Understanding the Impact of Bipolar Disorder
The amplitude of a bipolar person's mood (green curve) compared with that of an average person (green band).
Note: The duration of (hypo)mania and depression and their repetition over time varies from one bipolar person to another.
Bipolar disorder, also known as manic-depressive illness, is a complex mental health condition that significantly impacts a person's mood, energy levels, and ability to function in daily life. It's characterized by extreme shifts in mood, ranging from periods of intense elation and energy (mania, hypomania) to periods of profound sadness and hopelessness (depression). These mood swings can be unpredictable and disruptive, affecting various aspects of a person's life, including their relationships, work, finances, projects, hobbies, and overall well-being.
Understanding Bipolar Disorder
The Mood Swings:
Manic Episodes: During manic episodes, individuals may experience an unusually elevated or irritable mood, increased energy and activity levels, racing thoughts, decreased need for sleep, inflated self-esteem (grandiosity), and impulsivity. They may engage in risky behaviors like excessive spending, substance abuse, or reckless driving.
Hypomanic Episodes: Hypomania is a milder form of mania. people experiencing hypomania may feel very productive and creative, but their behavior may still be unusual and noticeable to others.
Depressive Episodes: During depressive episodes, individuals experience persistent sadness, loss of interest in activities they once enjoyed, changes in appetite or sleep patterns, fatigue, difficulty concentrating, feelings of worthlessness or guilt, and in severe cases, thoughts of self-harm or suicide.
Causes:
The exact cause of bipolar disorder remains unknown. However, research suggests a complex interplay of factors:
Genetics: Bipolar disorder tends to run in families, indicating a strong genetic component.
Brain Chemistry and Structure: Imbalances in neurotransmitters (chemicals that transmit signals in the brain) and structural differences in the brain may play a role.
Environmental Factors: Stressful life events, trauma and use of drugs can trigger episodes in people who are predisposed to the condition.
The Challenges of Living with Bipolar Disorder
Living with bipolar disorder presents numerous challenges that extend beyond the mood swings themselves. The unpredictable nature of the illness can make it difficult to maintain stability in various areas of life.
Work and Finances:
Holding down a job can be extremely challenging. Mood swings, lack of focus, unpredictable energy levels, and the potential need for time off during severe episodes can sometimes make it impossible to meet the demands of employment or entrepreneurship. This can lead to poverty or homelessness, as finding and maintaining a steady income becomes a significant hurdle.
Relationships:
Bipolar disorder can destroy relationships with family, friends, and romantic partners. The intense emotions and behavioral changes during mood swings can be difficult for loved ones to understand and cope with. This can lead to misunderstandings, conflict, and social isolation for the individual with bipolar disorder. New romantic relationships may be out of reach due to the impact of depression on self-esteem, social interaction, and energy levels.
Goals, Projects, and Hobbies:
The fluctuating energy levels and motivation associated with bipolar disorder can make it extremely hard or impossible to pursue long-term goals, complete projects, or engage in hobbies consistently. Individuals may experience periods of intense productivity and creativity during manic or hypomanic phases, followed by periods of apathy and complete lack of motivation during depressive episodes. This can lead to frustration, a sense of failure, and great difficulty maintaining a sense of accomplishment.
Health:
Individuals with bipolar disorder are at increased risk for other health problems, including:
Substance abuse: Attempting to self-medicate mood swings can lead to dependence on drugs or alcohol.
Anxiety disorders: Co-occurring anxiety disorders are common.
Cardiovascular disease: Bipolar disorder may increase the risk of heart disease.
Diabetes: Individuals with bipolar disorder may have a higher risk of developing type 2 diabetes.
Suicide: Sadly, the risk of suicide is significantly higher in individuals with bipolar disorder compared to the general population.
Social Stigma and Misunderstanding:
Unfortunately, mental illness, including bipolar disorder, is often stigmatized. People with bipolar disorder may face judgment, discrimination, and a lack of understanding from others who are unfamiliar with the complexities of the condition. This can further exacerbate feelings of isolation and make it difficult to seek help or support.
