Reflection on Bipolar Disorder

About The Author: The author is a member of a Unitarian Universalist (UU) congregation reflects on living with bipolar disorder.

I have chosen to share my experience in a safe place—a place of acceptance, a place where we share joys and sorrows. Some might say, “Some things shouldn't be talked about.” But keeping mental illness a secret perpetuates stigma.

I have manic depressive disorder, known clinically as bipolar disorder. I have the illness but it does not define me. I am an active member of this community, have many friends, participate in a long-term relationship, and function in the work world.

So, how has having this illness impacted my life? Certainly there have been extremely difficult times, in fact awful times. I have had profound depressions. I have felt existential, or cosmic, loneliness. But, especially when emerging from depression, I have felt the love of my husband, my family, and my friends.

As the poet Rainer Maria Rilke writes, “At bottom, and just in the deepest and most important things, we are unutterably alone…” But he goes on to express the feeling that emerges as I recover from a depressive episode. And I quote, “Think of the world you carry within you. What goes on in your innermost being is worthy of your whole love.” I would add, and worthy of the love of those around you.

I have also experienced episodes of extremely elevated mood, of extreme mania. Contrary to what you might think, extreme mania is not “fun” or productive. In fact it is a separation from reality. Thankfully I do not remember many of my thoughts during manic episodes. I do know that, contrary to the stereotype, I did not run up credit card debts or make disastrous financial decisions.

Manic depression is a biochemical disorder. Many scientists are conducting research which explores the presence of the genes which are involved in the inheritance of the disorder. Manic depression responds to medication. However it is easier to prevent manic episodes than it is to prevent or treat depressive episodes.

Bipolar disorder is not a result of how your mother brought you up; it is not anger turned inward. It is a sensitivity of the nervous system. It does engender anger in the person coping with it, anger at the need to cope with what at times seem like unfair challenges. Mood changes may result from stress, as the vulnerable part of the person's makeup is challenged.

So, how does one cope with this illness? Having a diagnosis helps. I can accept the fact that mood swings will be a part of my life, knowing that periods of stability will also occur. I often think of putting one foot in front of the other, an analogy which I can relate to the experience of backpacking. When backpacking in the Maine wilderness, there were many times when I concentrated on one step at a time. So why did I go backpacking? Good question! The experience of being self-sufficient and of experiencing the wilderness, including seeing moose and loons, listening to the stillness, and feeling the connection to the natural world made it worthwhile. It was worth the sore shoulders and tired feet.

Circadian rhythms are involved in mood swings. I need to get adequate sleep. Adjustment to time changes, including changes across time zones, are more difficult for me. I must take my medications, exercise regularly, and work closely with my psychopharmacologist. The tradeoffs can be compared to those required of a diabetic who needs a regular schedule of eating, exercise and insulin. I believe the difference relates to the fact that in my case the mental processes needed to cope are affected. At times I must accept the perspective of my doctor and of my husband.

I am resilient. Webster's defines resilience as “an ability to recover from or adjust to misfortune or change.” I can't say it has been easy, but I am grateful that through hard work, “luck”, and the love of friends and family, I have achieved resilience. I have been blessed with intelligence, good sense, humor, and persistence.

The medications available today make the journey possible. Lithium is the classic medication. Anticonvulsants, benzodiazepines, antipsychotic medications (known as neuroleptics), and anti-depressants are all part of possible regimens of prescribed medications. The side effects of these medications, such as weight gain and sedation, are difficult to live with, but the alternative of uncontrolled mood swings is far worse.

I believe that it is important to “come out” about this problem. As I reveal my challenges I allow others to realize what so called “mental illness” involves. I hope awareness that people with such problems are everywhere will wake other people up to the hurtful comments and assumptions made. You may remember when Thomas Eagleton was forced to withdraw from his candidacy for Vice President due to the revelation of his history of depression. You can think of other examples.

The passage in Massachusetts of legislation requiring “parity” in health insurance benefits has helped make necessary treatment more accessible. Parity means that the same health insurance benefits available to those with a medical or surgical illness must be made available to those with a biochemical mental disorder. Things are gradually changing.

In closing, I quote Katherine Hepburn in the film, “On Golden Pond.” She points out the universality of the challenges each person faces. You may remember her statement, “Sometimes you just have to look at someone and realize he is doing the best he can — he's trying to find his way just like you are.” Indeed, each of us, woman and man, is doing the best we can with the capacities and talents given us. We are all in this together.