[ultramar]

Hi Everyone,

Someone pointed out in another thread that I can be impatient with some people who are just discovering and getting used to their diagnosis --this is a fair point and I apologize for this.

So, by way of clarifying what has been a point of contention (more specifically something I have possibly disagreed about with some others here) I wanted to write about what is termed returning to one's 'normal' state between episodes. I'm going to make some citations and give my opinions below, but I hope that others will chime in with their thoughts and opinions.

From Psych Central:

"In everyday life, people have a variety of moods and feelings. These feelings include frustration, joy and anger. Usually these moods last one day rather than several days. For people with bipolar disorder, however, moods usually swing from weeks of feeling overly “high” and irritable to weeks of feeling sad and hopeless with normal periods in between."

The closest I could find to a direct quote from the DSM, from Brown University on the DSM IV-TR criteria:

"Bipolar disorder is characterized by the occurrence of at least one manic or mixed-manic episode during the patient’s lifetime. Most patients also, at other times, have one or more depressive episodes. In the intervals between these episodes, most patients return to their normal state of well-being. Thus bipolar disorder is a “cyclic” or “periodic” illness"

I'm emphasizing the criteria that one return to essentially what is 'normal for them' between episodes. Now, what's 'normal' or baseline for one person of course can be completely different from another. Some people tend to be irritable, others tend to ruminate, others are comfortable socially, other not, some are very sensitive, some have difficulty in relationships, some are relatively content and well-adjusted, etc. In other words, how one is, what kind of person one is -between episodes- literally runs the gamut of the human experience and the many many different characteristics people can have.

(As a caveat, people of course can and do have additional diagnoses regarding other difficulties they may have, including outside of episodes).

What I'm saying is that, neither in the DSM, nor in any other authoritative description of this illness to the best of my knowledge, is it stated that people with Bipolar Disorder have certain personality characteristics in common (irritable, fun-loving, whatever). The symptoms of the illness apply only to episodes, when one is sick. This is in part why it's described as a 'cyclical' illness.

So according to the criteria, between episodes, you just are who you are. Obviously, some people with Bipolar Disorder will have things in common, but not necessarily any more than others in the general population (aside from the commonality and challenges associated with having the illness in the first place).

I'm not making this up, this is the criteria (and not the criteria) for the illness.

So when I see people writing about personality-type characteristics shared by those with bipolar (whether sensitivity, reactiveness, irritability, rumination, etc., etc.) I respond, because the criteria of this illness has nothing to do with personality characteristics in common, nor day to day (non-episodic) moods and behavior. I try to normalize these things because they are, in effect, 'normal' in the sense as not attributable to bipolar/illness. Again, if you read about it, this is what you'll find.

I also point it out, because I worry about people thinking badly of themselves, pathologizing so much of their thinking, emotions, behavior to an illness -and I think it can end up being limiting, consigning to illness what is, at the end of the day, just who you are, as a unique human being, quite apart from the illness you have.

Obviously, I have no beef with sharing difficulties (and triumphs) not related to bipolar here, what concerns me is when these are sometimes in a kind of automatic way, attributed to bipolar.

So these are my thoughts on the matter, what say you guys?

[Travelinglady]

I didn't see what the other thread was about, but what you say makes sense to me. People can even feel depressed, I think, when something sad happens--and it not be caused by their bipolar disorder. Not all emotions or traits need to be attributed to it.

[manicminer]

Well made point there, ultramar.

And its one lesson I had to learn the hard way: not playing the "bipolar card." As in, not blaming my problems and actions on the disorder. Sure there is a chemical imbalance in the brain that ellicits itself in ways that produce different moods, but its how we react to and cope with those moods and impulses that is shown outwardly.

For example, a person with bipolar disorder might have the impulse to punch someone while in an agitated state. However, an impulse doesn't not throw your first. At some point you must make the conscious decision to launch the attack. So in that case and all other cases like it, "the bipolar made me do it" is not a valid excuse.

