[bugnuts]

…and it sucks. But after living with the underlying problem for nearly fifteen years, I feel like those closest to me, namely my family and certain friends, still lack a fundamental understanding of the causes and most importantly of how to react. As I decided to write about it for myself and for them, it struck me that many people out there must be in my same position, so this is for you as well.

I am not a defective. In the same sense that a diabetic has a problem with his blood chemistry, I have a malfunction in chemicals called neurotransmitters in my brain. In the same way that Hashimoto’s disease causes a person with a faulty thyroid gland to suffer all kinds of symptoms, Bipolar Disorder has many different effects. Doctors treat diabetes and Hashimoto’s with special drugs and with changes in how a person lives. Similarly, doctors and psychologists treat Bipolar with different combinations of drugs and with suggestions on diet and mode of living. The comparison only goes so far, however, because most people are perfectly willing to talk of their diabetes diagnosis or of the effects of their thyroid problems, but it seems we haven’t yet reached the point where talking openly about Bipolar Disorder is either easy or accepted.

Bipolar Disorder is scary. To someone who has never been in the body of a person with Bipolar suffering a moodswing, the experience cannot adequately be described in words so that it can be imagined. The extent to which it seizes the ability of the sufferer to have a simple discussion, deal with an ordinary issue, or do an everyday thing is very scary. To the person who has never experienced it, the sufferer should simply be able to “shake it off” or “rally”. You don’t hear people tell a migraine sufferer to “just get over it”. This is because everybody has had a headache at one point or another and everyone understands that headaches hurt and they don’t just go away because you want them to. Now imagine if a typical headache made it impossible, over a period of days, for you to even be around other people or to participate in an activity you would otherwise normally be doing…you can begin to get an idea of the impacts of a moodswing if not the feeling of one.

Bipolar isn’t reserved for crazies. The word “bipolar” is broadly used to describe everyone from a guy like me to a guy who takes a gun to work and shoots all his fellow employees. I don’t have suicidal thoughts or have imaginary enemies, but I do have periods when I’m energetic and productive followed by significant periods of lethargy and antisocial feelings. I’m an ordinary citizen: a successful attorney with my own practice, two great teenage kids, a marriage that has made it over twenty-two years, and a propensity for avidly pursuing my hobbies to the point of being borderline obsessive (I’m told). Although my moodswings don’t make me commit crimes or get me committed to an institution, they do make me less effective in my job, less likely to interact with my kids, way less likely to communicate effectively with my wife, and far less likely to take part in any of my beloved hobbies. Sad but not crazy.

Moodswings aren’t caused by events. Probably the single most frustrating thing is when I feel a moodswing taking hold and someone close to me who sees its effects asks “What caused it this time?”. What they’re really expressing is a belief that a Bipolar episode must be caused by something that happened to me externally, as in a negative experience or event. The “cause” is the apparent inability of my brain to properly transmit neurological signals among the lobes. Whereas it’s true that something negative happening may be the catalyst or accelerant to a moodswing that was likely to happen on its own anyway, it certainly is not the cause. If it were, I could simply ignore or overcome all negativity in my life and never suffer through another episode. Obviously that isn’t the way it works.

So just what is the disorder? A writer on WebMD defines Bipolar Disorder simply as: a mental illness that causes people to have severe high and low moods. Sounds about right. In my case, the high moods aren’t too big a deal since from the symptoms listed by the writer, mine really only involve increased energy, a reduced need for sleep, impulsivity, and OCD-like behavior. However, the low moods are the real subject of this writing: WebMD’s symptoms include loss of energy, feelings of hopelessness, loss of enjoyment of things that were pleasurable, difficulty concentrating, irritability, increased need for sleep, and alcohol abuse, among others. They also say that many people experience much more severe symptoms during certain seasons of the year (my wife will attest to this one). For me, reading their list the first time was like going down a checklist. They also say that genetics plays a big part in the presence of Bipolar, and again I must say that fits. Some medical journals have theorized that whether by genetics or chance, people with Bipolar Disorder have disparate levels of three neurotransmitters: serotonin, norepinephrine, and dopamine. Apparently there’s a need for the appropriate levels of each of these as well as a certain balance between them. I guess I have to take their word for it on this one since I’m unaware of any test to determine these levels. Point is, after reading a bunch of this stuff I now know for certain that I am not alone in suffering through periodic moodswings due to my chemical imbalance.

Medications work. When I was originally diagnosed with a form of Bipolar Disorder almost fifteen years ago, I assumed that I would take a few pills, change a few things in my life, and then just go on like normal. To the credit of the psychologist I went to, I felt way better right away. It turned out that just confronting my problems made me feel good and then the medication began to take hold. After toying with a few different drugs and dosages, we arrived at a combination of a slow-release antidepressant and lithium that kept me on a pretty even keel. About two years later I decided that my problems were behind me and I quit taking the meds cold turkey…what followed was an extended bout of depression that scared me (and my family) so bad that I’ve never intentionally messed with my medication since. I have come to believe that the drugs prevent some episodes altogether and more importantly they lessen the impacts of the moodswings that still happen by making them shorter and less severe. They are not some miracle cure for what ails me: I am resigned to the fact that I will have Bipolar episodes in one form or another or to one degree or another, for the rest of my days. I look at the pills like my insulin if I was a diabetic in that I’m committed to feeling better, the meds help in that regard, and so I plan on taking them as prescribed for the rest of my life.

