Living Bipolar (3 page)

A few months passed, and in February or March I felt better. Suddenly I was working two jobs that my mom had gotten for me. Shortly after this I started drinking alcohol and doing drugs again. One of my jobs was working at a restaurant, and I drank every night at the bar after work.

After some months passed I was right back to where I was before with doing alcohol and drugs every day in order simply function. If I didn’t drink alcohol or use drugs I was unable to do anything, for my mood would prevent me from putting one foot in front of the other. I drank every night to help me sleep, and I smoked pot everyday to control my mood and to be able to function in my day to day life.

The following Fall I went back to college and my world began to change again. I don't remember much starting around November. My memory has gaps for the next four or five months. What I do recall is feeling like everything in my life connected once again. I was comfortable with both my jobs, and I was on top of the world. I was writing a lot of poetry, and I was calling everyone I knew to read them my artwork. I would spend hours on the phone conversing with friends and family members, and I thought everyone was proud of me and my grandiosity made me believe people thought highly of me. It was as if I was coming into my own and I was ready to conquer the world, moving on to do big and great things.

The events in my life are fragmented after December. I was still writing poetry and at the time I did not have a car so I had to walk several miles to go anywhere. It's hard to know how many miles I was walking each day but it was around five or six miles, because that’s how far my favorite bar was from my apartment, and that’s where I went every day. One day I definitely remember walking at least fifteen miles home from the bar where I had worked.

I became obsessed with religion. I would read the Bible and find strong connections in the texts with my life. It felt like the Bible was speaking to me, and the passages that I read in the Bible seemed to indicate to me that I was on Earth for a much higher purpose.

One day I thought I was in a conversation with God. I thought God told me that I was His Son Jesus coming back to earth to save people, and therefore, I began to believe I was the Second Coming of Christ. Since I had a big scar on my neck and shoulder from the car accident, I believed this was emblematic of the pain and suffering Christ endured on the cross.

One Sunday, I remember going to church and I became overwhelmed with emotion, and I kept saying to myself, “I'm not ready for the responsibility of being the Second Coming of Christ.”

Sometime after this I went to my former high school one day and the police arrested me. Because in my mind I had done nothing wrong I thought I was being persecuted and this was further proof that I was the Second Coming of Christ. When I was being arrested the police asked me if I knew why I was being arrested, and I said no. They asked me if I knew someone named John, and I said yes, John is a bartender at my favorite bar.

Later I found out that I threatened to kill my best friend John, and there was a warrant issued for my arrest, and that’s why the police were after me. However, I never harmed him physically, nor did I even touch or threaten him in person.

Apparently I left a gruesome voicemail on his phone, and to this day I have no idea what I said, and I have almost no memory of it happening. To put this event in perspective it should be explained that John has been my best friend since I was a child of the age of three or four. We went to school together from kindergarten until the sixth grade, and we lived in the same neighborhood. We always spent the summers together as kids. (Later in the chapter
A Friend’s Perspective
John gives his own experience of being friends with someone who is Bipolar).

While I was in jail my mom told me my uncle, a neurosurgeon, thought that I was Bipolar, and this explained why I was acting the way I was. While my uncle is not a psychiatrist, he suggested that I be evaluated by a professional. I felt relieved at the notion that I was Bipolar, and that I could get better with medicine, but later I loathed this diagnosis. I did not want to be labeled Bipolar, because I did not want to be crazy.

THE ROAD TO RECOVERY

After jail I went to a dual diagnosis treatment center in South Florida to begin the recovery process. I felt amazing when I arrived in Florida, and every morning I woke up early and ran. My grandiosity told me I was going to show the other people in treatment how great I was, and I was going to lead them in the recovery process.

However, after being on top of the world for the first week in treatment, I crashed into a depression. I remember crying the majority of the time and all I wanted to do was sleep. I had no comprehension of the verbiage the others in treatment were using. Not only did I not want to accept that I was an alcoholic and a drug addict…I did not want to accept I was Bipolar! The idea of being labeled crazy and having to take medications for the rest of my life was overwhelming for me.