My Personal Experience of Living with Bipolar Disorder
Diagnosis and Treatment:
I was diagnosed with bipolar disorder only after I turned thirty-three. For twenty years I have been suffering from the brutal symptoms of a serious illness that I didn't know I had.
Like most people with bipolar disorder, it took many years for doctors to understand my condition. We have tried different medications and dosages to stabilise me. It's a never-ending process that doesn't always work as the disease evolves with time, the seasons and events in my life.
Impact on My Daily Life:
Having bipolar disorder means that I went through episodes of uncontrollable hyperactivity and I'm almost always depressed. Dark thoughts, sometimes suicidal thoughts, are part of my daily life. I wake up with them, go to sleep with them, and they give me nightmares.
I am unable to foresee my energy and mood for the following day, making it most of the time impossible to make plans. People have much more energy than I do and feel rested with much less sleep than I do. My sleep is irregular and I usually need eleven hours to feel rested. People accomplish a lot when I struggle to do anything. To the point that they look like super humans to me.
I almost never finish what can't be done in a day. Because my condition wasn't diagnosed, for decades I didn't understand why most projects were too big for me. This created a vicious circle: I start a project that seemed doable at first -> failure -> disappointment -> frustration and self-loathing -> depression.
Social Isolation and Anxiety:
I went through years where I talked to only one person a week: the cashier. And the words were just "good afternoon", "thank you", and "goodbye".
I literally had no friends for 12 years. Depression and mood swings made it impossible to make friends.
The depression caused me to spend so much time alone indoors that getting on a bus or walking down the street gave me anxiety.
The Illusion of Escape:
I've moved too many times because I thought I was depressed because of the climate, the city, my social network, the lack of job opportunities, or the unavailability of certain hobbies. But the problem is my illness, and moving only makes it worse.
Coping Mechanisms and Finding Balance:
For 25 years I was in a cycle of spending my days at the computer, gathering knowledge but never applying it. It was a way to escape the dark thoughts of depression and to get the dopamine I was missing. Today, as the medication seems to be working, I have a little more success trying to spend time outdoors, at the gym, or with people rather than online.
Financial Struggles:
For decades, I didn't know that my efforts to be an entrepreneur or to keep a job were always thwarted by my undiagnosed bipolar disorder. That's why for years, I had to survive on the Revenu de Solidarité Active (RSA), a small french social security benefit. It was very difficult financially and morally to end up so low. Especially when society constantly accuses you of being lazy. People in wheelchairs don't have this problem because their handicap is visible.
I have tried so many times to hold a job, to build a business, but it requires a stable mood, regular hours and a level of energy that my illness refuses to give me.
After many years, I've finally come to terms with this fact and stopped feeling guilty about not being able to keep a job or be an entrepreneur. I hate it but I have a disability and it's controlling my life. Trying to fight the limitations imposed by my illness only leads to me hurting myself.
Since 2020, I have been receiving a disability allowance to help me live. Because the system is badly set up, I didn't know I could get it. A local institution called MDPH du Cher denied me this right for two years for unfounded reasons. This allowance is less than half the median monthly net wage in France. But when you have nothing, it's everything. In order to continue to be helped, I have to justify every two years that I am still sick, even though I have a chronic disease that the doctors don't know how to cure.
People from my country and younger than me have long-term jobs, own houses, some have children, travel abroad. I can only rent a 28 square meter studio. I have to constantly question the cost of my cheap food. I have to think for weeks before buying something. My parents lend me a car because I can't afford one, even though I should have the means to buy one by now. For 8 years, I haven't gone on vacation by myself.
Impact on Relationships:
I've been single for 17 years because I was too depressed to attract women. I'm not exaggerating. Not a hug, not a kiss, not a date, nothing. Bipolar disorder destroyed my first relationship and I still regret leaving my girlfriend. Everyone knows it's time to move on. Sure. But let me explain how depression destroys your ability to meet love:
Depression means not being able to communicate with people. Depression means looking very sad, having a bad haircut and wearing bad clothes.
Depression means being slouched and hunched over, withdrawn.
Depression means not going out except to buy food.
