday, September 4, 2011

Living with Bipolar Disorder


I have a mental condition called Rapid Cycling Bipolar Disorder. I’ve had it for as long as I can remember, but I was diagnosed with it when I was eleven or twelve. Having that sort of external attention directed at your mood and the way you think has a remarkable way of getting you to notice it yourself, and I believe that, if more people spent less time thinking about how they feel and more time thinking about the reason they feel the way they feel, there’d be a general upswing in the human condition.
Bipolar disorder isn’t what most people think it is. People my age tend to think of Bipolar Disorder as being rapid mood swings from happy to angry and back again. They think of it as a perpetual case of a short fuse. Those who are said to be bipolar are those who go from being chummy to being cranky during a beat. I’m sure it seems that way, to those on the outside looking in, or else that wouldn’t be the impression we have of the disease.
I can’t speak for the other forms, since I don’t have them, but Bipolar Disorder is varied, much like the autism spectrum disorders. At its core, though, bipolar disorders share their root in a malfunction of the brain’s natural rhythm. As humans, our brains don’t always work the same way from day to day, month to month, season to season, or year to year. Anyone who has ever been a student knows that there are days when learning and working with the brain is easy, and there are days when memory, retention, and logic just don’t want to work with each other. You artists out there know that there are days when creativity works and days when it doesn’t. Everyone out there has had days where they are “just tired” or “just cranky” with no discernable reason. These ups and downs are known respectively as the manic state and the depressed state.
Psychological depression isn’t the same thing as the emotion of the same name, though the two often walk hand in hand. Think of the brain for a moment like being a computer, and chart its performance on a graph. You end up with a vaguely sinusoidal curve, a series of ups and downs. The depressive state occurs when the brain is performing below average. By comparison, Psychological mania isn’t a crazed state; it is the state when this graph goes above the baseline. In depression, the brain is “running slower”, and in mania, the opposite. It’s not a perfect analogy, I understand, but it is close.
For quite a few years, now, I’ve been taking a medication called imipramine.  Imipramine is a common antidepressant with a few side effects that are rather immediate, making it less popular than some of the newer antidepressant drugs. The most common are drowsiness and changes to the heart’s rhythym, but can be adjusted away with changed dosage. As well, a prescription comes with supposedly-regular bloodwork due to the risk of liver damage, but a decade of use seems to have done no damage to that particular organ whatsoever. I take it at night, the lowest available dose, and I supplement in the winter with vitamin D, which is said to help somewhat with mood.
The reason I talk about medication is that most people with BPD have difficulty taking it, and I am no exception. It is easy, when manic, to forget to take the medication. The manic phase is something of a high, a period of accelerated learning and creativity. Many medications affect the quality, frequency, and duration of these periods.  Me, I’m learning to be creative and to be productive without them, because, hard as it might be to get fired up without mania, it’s even harder to motivate oneself to create, produce, or do anything other than be entertained when depressed. In classical bipolar disorder, you might have one of each period in the run of a year. In rapid cycling, at least in my cycle, these fluctuations take place over the course of a month. The dizzying rise and the subsequent crash are as hard if not harder to go through than the elevated or depressed states themselves. Irritability sets in, and a short temper. Everything becomes an insult and anything less than absolute compliance becomes a frustration. When you’re manic, you know everything, you see. When you’re depressed, you can’t be bothered to fix anything; it’ll just revert back to the way it was before anyway. That’s why the medication is important.
It’s not the only thing, mind you. There isn’t a medication on earth that would make someone well-behaved, courteous, even-tempered and productive. It’s just not there. But the anti-depressants and mood stabilizers and all the rest of it level out the cycles. Instead of a roller coaster, you get a pattern more like a normal pattern, more like a hilly countryside road. From there, you’re free to learn the things you never got a handle on in the first place. Things like healthy ways to diffuse your anger, how to deal with conflicts calmly. You learn how to motivate yourself even when you’d really rather not be doing anything, and you learn how to let yourself relax when you’ve been treating yourself too harshly.
Life is a learning experience, after all. If you don’t learn how to play nice with others, you won’t get very far.

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