TIPS ON COPING WITH THE BIPOLAR DIAGNOSIS

C
oming to terms with having the (bipolar) disorder may mean admitting to a new role for yourself in your family, in the workforce, or in your personal relationships. It may require you to make some decisions about restructuring your life and priorities, which may mean viewing yourself differently…

WHAT IS THE BEST WAY FOR ME TO THINK ABOUT THE ILLNESS?

1.Bipolar disorder is not a life sentence.

2.Many creative, productive people have lived with this illness.

3.Try to maintain a healthy sense of who you are and think about how your personality strengths can be drawn on in dealing with the illness.

4.The way you feel right now is not necessarily the way you will feel in three months, six months or a year.

5.There are things you can do in addition to taking medications to control the cycling or you mood states.

-Miklowitz 2002: 54, 67-68

I didn't know how to live without using drugs and alcohol, and the idea of living without using substances was a concept I would not subscribe to. Just being in treatment was hard to do. The medications prescribed to me only seemed to make me tired and I thrived off energy. I believed the medications took away who I was as a person and that made me depressed.

It is very important to understand that the Bipolar illness could not have been treated until I was sober from drugs and alcohol. Medications for the Bipolar illness cannot work if you are using substances. Once, however, I got sober the Bipolar illness could be treated, and I could take action in recovery for the Bipolar illness.

Eventually things got easier. After I left treatment I remained sober, and I got a job where I was successful. After a year at the job I moved my way into management, and my life was going well.

After being sober for two years my life and mood became unstable and I couldn't handle anything with myself or with other people. I had thoughts of suicide every day, and I was paranoid beyond belief. I constantly had visions in my mind of everything in my life falling apart. It felt like my world was coming to an end. To give you some examples of the paranoia I experienced, every time I went to get money out of the ATM I honestly was scared that all the money in my checking account was going to be gone. Also, I was fearful that I was going to lose my job at any moment and I believed other people were out to get me. And when I got a phone call from a number I didn't know, or when I checked the mail, I was scared that something bad had happened. Anxiety and fear of other people ruled my life and my emotions.

PSYCHIATRIC COMORBIDITY

The most common psychiatric comorbidities are substance related, anxiety, personality, and eating disorders…Illness prevalence and comorbidity with Bipolar disorder are:

1. Substance Use/Abuse -- 44 to 61 percent

2. Anxiety Disorders -- 24 to 42 percent.

3. Personality Disorders -- 30 percent general prevalence (comorbidity is debated due to symptom overlap)

4. Eating Disorders -- 0.5 percent to 3 percent

-Keck and Suppes 2005: 5-14

Paranoia in my life lasted for years. But I never realized any of this paranoid thinking was abnormal, so I never discussed it with my doctor. I thought if I worked harder on myself I could combat my negative thinking. As a result of my thinking I believed I was defective as a person. For two or three years I had suicidal thoughts on a consistent basis, but I was scared to share this fact with my doctor because I thought I would be committed.

However, it’s extremely important to understand that I was never
suicidal,
and I never had a plan of killing myself
.

For me, I was ashamed of talking about the suicidal thoughts. I believed I had the thoughts because of what happened in my past from being sexual abused as a child and from the brain injury. I never made the connection to the thoughts being a part of the Bipolar illness. I would beat myself up every day telling myself I was inferior, and inadequate, compared to others because of the suicidal thoughts. I believed myself to be broken and if anyone found out the truth about who I was they wouldn't like me. These thoughts lead me to not sharing them with anyone, and I kept most of how I was feeling to myself. Today I’ve learned that keeping thoughts and feelings bottled up inside is extremely ruinous to my health and mental and emotional state.

