I’m often asked (sometimes not very directly) what it is that makes me consider myself ‘mentally handicapped’ – to choose the chief piece of nomenclature at current. I would reply that I’ve actually had a number of afflictions and experiences that make me take mental health more seriously. The biggest one is undoubtedly the diagnoses of Bipolar disorder I received when I was still a young woman. I’ve always wanted to describe to my readership what exactly the nature of the illness is but I came up against two thinkable obstacles. Firstly, the amount of dry, dated pop psychology and iffy epidemiology that muddies the waters around what can definitely call the illnesses’ symptoms. This leads on to the second and more fundamental problem with describing it; its near-total individuality. Bipolar, like many illnesses around it, is essentially a list of the common factors and defects and habits of the minds and bodies of people who report it’s symptoms but doctors tend to forget this.
Suffice it to say that Bipolar is utterly unique to each and every individual that has it. In my case, pinning this down also has the added complications of Attention Deficit Disorder and Dyslexia, two more common syndromes of symptoms. Regardless, I wanted to try to write an article that explained what it does to someone on the inside and what it might look like on the outside and how neither of those things needs all be bad.
We know that treating Bipolar is based on ideally keeping the patient away from ever completely entering the opposed but not necessarily opposite states of Manic or Depressed. What constitutes these two states and what idiosyncratic things can lead a person towards them can often be extremely hard to generalise. Many doctors think of Manic and Depressive as being two extremes and while it’s true that these can sometimes feel – and very often look like – polar opposites, there are plenty of shades of grey. More specifically, a person with Bipolar might not exhibit what others think of when we think of mania or depression but themselves might be subject to a very specific set of emotions from which the catharsis or stimulus of a certain set of behaviours is the only release. They’re fine, look at how they’re acting. But how they’re acting may well be the kicks and flails that keep their head above the surface.
Now consider the opposite. On more than one occasion my relatives have seen me stave off a depressed state for a good amount of time. Seen me remain consistently happy and upbeat, only to mistake it for a lapse into the manic side of things. Oversimplifying things in this way has lead to me being hospitalised, not exactly the caring attention most family members would want to provide. Instead, it might be reasonable to look at triggers. Lots of different kinds of behavioural and biochemical changes are brought on by triggers and trauma can most certainly come to define them, too – as has been so popularly termed on the internet as of late.
It may sound like a very radical piece of thought but perhaps we should let people with bipolar define the boundaries for themselves. From there, any number of things can help them drift back between the two poles into some kind of normality. Regular medication can often help rebalance someone’s constitution and to set out a routine of self-care that the patient undertakes themselves makes for a subtle injection of acknowledgement of how bad one’s symptoms can become. This is only one example but if we can offset medication and self-care from the usual cannon of hospital treatment we can reserve said treatment for those who are still figuring out the best course of action for them, for those who are in need of emergency treatment and for those who are in need of consistent care by medical professionals should they enter a manic state or have a breakdown.
This, then, puts the emphasis on those with Bipolar retaining the set of habits and routine’s that best keeps them out of harm’s way – and once again this is a reversal of the way in which doctors inform patients about what they should be doing. Is it possible then to establish a model for lessening the effects of Bipolar as far as humanly possible; one that is a collaboration between doctor and patient?
Such dialogues are essentially what’s happening in the course of psychotherapy anyway. Where what would be considered in the regular practice as an exception: a doctor asking you about your individual experience and requirements, here it is the very basis. Therapy has the potential to combine the very benefits of building a rapport with a friend or family member, allowing them to know more about your symptoms and habits, with the security and reassurance of talking to a medical expert. But, like the isolated example of medication I gave above, this one method is not a cure-all.
Instead, one must consider the demands of their illness holistically. Saying that you have Bipolar is a summary of its parts and it’s efficient to break those parts down into symptoms, habits and incidents – good days and bad. Any decent kind of framework, then, would consider all of these elements. For myself and others, keeping a journal was an effective way of collating all these elements as they appear on a day to day basis. Once that was done, it was possible to outline what constituted a good day or a bad one – and ostensibly possible to categorise it further as having a ‘manic’ or ‘depressed’ bent.
In my case, I was able to separate things more distinctly into those moments I was ‘lucid’ and those times I was not. This was particularly effective when it came to intervening in the course of slipping between the two modes. Eventually, I was able to sit with those who knew me and my condition well and tell them exactly what to do should they see evidence of extreme behaviour. If they were concerned by my incessant chatting, midnight adventures and peerless energy levels then they could rely on the fact that I I, not the caricature of myself that I had become, needed to be calmed, medicated, restricted or even hospitalised. And I could tell them where was best to do it. Counter-Wise there was always the possibility that I could become depressed, despondent, unresponsive; I needed to prepare some solutions for that time, too.
Quickly, then, Bipolar disorder is a mental illness that can come under the generalist description of ‘bad chemistry’ and is all too easy to lump in with Schizophrenia and Major Depression. Truthfully, it’s a weakness in the brain’s interpretative power that, for better or worse, makes it easily wound up by a confluence of emotions, moments, circumstances and idiosyncrasies. And not one case is the same as the other.
Dealing with it becomes that much easier with the help of the following:
(1 Don’t ignore the earlier signs that something is pushing your mood or energy levels one way or the other.
(2 Keep a record of these moments, of how they feel when you’re are at least partially lucid. Which ones can you control? Which ones can’t you? It’ll help with defining triggers.
(3 Leave a safety net in place, an action plan for if anything goes wrong. Show the people who are going to enact it this article, establish trust.
(4 Learn from each encounter with your illness, adapt what you’re going to do in the name of self-care more and more precisely.
(5 Show this evidence to Doctors, make them understand the individual circumstances of your case.
(6 Feel free to bask in the positive sides of the level of confidence this can bestow.
I sincerely wish you the best of luck.