Just like when I was in the p-ER and asked the p-doc if I could have a doctor's slip to get out of my underage drinking violation since I now knew I had bp. He said, "Absolutely not. The bipolar may have contributed to the impulsiveness of what you did, but you made the decision to put the alcohol in your body that helped bring about the behavior."

I've also learned that many of my behaviors have absolutely nothing to do with the bipolar disorder, but come from the way I think. I think like the hurt child I was growing up, making me introverted, antisocial, afraid, paranoid, easily irratable and the like, which is a prime example of the citations you provided.

Thank you for the post. I'm a firm beleiver in "what is normal, and who came up with it?"

[comicgeek007]

I honestly have no idea what I'm like normally. I guess my "normal" is a bit depressed, but in the golden melancholy way.

My art teacher in high school said there were two kinds of melancholy: golden and black. Golden melancholy is where you're depressed, but just enough that it makes you want to DO something and express it in some way, like art. Black melancholy is where you can't be productive and end up expressing it in destructive, often self-destructive, ways.

[manicminer]

Originally Posted by comicgeek007

I honestly have no idea what I'm like normally. I guess my "normal" is a bit depressed, but in the golden melancholy way.

My art teacher in high school said there were two kinds of melancholy: golden and black. Golden melancholy is where you're depressed, but just enough that it makes you want to DO something and express it in some way, like art. Black melancholy is where you can't be productive and end up expressing it in destructive, often self-destructive, ways.

Never heard it put this way, but that makes perty good sense. Thanks for sharing.

I guess my depressive times fall into the black area (can't get out of bed or find motivation to do anything, drink myself into oblivion, make sui plots).

[BipolaRNurse]

Ultramar, you are spot on, and I'm glad you've stated your points in this new thread. They are educational and commonsense, and this is very helpful to 'newbies' like me who haven't yet got it all sorted out as to what is due to our illness and more importantly, what ISN'T. I'm sure there are those who actually prefer to use BP as an excuse for bad behavior or an attack of selfishness/stupidity; for myself, I can't wait for the time when I know the personal manifestations of my illness well enough not to freak out when things go sideways.

I've been diagnosed only a little over a year, and I still tend to get anxious when I react badly to some stressor.....it's like Chicken Little running around screaming "The sky is falling!!" when it's only a sprinkly rain-shower. Posts such as yours help reassure us less-experienced BPers that we aren't as crazy as we think, and that everything really isn't about the illness. Thank you.

[BlueInanna]

I like that gold & black melancholy analogy - makes much sense to me. Oftn my meanlancholy is golden like that, I get dreamy and everything is so sad yet beautifuyl. Where i'm feeling my feelings but have enough hope to hold on. i also get tha black one and thats the scary one. this is an interesting thread, thanks.

[comicgeek007]

Originally Posted by BlueInanna

I like that gold & black melancholy analogy - makes much sense to me. Oftn my meanlancholy is golden like that, I get dreamy and everything is so sad yet beautifuyl. Where i'm feeling my feelings but have enough hope to hold on. i also get tha black one and thats the scary one. this is an interesting thread, thanks.

Thanks.

I do get into a black melancholy a lot >_< I think I've gotten just clear of it though because I can write again.

[thumb]

Thank you Ultramar. That was great reading with morning coffee.

On to yoga....with apprehension, effort and determination!

lamictal 200
zoloft 200

[catsrhelm]

Hello, Ultramar. I define normal as in mood stabilization. However, it is only temporary, not permanant. Why? I still am bi-polar underneath it all and no medication is goof-proof. Medication still wears off. I still cycle between the depression and mania.

As for your other post, I didn't see it, and well, we are all human. Would you accept this free hug?

[Trippin2.0]

Thank you Ultramar, you say so much of what I think and yet none of it sounds *****y or snooty coming from you I always say that I refuse to attribute every nuance, every flaw to my dx because that takes away what little sense of power or control I have regarding bp. And I like control

I think I have moved from a week of black melancholy onto some golden melancholy... I prefer this one.