Depression means going to social events extremely rarely and feeling like an inadequate ghost. People avoid you, which makes you leave early because the situation is not pleasant.
Depression means having nothing to talk about because you don't do anything with your days and you don't think about anything except the idea of killing yourself.
In short, depression makes people, especially women, run away from you because you're scary, repulsive, and boring.
Experiencing Mania:
I had episodes of this kind of uncontrollable hyperactivity. During these long periods of several months, I barely slept and exhausted myself to achieve goals that were completely unrealistic. I was chasing a stable financial situation and something that would stop my depression. Mania always ends with a descent into crippling depression. I have learnt the hard way that these intense episodes are due to my illness. My bipolar disorder is here to stay until science finds an effective treatment. I have to live with it, even though I alternate between thoughts of killing myself to end the suffering, and thoughts of delusional projects that would only hurt me if I pursued them. Mood regulators aim to avoid these uncontrollable variations, but they don't always work. I have to stay hyper vigilant.
Family Dynamics:
One of my great-grandmother had bipolar disorder. Some people in my family sometimes suffer from depression, but not the extreme brutality of bipolar disorder like I do.
I am a burden to my parents. It's very complicated to manage me, my episodes of depression, my hyperactivity episodes, even though my mother is a former psychiatric manager. My brother and sister, like most people, have a hard time understanding how I function and what my daily struggles are. My parents have always helped me when I've was stuck in hell, even though it's a daunting task to help a person with bipolar disorder. I'm very grateful to them.
Social Stigma and Lack of Understanding:
Bipolar disorder has destroyed my ability to hold down a job, to build a business. The mood swings, the constant very low energy levels - all of this makes it impossible to hold down a stable job. I constantly have to explain this reality to acquaintances, people and institutions.
I'm often met with a disheartening lack of empathy: some people offer unsolicited advice on how to get a job, or recommend gurus, training or coaches. It's like telling someone in a wheelchair that they could walk if they really wanted to and then giving them dumb advice on how to do it. It's like expecting me to overcome my bipolar disorder through sheer willpower alone, ignoring the fact that it's a complex hellish chronic condition that requires ongoing treatment and support. The definition of a disability is that it can't be fixed. When you have severe bipolar disorder, trying to build a life is like building a house of cards that the illness blows down every time.
Over the years, I have learned to ignore people's opinions and stopped feeling guilty about not being able to earn a living. Sometimes, people tell me: "You don't look like you have bipolar disorder." This is the case when I take my medication regularly, and like all people with bipolar disorder, if I stop, I become completely unstable, irrational, and it shows. Also, people only see me when I have enough energy to leave my apartment. They don't see the hell in my head, the nightmares, the suicidal thoughts, the frightening state of my bank account, and the stupid things my disease keeps making me do.
By the way, people with bipolar disorder must NEVER decide on their own to stop taking their medication. Unfortunately, many do when they are in a manic phase.
Hope for the Future:
I sometimes think of poor countries where there are fewer than a few psychiatrists per million people. So many people with mental illness go untreated. It's terrifying. I hope that science will develop fast enough to be able to cure all mental illnesses.
Seeking Help and Support
With appropriate treatment and support, people with bipolar disorder can reduce the severity and frequency of mood episodes, and live a little less hellishly.
Treatment Options:
Medication: Mood stabilizers, antipsychotics and antidepressants are often prescribed to reduce symptoms.
Lifestyle Changes: Maintaining a regular sleep schedule, eating a healthy diet, exercising regularly, and avoiding drugs and alcohol can help stabilize mood.
Finding Support:
Mental Health Professionals: Psychiatrists provide diagnosis and treatment. Social workers provide assistance with paperwork, finance, and daily life.
Support Groups: Connecting with people who understand the challenges of living with bipolar disorder can provide valuable emotional support and practical advice.
Family and Friends: Educating loved ones about bipolar disorder can help them provide better understanding and support.
Remember:
If you or someone you know is struggling with mental stability, it's very important to consult with a qualified doctor.
Disclaimer: This information is intended for educational purposes only and should not be considered medical advice. Always consult with a qualified doctor for diagnosis, treatment, and guidance regarding any mental health concerns.