Bitching @ Bipolar

The good parts of mania are so, so good. Sometimes it’s like MDMA, sometimes coke. Love swells and fills your heart and then stretches its fingers to strum songs on your ribcage. Colours are more saturated, everything is … well, as Kurt Vonnegut said …

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Yes, the dark side of mania is scary, dangerous, ridiculous and so no, it’s not worth hanging on to.

Still.

When/if it goes away for a long time, I will miss it. I always thought it was the universe paying a karmic debt, giving me all that love and shiny constellations and laughter. I’m damn glad I relished those good bits while they were good. I wouldn’t miss the bad bits at all, obviously. And the rest of it (depression and mixed episodes) can leave any time they like. The absolute pain … I don’t actually know how to describe it to anyone who hasn’t felt it.

Too often, we’ve been guilty of conceptualizing bipolar disorder only from the neck up. This is clearly a brain and body disorder.

This thing, this neurobiological, neurotoxic fuckup that some people blithely say shouldn’t be medicated, presents in so many sizes and shapes that it’s not possible to just wave a wand and cure it. I don’t know what works for less severe bipolar, because mine is apparently very severe, but nobody can convince me that a dab of essential oils on my neck will fix it all. The only natural treatment for bipolar that works (for some) is lithium.

I’d rather be realistic than float about with blinkers on. Bipolar shrinks your hippocampus, causes increased cortisol … the consequences can be quite hectic. And beyond brain damage, heart disease etc, there is always the bipolar depression that occurs in more cycles than MDD and the suicidality that grabs you by the jugular and doesn’t let go, no matter how long it has to wait. And if you don’t kill yourself, you have a shorter life span, heart disease and earlier onset of general geriatric decay to look forward to anyway. And more. I have to take the mofo seriously, it has already fucked up a lot of my life. But that’s what you get with a late diagnosis.

My own clinical experience has been very clear that the more episodes they have, the more cognitive impairment they have and the more difficult it is for them to get back to work and fulfill their roles and responsibilities.

(Source link further down)

Yes, I know that today is the first day of my life and so on … but sometimes I need a break from looking on the bright side (lol) and acting stoic. Sometimes I want to howl and bellow at … who? What? There isn’t even something to yell at.

Don’t comfort me, mkay? I promise I still know how fortunate I am. If you made it this far, tyvm for doing so. I feel better for it. Scroll for more from the transcript I’ve been quoting.

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More excerpts from: The Evolving Understanding of Bipolar Depression Neurobiology and the Relation to Diagnosis (Roger S. McIntyre, MD, FRCPC)

… people with bipolar depression more often present with so-called atypical depression. That is, they have hyperphagia, hypersomnia, and so-called leaden paralysis — a significant terrible fatigue particularly accentuated in the winter, but not always. These individuals who have bipolar disorder very often report an early age of onset, often before 25 years of age; in fact, very often before 20 years of age.

The lion’s share, however, of individuals who have bipolar disorder do not in fact present with severe mania. They often present with an admixture of subsyndromal depressive symptoms as well as hypomanic symptoms. In fact, longitudinally the most common presentation is this composite of depressive and hypomanic symptoms, which often is mislabeled as anxious depression or agitated depression;

Now, in the brain there is white matter and gray matter, and there is reduction in cell counts seen in both, with more replicated evidence, frankly, in loss of white matter.[16] So in other words, bipolar could be conceptualized as a white matter disease. And we also see a loss of what’s called neuropil, which is what I refer to as the connective tissue within the brain. Taken together, this loss of brain tissue may be more likely observed in those with more progressive illness. Speaking to the neurotoxicity of bipolar disorder, this is not only a disquieting observation, but it’s also really alerted us that at the brain level something’s changing. This may subserve the phenomenology we see, — the more recalcitrant bipolar over time, as well as observations of patients who may not be responding as well to the treatment after 10 or 15 episodes compared to those who’ve had 1 or 2 episodes.

We as clinicians, and the literature certainly supports what we’ve observed, have noticed that many patients with bipolar disorder pursue what appears to be a progressive course. In other words, episodes become more frequent over time, and become longer in duration. The well intervals become shorter and shorter, and the symptoms become more severe. As I was saying moments ago, patients often complain of, or evince cognitive deficits. And the treatment interventions, whether pharmacotherapy, psychosocial interventions, and maybe even neuromodulator treatments such as electroconvulsive therapy (ECT), may not be as robust after 15 or 20 episodes when compared to the first 2 or 3 episodes.

