Not quite but I needed a catchy phrase for the marketing appeal. Just had an impromptu appointment with my former ARNP, Kay. Don't like Kay. Have an appointment with my new one next month because I don't like Kay but I needed an appointment....bad like.
In honor of Mental Health May, I'm going to teach all you lay folk about Bipolar. If you haven't picked up a few things contextually from reading me over the last couple of years, this is going to be textbook verbage for you. I'll have some reference from official sites. I'll steal from them too. I'll give you insight from my own mind if need be. BUT I think it's important because...well, I need to go into the hospital and I can't. I've had to go into the hospital for years but it's not a practical thing for me. So, I'm going to educate on why...why I should have and still need to be hospitalized.
Hello, I'm Ms. Naomi and I'll be your teacher for the day. Let us begin.
First, a definition.
Bipolar Disorder was in the past called Manic-Depression. I think because of its past name a lot of the misconception of what it is has come about. The belief that bipolar is the altering states of extreme happiness and extreme sadness. Not so. Doesn't happen that way.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (commonly known as DSM-IV because it is in its fourth major edition) says, "Bipolar Disorder is characterized by the occurrence of one or more Major Depressive Episodes accompanied by at least one Manic Episode." Bit vague, yes? Okay, so what defines a depressive episode and a manic episode?
Depression can involve:
- Changes in Activity or Energy Level (decreased energy, fatigue, lethargy, diminshed activity, insomnia/hypersomnia, loss of interest in pleasurable activities, social withdrawal)
- Physical Changes (unexplained aches/pains, weight loss/gain, decreased/increased appetite, psychomotor agitation/retardation)
- Emotional Pain (prolonged sadness, unexplained/uncontrollable crying, feelings of guilt, feelings of worthlessness, loss of self-esteem, despair, hopelessness, helplessness)
- Difficult Moods (irritability, anger, worry/anxiety, pessimism, indifference, self-critical)
- Changes in Thought Patterns (inability to concentrate, indecision, problems with memory, disorganized)
- Preoccupation with Death (thoughts of death,suicidal ideation, feeling dead or detached)
Mania can involve:
- Increased Energy (decreased sleep, little fatigue, increase in activities, restlessness)
- Speech Disruptions (rapid/pressured speech, incoherent speech, clang associations)
- Impaired Judgement (lack of insight, inappropriate humor/behaviour, impulsive behaviour, financial extravagance, grandiose thinking)
- Increased/decreased sexuality (inappropriate sexual behaviour)
- Changes in Thought Pattern (distractibility, creative thinking, flight of ideas, disorientation, disjointed thinking, racing thoughts)
- Changes in Mood (irritability, excitability, hostility, feelings of exhilaration)
- Changes in Perception (inflated self-esteem, hallucinations, delusions, paranoia, increased religious activities)
Now, I know some of those things are very clinical in speak like suicide ideation (thoughts of committing suicide). In reference to me, I describe my suicidal tendencies as either being actively suicidal or inactive. When I'm actively suicidal, I'm looking for ways to kill myself. I've got plans. I'm looking for methods. I've got the pictures laid out in my head. When I'm inactive suicidal, I'm just preoccupied with death. I just am tired of life and want to be dead. I'm tired of life and trying. I'm not actually looking for method or wanting to remove myself. Just wanting to not exist.
Remember that these symptoms are just some of what can be present in bipolar. What gets difficult is when clinicians/professionals have to diagnose a bipolar. There are more than one type of bipolar disorder. And because of the symptoms and the varying degrees of bipolar there are symptoms that fall in episodes other than mania and depression (hypomania, mixed episodes).
There are three types of bipolar: Bipolar I, Bipolar II, and Cyclothmic Disorder. A person will be "assigned" a diagnosis based upon the frequency of their episodes and the intensity of each.Frequency and intensity are neat little nuances (note the sarcasm) about bipolar. We have rapid cyclers, ultra-rapid cyclers, ultra-ultra rapid cyclers and so on and so on which refer to the speed in which a person moves through episodes.Then we have the definition of episodes themselves which can be full blown mania or hypomania (milder form of mania) or a mixed episode which has components of both mania AND depression.
On top of having an affective disorder (mood disorder), many bipolars will self-medicate using drugs and alcohol which leads to chemical dependency and rehab. I also know many a bipolar including myself that have been diagnosed with borderline personality disorder in conjunction with bipolar because of relationship issues (should we discuss Mrs. Devine right now?!...by the way, I don't agree with the BPD diagnosis for myself. I may have some codependent ways. I have trust issues. BUT if I would get rid of the cancer that is my mother and work on my self-esteem then things would be much better in that arena. Maybe the docs have a point but I don't want to say yes...but I digress).
