What I wish people knew about bipolar disorder

Photo by Nick Fewings on Unsplash

Many misconceptions shroud bipolar disorder, and while most of us understand that people with bipolar disorder suffer from depression and mania, we also need to realize that nothing, including bipolar disorder, is as clear-cut as they seem. People suffering from this disorder battle against many things outside these two known states. 

Here are a few things we need to understand about people who have bipolar disorder:

#1 We’re not constantly experiencing symptoms
Individuals with bipolar disorder experience periods of extreme changes in mood and energy levels, but not around the clock. First, these shifts are called “episodes,”—and there are a few different types:

• Mania: A manic episode is typically characterized by having high energy and activity levels, a reduced need for sleep, and feeling confident or euphoric. But someone in a manic episode may also feel irritable and agitated while also being energized.
• Hypomania: This is a less extreme version of mania but generally presents as high energy and activity while feeling as if you don’t require sleep.
• Depression: A depressive episode may cause a person to feel sad or down, exhausted, or may have difficulty concentrating or thinking about death or suicide.
• Mixed: A mixed episode means that a person is simultaneously experiencing a manic or depressive episode with some symptoms of the opposite mood state.

The types of episodes you go through depending on whether you have bipolar I or II (the two main types, although there are other conditions related to bipolar disorder). And how a person feels or acts during their bipolar episodes (and their length) can vary greatly and be entirely subjective. (Mood episodes generally last at least a week.) But bipolar episodes, regardless of what types affect you, are interspersed with periods without any symptoms—which is essential to remember.

#2 People diagnosed with bipolar disorder have different experiences
How bipolar episodes cycle and present for an individual depends on all kinds of things such as the person’s age, illness severity, which medications they are being treated with now, which medications they were treated with previously, whether they are taking their medications—all sorts of factors. So, as you can imagine, bipolar disorder can be very complex to treat and manage. Successful treatment is keeping open and regular communication between a patient and their doctor.

#3 You can’t just snap out of an episode
Medication is needed to treat symptoms if someone is already in full mania/hypomania or depression. One cannot pull themself out of a mood episode. Sometimes people will be aware that they are in or near an episode. Still, not all the time, depending on the person’s level of awareness and familiarity with their symptoms as well as the severity, this may affect whether or not they have the attention to take their medication.

Some medications for bipolar disorder can treat mania, hypomania, and depression, while other drugs only treat certain episode types or combinations. In addition, some medications can prevent symptoms from becoming a full episode if taken in time. This is where psychotherapy plays an essential role, as it helps teach a person with bipolar disorder how to spot and manage those early symptoms.

#4 It’s a lifelong diagnosis that needs to be constantly managed
Bipolar is a lifelong diagnosis, and ideally, very soon after those first mood-elevated episodes, that person gets word from the appropriate experts and clinicians that they are at risk for the rest of their lives of having another episode. So, a person with bipolar will very likely be on medication and working with a therapist throughout their life. But unfortunately, the symptoms don't magically disappear because I go to therapy and I have medication, and I've taken the time and effort to develop coping mechanisms. A mental health disorder is like a cold, but the cold is in your head. Sometimes I need to sleep a little more. Sometimes my appetite isn't there. And I need my medication to help the process along.

#5 Mania is not fun
Some people would say, “Thank God you aren’t depressed all the time. At least you have energized happy moments. That should make up for the days of depression”. While having a lot of energy is great, it can be hazardous when you have no control over your actions at that “high” moment. Imagine being filled up with restless energy, losing touch with reality, and you are irritated you are angry, and you can’t get your body to shut down and have rest. You are awake when the world is asleep and drained, but the energy won’t let you go to sleep. You make decisions that on a regular ground you won’t do, but at that point, your mind rationalizes and justifies that decision. These periods of overspending, irrational thoughts and actions, and overconfidence tremendously impact their family relationships, social life, and financial stability. So no, mania isn’t fun.

#6 People living with bipolar disorder can and do thrive and flourish
People are not aware that there are lots of people who have the condition, including leaders of major corporations and musicians. We’re often viewed as defective, yet the evidence is contrary. Just because I'm managing and have a life where I can be a full-time employee and take care of my family doesn't mean I don't have bipolar disorder anymore. People with bipolar disorder aren’t necessarily suffering. Many famous, talented, productive people have dealt—I hate the word suffer—with bipolar disorder.