Bipolar exists above and below the neck, and in fact, it is the metabolic complications of bipolar disorder, in part related to medicine and in part to biology and other factors, that leads to not only a decreased likelihood of recovery and a more unfavorable course of illness, but also accelerates premature mortality, with heart disease the most common cause of mortality in this population.

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blahpolar

battlescarred, bright, bewildered, bent, blue & bipolar

25 thoughts on “Bitching @ Bipolar”

    1. I know exactly what you mean, the internet definitely needs dislike buttons :) and thanks and I’m sorry if I messed up your mood. It’s positive to read that most people with bipolar don’t have it severely.

      Liked by 2 people

      1. Right now I don’t have it too badly or should I say I haven’t been symptomatic too much for the last couple of years. That has been thanks to tweaking meds w/ my Dr. almost the instant I do (get symptomatic). I know exactly how blessed I am for this – because I do know how bad it can be/has been for me. Annnyway. Big hugs, wish they were in person. Have I said that to you already?

        Liked by 2 people

  1. So, what they’re saying is, there’s a physicality to the brain difference in patients with bipolar? If this is true, why can’t they use this information as a diagnostic tool rather than spending ten fecking years waiting to witness the right balance of mania vs depression?!

    Liked by 1 person

  2. All I can say is that it ain’t easy being a lithium poppin’ bipolar bitch! I have the severe kind…at least I have some bright spots in my day such as this blog!

    Liked by 1 person

  3. Yes, there are structural differences in the brains of those with bipolar disorder, but to use brain scans for diagnostic purposes is now too expensive and requires being off medication, as proper medication corrects deficits. A scan of a brain with bipolar disorder that is properly treated and that is treatment responsive looks much like a healthy brain. You want to go off meds to see how f*cked up your brain is? I won’t take the risk. Going off meds is a really bad idea in my opinion.

    Holiday wishes for all to be laid, I mean loved (and laid), over the holiday season.

    Liked by 2 people

  4. I really appreciate this, especially as a fellow-bipolar. I specifically appreciate how you remembered that this is certainly for some, not all, as I try to keep that in mind as well. Generalized statements surely have no place in the bipolar community.

    Something that I have always noticed in my bipolar: sometimes it’s so severe it needs to be medicated, other times without any medication it is manageable under organic remedies. I strive to keep myself at organic level, since that is how I lead my life, but I cannot let myself deteriorate nor put others at risk if and when I indeed need something stronger.

    Like

      1. I primarily use passion flower pills, which naturally millifies me. I don’t take them all the time, but frequently throughout the school semester and especially before and on test days. Basically, if I know I’m about to do something that could possibly throw me overboard, I take one. However, even at the beginning of a manic moment or during, I can still take one or two (usually two at that point) and let it stop me before something truly bad happens.

        Also, I daily soak in eucalyptus, or sometimes I just put it in hot water in a mug and sniff it. Smelling eucalyptus puts me in a euphoric state, although it is not very practical.

        Finally, incense and burning cigars throughout the house just outright makes me feel content and often sleepy.

        For some people, chnaging to an organic diet can help. I say it helps, but it certainly doesn’t cure or completely prevent anything. It’s all a lot of work, which viewing it as such can be extremely counter-productive, but I find ways to enjoy it all and look forward to it. I like to stay away from medications because they either don’t work, or they set me off in other ways (long-ago experience, so a lot may have changed in me and in the medicine world). I certainly don’t discriminate against medication, and I promote it for those who certainly need it, but I always feel like it’s something not for me. I could be wrong; we’ll see how my bipolar reacts over time.

        Liked by 1 person

            1. I appreciate it fuckloads – my comments are generally too brief, I sorta use up the energy in blogging. When I’m down I go quiet. So I definitely appreciate your novels :)

              Liked by 1 person

  5. You hit the nail on the head again, my friend.
    And……don’t tell anyone……being stoic isn’t always what its cracked up to be ;)

    Like

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