Bipolar has been treated a various of ways. Traditionally the most famous med is Lithium which involves monthly blood tests to test toxicity levels. Medication is probably the most important friend to a bipolar. Giving a person a level mental and emotional playing field is probably one the best guarantees that he/she will be able to function in his/her daily life. Mood stabilizers like lithium are at the top of a bipolar's list. Amazingly most of the meds used to treat bipolar have first been developed to treat epilepsy, and most bipolars including myself become guinea pigs for the new meds in the bipolar world. Other than lithium, all my mood stabilizers including my current one, Topamax started out as such. On top of the stabilizer, a bipolar may take a host of number of other meds: anti-depressants (starting a new one today, Zoloft), sleeping meds, anti-psychotics, narcotics, etc, etc, etc. And a new fad which was very popular decaded ago that is coming back is electroshock therapy (eh, my memory is entirely too important to me, wouldn't do it). Finally, I wouldn't recommend doing anything without seeking psychotherapy. Talking to a professional is important. Just maintaining the physical part of the illness is not going to get any bipolar through it. I believe in treating any illness/disease entirely. The body isn't separated into individual components. It works together so treating all of the system as one functioning unit heals the whole of it. And bipolars have to do the same especially since so many of us have problems maintaining relationships, jobs, stabile lives within the parameters of the law.
I'm going to stop because my mind is rambling now. I can't focus all the thoughts within it. I've had a bad couple of days and I've reached my limit on this subject for right now. I just wanted to introduce this to you. It's important to me....and I swear to GOD I'm going to stab this fucking guy next to me if he doesn't stop making all this fucking noise....eh! Off the point, sorry. I struggle. I don't think many of you know how severe. I think those that talk to me on a regular basis know but still you haven't see me at my worst. You've spoken to me when I'm still coherent and can answer the phone or dial a number. You haven't dealt with me when my arms are jerking away from my body or when I'm pacing the floor and I'm talking in tongues...I'm not joking or being sarcastic. You haven't seen me when I've grabbed the knife or when my body has started convulsing. My worst moments that you have experienced with me are when I'm still capable of talking to you.
The last couple of days have been brought about because of stress. Episodes can happen because of that. Moods fluctuate with no rhyme or reason. They also occur because of situations. I'm worried about a new job. On top of that I've been dealing with some depression and I could tell my meds were needing an adjustment for a bit of time now...just ignored it for a while.
SO what have I been feeling?
Physically my heart feels like it's going to explode. It feels like it's racing a thousand miles a minute. Then it feels like it skips a beat. I feel like it's going to force itself from my chest and burst. My legs want stop bouncing. My hands and fingers keep moving sometimes I find them clenching and unclenching, sometimes just shaking, sometimes just wiggling. I want to race. I want to actually run a marathon. I feel inspired to run the Iron Man even though I can't physically run the 50 yard dash without getting winded. I'm exhausted and feel like lead but restless. I want to punch everyone just so I can get into a fight. I want to feel physical. I want to feel that release of endorphins. Emotionally, I feel evil. I want to make people cry. I want to cry. I feel like I'm burst out into tears without cause right now. I feel hopeless. I feel like I could write a best selling novel but I feel like I'm the shit of the earth. I feel like I'm smarter than every single one of you out there and honestly, your opinion is shit to me. I think less of all of you. But I feel worth not one single iota of your time or patience or love. I want to go swimming. I want to sleep all day. I want to be in a coma and never wake up. I want to steal a belt from the store. I want kill myself. I want dig up my back yard and plant a garden. I want to call my mother up and just cry. I want to hate right now. I want to dress in my best clothes and flirt with a beautiful man and just be adored. My back aches. I miss Emma and I weep that she's in school right now. I don't want to talk to anyone. I wish I didn't exist. I want to see my blood. I want sushi. I want to take roll after roll of pictures of random people and places. I want to clean my house. And now suddenly moments later....I feel none of that. I feel unreal. I feel like a dream.
I have had more than five significant mood swings today. I've been awake since 6 am and it's now 12:40. THIS, my friends is daily life for me. By the time I speak to many of you or write something or function, I've probably already had at least two.
Remember: Don't neglect your mental health. MIND YOUR HEALTH!
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