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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Creativity meets mental illness

An article popped up in my Google Alerts:

A study of the medical records of 150,000 individuals has found that the relatives of patients diagnosed with schizophrenia or bipolar disorder are more likely than the general public to be creative professionals such as actors, dancers, musicians, visual artists or writers.

The researchers cannot be sure whether the link is due to the shared genes of the family relatives or a shared upbringing and environment, but they suggested that it could be explained by similarities in the way the brain works in creative people and in patients with schizophrenia and bipolar disorder.

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Bipolar disorder and relationships

Very often I meet people with bipolar who are convinced they are unloveable, will never have a relationship, marry, etc.

Perhaps I am not an objective judge of such statements, seeing as I am in a 3+ year relationship, during which I got diagnosed, landed in depression so deep I couldn’t walk without help, mania that got me into hospital, fought (successfully) a substance abuse problem and remain without steady employment. Our relationship survived all those things and remains in great shape. *knocks on wood* So my answer to that is, basically, no. You are NOT unloveable. You CAN have a relationship. You CAN get married. Have a house, children, garden, whatever else your heart desires.

Having said that, bipolar is going to make it much more difficult.

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ANTs: What makes depression the worst thing ever

Caution: The post below may be triggering to people currently suffering from depression

Wait, you could say. There are people dying left, right and centre. Surely depression isn’t as bad as that.

Thank you for reminding us about the fact we are (mostly) privileged. We (mostly) have health insurance, (mostly) are not refugees, in our countries there is (mostly) no war. We use this knowledge to make ourselves feel worse, or, more precisely, our depression does. Marian Keyes, a famous (and brilliant!) multi-million selling writer, wrote once:

It has been like being poisoned, it’s felt like my brain is squirting out terrible, black, toxic chemicals that poison any good thoughts. I’m well aware that I have an enviable life and there are bound to be people who think, “What the hell has she got to be depressed about?” But whatever has been wrong with me isn’t fixable by an attitude shift.

To me, the worst thing about depression is that it eats at the very core of our souls. In stable, “normal” state, we are certain of some things. My boyfriend loves me. I love photography. I’m writing a novel and I’m 2/3 through. I’m having friends coming to dinner on Friday. My parents love me. Those things are so obvious we don’t even bother actually thinking about them, they are a built-in spine of our existence.

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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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How to explain depression

I often speak to people who don’t understand the nature of depression at all. They are convinced they’ve been depressed — “once after a break-up I cried for three days and listened to Nick Cave a lot, but I just pulled myself together and stopped being depressed”, which kinda suggests you’re just too weak or lazy to un-depress yourself. All it takes is pulling yourself up by the bootstraps, they suggest. Why don’t you stop being depressed? It’s easy!

Except, of course, it isn’t, and they have no clue what they are talking about. Bipolar depression is a chemical imbalance in the brain. (Apparently latest studies suggest it is a sort of inflammation.) You can’t stop being depressed any more than you could stop having cancer. There are ways to improve your mood, but when you’re in the darkest pits, those ways aren’t likely to work. For instance, physical exercise helps, but knowing that doesn’t help much when you can barely get dressed without assistance and taking a shower seems to be the same level of difficulty as climbing Mount Everest without oxygen tanks.

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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

Internalised stigma

A friend has told me he met a really fantastic girl. She’s everything he dreamed of. They’ve been dating non-committally for a few months, and now he asked her to be his girlfriend. Her response? “I can’t be anybody’s girlfriend,” she said. “I have bipolar disorder, and it’s a terrible illness. I’m just not fit to have a relationship, any relationship at all.” He asked me how he could convince her. “You’ve got bipolar,” he said, “and you’re in a relationship. It’s possible to have a relationship while having bipolar, right?”

Of course it is. But then the problem with bipolar disorder is that it doesn’t actually make anything impossible. You can be a respected professor of psychiatry like Kay Redfield Jamison. You can be a super-popular actor and TV personality like Stephen Fry. You can be a chart-topping singer like Robbie Williams. You can be married, have kids, a good job. It’s just that for us it’s harder than for “normies”, and some of us overestimate the difficulty level based on what we heard and read about ourselves. And this is where internalised stigma comes in.

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Bipolar and addictions (Dual Diagnosis)

According to www.dualdiagnosis.org, 56% of people with bipolar disorder suffer(ed) from addiction to drugs or alcohol at some point. According to www.drugabuse.gov, the rate for general population (in America) is 8.9 percent.

Obviously there is something about bipolar disorder that correlates with high addiction rate. While I am not a medical professional or addiction counsellor, I will hazard a guess that bipolar makes you predisposed to addiction, not the other way round. There are some drugs that can trigger a bipolar episode (in particular marijuana and LSD), but they do not create bipolar disorder in a mentally healthy person. They may only make it manifest earlier.

There are a few obvious reasons why bipolars tend to become addicts. One of them is self-medication. I used to self-medicate my depression with alcohol for years – it seemed to be the only way to make the black dog go away for a few hours. I knew that alcohol is a depressant and on some subconscious level I probably realised that I am making things worse for myself long term, but at those times the only thing that counted was quick relief which the bottle provided. The same scenario happened daily: I’d be terribly depressed, I’d get drunk, depression would be replaced by euphoria, I would do some really stupid things, go to sleep, get up in the morning and scream “F–K!!!” (I never blacked out; I always remembered what I did the day before, and it was always terrible and make me more depressed.) Repeat. Repeat.

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Book vs life

One of the readers of “Bipolar For Beginners” has been chatting with me online the other day, then she mentioned she was having a glass of whisky as we spoke.

My automatic reaction was “don’t do it!”. Alcohol stops correct processing of medication by the brain, and in conjunction with Depakote/Depakine it wrecks your liver real bad. Unfortunately, alcohol is also something people enjoy. In fact, even while I was on Depakote, my doctor told me it would be fine for me to have one beer per day. It’s just that at the time I weighed over 100 kg, and so one beer was hardly going to make a noticeable effect, so once I finished my pint all I wanted was another one.

Another piece of advice which is easy to dispense but not so much to follow: “Avoid stress”. We can do certain things to limit the amount of stress. We can look for a less stressful job, avoid watching or reading things that we find triggered. But let’s say your brother contracts a deadly illness. How exactly are you going to avoid stressing over it? Or – an example from real life – your parents constantly smoke weed, and you live with them. Your friends smoke too. How easy is it going to be for you to avoid using yourself?

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