Acceptance

It’s been 3.5 years since my diagnosis.

My original reaction was *TRIGGER WARNING* a suicide attempt *END TRIGGER*. Having been diagnosed with major depression in 2004, I took years to learn what it meant, how I can fight it, what I can do about it. Depression became a part of my personality; I tamed it, and I was victorious. Or so I felt. The six months before diagnosis were my best period ever – I thought. It was blazing hypomania, and everything about it felt perfect. I thought: this is the real me, finally. Free of fear, free of tiredness, full of ideas. I spent money because I knew Gods would make sure I get more of it, and soon. I tried to start two businesses at once (graphic design and coaching, and I knew nothing about the latter but people loved confiding in me so I felt qualified enough), while juggling a part-time job as a bartender AND learning what my dream career was. I slept 3-4 hours per night, overexcited with all the ideas and power I seemed to have. I have never been more creative, seductive, simply happy.

And then a mixed episode hit and I was majorly confused. I thought my antidepressants stopped working for some reason. I went to a psychiatrist demanding a fix. Instead I got a new diagnosis, and was told that the period when I felt so good was actually an illusion. It was all fake, chemistry malfunctioning in my brain. I was absolutely heartbroken. It wasn’t only that I had to learn living with a new word in my medical dossier; it was the fact that while depression can be cured and not return, the same is not true with bipolar.

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“Why can’t you just get better?!”

For some of us, this is a question that our families or loved ones ask us. For some, like me, it’s a question we ask ourselves. We’re taking our pills. We’re sleeping eight hours every night. We aren’t doing drugs or drinking. So why the hell can’t we just get stable?

When I published my book, one of the people who read it told me that it felt very strict, particularly in the guidelines about not drinking. Personally I haven’t had a drop for over a year now. I haven’t used any illicit drugs for many years. I religiously take my pills (since diagnosis in 2011 I forgot my pills only once) and no matter what, sleep eight-nine hours. Every. Single. Night. Yet I am still rapid cycling and finding it hard to keep appointments, because while on Tuesday I felt great making an appointment for Friday, on Thursday evening I turned into a plant and stayed in this state until Saturday, when I jumped out of bed energised by the thought of buying a new Macbook Air. (I can’t afford a Macbook Air.)

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Question: Is my girlfriend bipolar?

Hello and sorry about a break in posting. My bipolar was acting up (I’m sure you can relate). I’m back though, with a question from a reader:

Hi, I would like some advice. My girlfriend Jane [name changed] is showing symptoms of bipolar. I think she’s hypomanic (but I am not a doctor). I’m scared, confused and I don’t know what to do. Could you give me some information? Most of all, what can I do as her boyfriend, and how to help rather than harm?

Lost in Miami

Dear Lost,

I’m not a doctor either but here are my thoughts.

First of all, symptoms resembling hypomania do not have to mean bipolar disorder. They can also be a sign of thyroid problems (I found this hard to believe for a long time until I met a few people who, indeed, exhibited all symptoms of bipolar, only to find out they had malfunctioning thyroid). They can also feature in other illnesses, such as borderline, schizoaffective disorder or schizophrenia. Only a professional can give you a clear diagnosis.

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“I don’t think I’m sick”

Oddly enough, one of the symptoms of both unipolar depression and all phases of bipolar disorder is the idea we aren’t sick.

In depressed phase, it is associated with lowered self-esteem. Together with all other negative thoughts comes the idea that we are just lazy, and we’re just pretending, and we don’t have depression at all. (This is greatly aided by having relatives or friends who provide us with helpful phrases along the lines of “why don’t you just pull yourself by the bootstraps” and “you know, you could just try not to be depressed”.) And so we find ourselves on the floor, curled into fetal position, thinking we’re just imagining all this and in fact don’t have any reason to feel bad, so why don’t we get up and do something. Then we don’t get up and we don’t do something, because depression won’t let us move.

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Did the Germanwings pilot suffer from bipolar disorder? *TW*

Andreas Lubitz’ name started appearing in my Google Alert a few days ago with speculations on whether he was depressed, or, in fact, bipolar. But a confirmation showed up yesterday:

In the days running up to the Germanwings crash, Andreas Lubitz repeatedly logged on to his computer under the name “Skydevil” and searched for information on cockpit security, it has emerged.
Prosecutors in Dusseldorf revealed last week that the 27-year-old co-pilot had looked up suicide methods and medical conditions but now a German newspaper has claimed to reveal the exact words used.
[…] From 16 to 23 March – the day before the disaster – he repeatedly searched terms including “bipolarity”, “manic depression”, “migraines”, “impaired vision” and “acoustic trauma”, investigators with access to a tablet computer found in his apartment told the newspaper.