SUICIDE AND HOMICIDE RISK

Patients with Bipolar disorder have 10 to 15 percent lifetime suicide rates. Every patient who may have Bipolar disorder or describes depressive symptoms should be asked about suicidal ideation, plans or preparations for suicide, and intent to act on those plans. They should also be asked about access to medications or firearms that may be used to commit suicide. In most instances, suicide attempts are associated with depressive manifestations, either during a major depressive or mixed episode.

While homicidal behavior uncommon, clinicians should also query a patient as to aggressive impulses towards others. A past history of aggressive behavior or legal difficulties as well as aggressive behavior associated with alcohol or other substance used should be explored.

-Keck and Suppes 2005: 4-19 and 20

FAMILY HISTORY

I have often thought about the potential impact of passing the Bipolar illness on to a child. If I have a genetic predisposition for the illness I do not want to have kids, as I would not wish this illness upon anyone. Therefore, I have researched my family history to learn if anyone in my family has ever had the illness. In my family history, there is no one known on my mom or dad’s side who had the Bipolar illness. I was told by a neurologist that the brain injury caused the Bipolar illness. In fact, my therapist’s sister was in a car accident, and suffered head trauma, and as a result her sister developed the Bipolar illness.

Past history of head injury should always be part of a medical assessment for the possibility of Bipolar disorder because head injury in and of itself can be either a causal or an aggravating factor for bipolar symptoms. Given that many untreated patients with Bipolar disorder have low impulse control and a tendency to engage in risky behavior, the possibility for head injury becomes particularly pertinent.

-Keck and Suppes 2005: 4-17

TRIGGERS

Triggers with my mood have been difficult to identify, but through journaling my moods I have been able to notice patterns. For example, lack of sleep is one of my main triggers, because when I don’t get enough sleep I am more likely to get into a negative mood. Most of the medications I take are at night, and most of the medications I take make me tired. Therefore, if I don’t get enough sleep I am more tired the following day and more likely to get in bad a mood.

Almost any stressful situation can trigger my mood, whether it’s financial, with relationships, or with work. A bad day at work can seemingly push me over the edge, therefore, I work on taking small breaks, focus on my breathing, not taking things personally and keeping things in perspective.

A change in the seasons definitely affects my mood. In the Fall and Winter I get more depressed, and in the Spring I am more manic. Criticism by others can trigger me and send me into a tailspin. I am sensitive and at times I can take things personally, and if someone criticizes me it can send me into depression or anger. When I am in a relationship and I have a fight with the other person; it can either get me down or send me into mania. Also, being around negative people definitely has an effect on me. A negative person seems to drain my emotions.

What I’ve learned is that triggers get me stuck in my head, and when I am in my head I am in my own way of moving forward and being happy. Triggers cause me to become obsessed with the problem, and when I am obsessed with the problem I project negatively, worry, I’m anxious and paranoid, and I have the tendency of falling apart, which then causes me to get down, angry, and feeling hopeless and helpless.

Some medications have caused me to gain weight, and gaining weight and eating poorly can trigger my mood to where I get down and depressed. When I started to take Zyprexa I began to eat everything in sight, and I put on 25 pounds. Additionally, some of my night medications cause me to wake up and eat a lot of food at night. But through changing my diet I have lost all the weight I gained. I learned to eat smaller portions and healthy food.

Knowing what triggers my mood has afforded me the opportunity to avoid stressful situations. Or if I find myself in a situation which triggers my mood, I work on keeping things in perspective and realize that I don’t have to get worked up in emotion and I work on slowing myself down mentally. But even being aware of what triggers me, does not mean that I don’t get triggered.

Today I strive for consistency and routine. I struggle with depression more than anything else. I fall into depressions periodically throughout the year, and when I am depressed I lose sight of everything good in my life. But in changing how I live I have found that depression in my life today does not last as long as it as in the past. When I am depressed I work on being good to myself, and I take action in my recovery any way possible. I have learned that if I can push myself to exercise, or talk to other people, journal, mediate, or take a nap, it helps me with my mood. Taking a nap sometimes is the best thing for me, and sleeping can help to break my mood.