So how should people react? Stated simply, leave me alone. There is no amount of attempted “TLC” or “cheering up” that is going to make a moodswing go away. The whole point is that they are the result of a chemical imbalance: getting one is involuntary and thus getting out of one is not something within my control. And don’t try and get me to rally…in fact, any attention tends to induce a negative reaction inside me that necessarily drives the people who would be closest even further away. We (I) now know that these episodes come and then they go and as such, I prefer being left alone in that dark place to just ride it out. I am fortunate that I can spend time alone both on the job and off during most days, and my family has been remarkable over the years in this regard. The people closest to me can see a moodswing, even from a distance, in an instant so I must wear some symptoms on my sleeve. The challenge for those people is to not be angry or frustrated because of the existence of the moodswing or because I can’t defeat it. All these years should have taught everyone close to me that certain things are not within my power to change no matter how hard I try, so expressing anger or frustration because I’m heading for or am already deep within another episode can only make things worse.

Like I said, I get moodswings and it sucks.

But then…

…a day comes when I just simply feel better. I prevented myself from editing the above because I wrote it when I was in the throes of a very deep three-day moodswing that apparently ended last night in my sleep. I will not labor to convince any reader of my mental state other than to repeat that my wife politely described my mood yesterday as “introverted”, and my teenage son, who is painfully nice, said that I was “quiet”. My family has seen these states too often for too long…I firmly believe that we would not still be a family if I had not sought help and if the effects of my Bipolar were not lessened by my medications. Having a truly special spouse helps too.

I don’t feel like a defective. The only time this issue comes up, usually at my suggestion, is when I’m in a funk or shortly thereafter. In the aftermath of a bad episode, when I have my faculties back, I find myself finding different ways to describe or excuse my behavior to my kids and my wife. I want to just say “screw that”, but I know what they saw and I can guess what they felt when it was happening. I constantly wish I could go back and do some singular thing that would have prevented me from being “quiet” or “introverted”, to quote two biased sources, but again that isn’t how it works.

This is why Bipolar is so scary. As I sit here writing this, I am calm, collected, happy, thoughtful, patient, cerebral, etc….this in light of the fact that I just found out several hours ago we have a major issue effecting our daughter’s college future. I told my wife on a walk this afternoon, “If this happened two days ago I wouldn’t have been able to deal with it.” The situation is still crappy with or without me there to deal with it, but I’m certain a resolution is more likely with me (today’s me as opposed to yesterday’s me) involved. That there are several “me’s” is what is scary.

I’m tired of my disease affecting my life. Those words are undoubtedly uttered by many people with many illnesses much more dire than mine. The common thread, however, is when a malfunction in the body takes over our day-to-day interaction with people we care about, and it pisses us off. Even within a tight circle of friends and family, mention of “Bipolar” or “depression” is not cool because it’s not understood…but I understand that. It doesn’t lessen the potential seriousness of the disease that its effects come and go in a person like me, and when I’m not in that dark place, I don’t take my Bipolar for granted.

I have no clue what causes my disease. Honestly, it is pathetic that advanced medicine has not figured out how to overcome chemical imbalances, from diabetes to thyroid to bipolar and beyond. Of course, if you believe that “bipolar” is not in fact a chemical issue, then the medical profession is doing a dandy job just throwing all kinds of drugs out there to see what sticks. This disease is overdiagnosed by physicians who have no clue about its origin, symptoms, and causes which diminishes the gravity of the situation for those of us who actually suffer from it. I can’t define much about the science of Bipolar, but I can say that its effects take over my daily life and it hurts and therefore a cure should be out there.

I’m over any stigma about taking the meds. In the beginning, the thought of taking pills for a long period of time was unsettling to me at best. I found it hard to tell friends why I wasn’t drinking with them or why I seemed subdued. Eventually, I started answering all questions honestly: “I’m taking pills that help my mood…” and “they work best if I don’t drink on top of them.” Frankly, I was glad to see certain people react poorly because it only pointed out who I wanted to keep in the circle and who I do not. It was a life-changer for me to start on my medications, but as I said above, I am convinced that taking them as prescribed makes my life better.

Different people will react differently. My family understands me well enough to leave me alone if in doubt. I know that actually sounds terrible, but it’s true. Most of my friends, on the other hand, do not understand things so clearly and thus I choose not to attend certain social functions. Today, for example, I felt like returning any and all texts or phone calls no matter how trivial. Yesterday, on the other hand, I wouldn’t have communicated with someone if their house was burning down. When it’s bad, I’ll keep my contact to a minimum, even about the important stuff like fishing or golf. When it’s good, I’ll respond to any communication quicker than anyone.

So I had a moodswing, and it sucked…but I’m better now.