[emgreen]

In don't think I have much more to add that wasn't in your post, or that others have contributed...But I couldn't agree more. You couldn't have expressed your point more eloquently. Thanks.

[C.Oliver]

I guess I have trouble with this because I have no 'normal'. I am either hypomanic (and mine are ugly not happy) or various levels of depression from moderate to severe. I have NEVER had a normal day in my life. I guess I don't have any 'between' episodes to deal with...

Gosh this sounds like a 'poor me', sorry

C and Oliver (my Service Dog)

[emgreen]

At times I feel really self-conscious (paranoid?) about going out in public -- especially when I'm feeling clinically depressed. It almost feels like others can read my feelings, which makes me feel really anxious. When I get like this my therapist always points out that other people are too wrapped up in their own issues to notice me. In other words, they're wrapped up in their own depression, self-consciousness, anxiety...or merely their "normal" daily issues. This perspective helps me realize that what I may view as "abnormal" thinking patterns, for the most part are, to a significant degree, really "normal" parts of the human condition...

I don't know how closely this thought adheres to the point ultramar raises, but my therapist's words seem to touch on ultrasmar's definition of "normal." It's not always BP...It's the nature of the human condition.

[ultramar]

Originally Posted by catsrhelm

Hello, Ultramar. I define normal as in mood stabilization. However, it is only temporary, not permanant. Why? I still am bi-polar underneath it all and no medication is goof-proof. Medication still wears off. I still cycle between the depression and mania.

As for your other post, I didn't see it, and well, we are all human. Would you accept this free hug?

Yes, that hug is comforting! Thanks for sharing. I get the med thing. I completely agree that 'normal' is basically stable (with all of the challenges, sometimes huge ones, of every day life, some with more baggage than others), but it is, sadly, temporary, almost by definition -cyclical meaning that there's always that danger of cycling into something that what I think of 'sick.' As in, "I'm ill (at the moment)." It is, as Bipolar nurse pointed out, sometimes difficult to tell, when we're 'ill' and when it's something else going on.

[ultramar]

Originally Posted by C.Oliver

I guess I have trouble with this because I have no 'normal'. I am either hypomanic (and mine are ugly not happy) or various levels of depression from moderate to severe. I have NEVER had a normal day in my life. I guess I don't have any 'between' episodes to deal with...

Gosh this sounds like a 'poor me', sorry

C and Oliver (my Service Dog)

No, it doesn't sound 'poor me' at all. You have mentioned other issues/diagnoses and clearly have a lot of challenges between 'episodes,' a lot of different things going on. For years I had (and still do, to an extent) a horrific time just getting out of the house, which has affected my work, social life, everything. A tenuous grasp of safety, a nasty case of PTSD, some horrific things that happened when I lived in South America, amongst other things, that I may always struggle with in one way or another. I try to think in 'baby steps' -every little step forward I make, a triumph, small to some, huge to me. So... shall we take baby steps? I hope you can feel better, little by little, over time.

[ultramar]

Originally Posted by emgreen

At times I feel really self-conscious (paranoid?) about going out in public -- especially when I'm feeling clinically depressed. It almost feels like others can read my feelings, which makes me feel really anxious. When I get like this my therapist always points out that other people are too wrapped up in their own issues to notice me. In other words, they're wrapped up in their own depression, self-consciousness, anxiety...or merely their "normal" daily issues. This perspective helps me realize that what I may view as "abnormal" thinking patterns, for the most part are, to a significant degree, really "normal" parts of the human condition...

I don't know how closely this thought adheres to the point ultramar raises, but my therapist's words seem to touch on ultrasmar's definition of "normal." It's not always BP...It's the nature of the human condition.

Yes, and your anxiety is another challenge you have to cope with, something else to work on. Therapy has helped a lot with my anxiety, although it's taken a long time, and I still have a long way to go. Also, surprisingly (or not, I don't know) Seroquel has ended up helping me with it -the only positive 'side effect' I've had! Though I suppose anything that knocks you out with the sledgehammer Seroquel can me, may end up knocking out some fear in the process... Hugs to you.