I can’t say I’m surprised. Experts in my Google Alerts claimed, rightfully, that a depressed person doesn’t come up with a detailed plan to die, then execute it, taking 150 people along. Most depressed people, when suicidal, either lay down on their sofa curled into fetal position, or, when a sudden boost of energy comes, harm/kill themselves immediately, without waiting for a week until the right chance comes along.

One of the possible mind states in bipolar disorder is called dysphoric mania. Essentially it means that the person afflicted suffers similarly as during depression, but has the manic energy, creativity, anger and pretty much random other symptoms of mania, like delusions of grandeur. If this was the case of Lubitz — IF, I said — what he has done becomes understandable. (Not justifiable!) A person with delusions of grandeur thinks of themselves as being on a whole different level than “normal” people; when they’re creative, they come up with elaborate plans; when they’re energetic, they put those plans into life; when depressed — see the dysphoric bit — they want to die. Putting all those together would mean — IF I am correct — that people on board of the Germanwings plane didn’t matter to the co-pilot. He wouldn’t mind them not being there at all. The only reason the captain mattered was that he had to be removed from the cockpit. IF Lubitz was in dysphoric mania, he didn’t think of himself as killer of 150, he was just finishing off his personal life story, possibly feeling proud that he is flying an Airbus at his last moments of life.

Should bipolars be allowed to be pilots? I can’t give you the easy correct answer to this question. A lot of people drink alcohol. Should they be allowed to drive? You can’t tell for sure that they will never try to drive drunk or hungover. In many countries, especially those with tight anti-abortion laws, women throw away their infants to die. Should people be forbidden from having sex?

It is an incredibly harmful things when media try to extrapolate single cases onto the whole population. Would papers all over the world be so quick to report Lubitz’ searches if he googled “Barbie dolls” and “strawberries”? I am about to start a second draft of a fictional novel I am writing, and I have been googling “suicide using medicine” and “what happens to the body in the morgue”. If I got hit by a train tomorrow, and was famous enough to warrant papers to go through my Google searches, I’d look very interesting to the media.

A great majority of people suffering from bipolar do NOT kill themselves or others, do NOT fly planes into mountains and generally live rather boring lives (especially if, like me, you follow doctors’ orders to a tee). But newspapers never report “An exclusive: John Doe, who suffers from bipolar disorder, hasn’t killed anyone today”. They never write “Jane Smith, who does NOT suffer from depression, bipolar disorder, schizophrenia, narcissistic disorder or antisocial personality disorder, killed her husband by hitting him on the head with a frozen trout. Should we stop selling fish to mentally healthy people?”

My next plane flight is planned for July. When boarding, I will not be wondering whether my pilot: suffers from a mental illness; is drunk; high on speed; just got served divorce papers; his son committed suicide; daughter announced she’s lesbian; does his mortgage exceed the value of his house; did his favourite football team lose 6:0 last night. If you search well enough, you can find a reason any person should/could be forbidden from flying planes, driving buses or trains. I am deeply worried Lubitz’ case will take the public view on bipolar disorder ten years back. I hope and pray that what happened will not lead to a blanket “mentally ill people should not perform any public jobs” sort of “solution”. My name is Grant, I have bipolar disorder, and I am not Andreas Lubitz. And neither is any bipolar person that I know. Don’t tar us all with the same brush.

Photo: Michael Mueller, AP

Hypomania vs. mania

The book definitions of hypomania and mania seem to make the difference between the two pretty unclear. They generally either list hypomania as “mild mania”, or — the other way round — mania as “stronger hypomania”. Then list the same symptoms next to both.

Here in the Netherlands the definition is a bit clearer: mania requires hospitalisation (or arrest, but hopefully the former). Hypomania is what you can cope with by yourself; mania requires help. While this still isn’t a 100% clear division — how are you expected to know, especially when manic, that you have now crossed the threshold and you need hospitalisation? — it’s helpful, because it gives a clear and understandable difference.

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