If you care for someone with Bipolar Disorder, know the basics about the illness and side effects. You’ll learn as you go. It’s important that you don’t keep asking how they’re doing; that will stress them out. You will have to up your game to catch the nuances of body language and conversations.
Different types of Bipolar Disorder.
There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, irritable, or energized behavior (known as manic episodes) to very “down,” sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.
Bipolar I disorder is defined by manic episodes that last for at least 7 days (nearly every day for most of the day) or by manic symptoms that are so severe that the person needs immediate medical care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) are also possible. Experiencing four or more episodes of mania or depression within 1 year is called “rapid cycling.”
Bipolar II disorder is defined by a pattern of depressive episodes and hypomanic episodes. The hypomanic episodes are less severe than the manic episodes in bipolar I disorder.
Cyclothymic disorder (also called cyclothymia) is defined by recurring hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.
Until the doctor gets the medication balanced, you might have to take a medication for a month or longer to see if it works; if not, the doctor tries another. Changes in medication will continue until the Psychiatrist finds the right mix of medication. I went through many drugs in the beginning because I’m treatment-resistant, which means many medications do not work on me. It’s important to note that over time, medication can stop working, and the Psychiatrist has to find another medication. I’m currently taking a cocktail of 6 different medications.
In the 32 years since I was diagnosed, I’ve experienced rapid cycling, mixed features, hypomania, and depression. The most difficult for me to manage is rapid cycling. One minute you feel great, and 15 minutes later depressed. This is a very unstable time. Make sure you let your Psychiatrist know about your rapid cycling.
If possible, find a Psychopharmacologist over a Psychiatrist if you can find one. The difference is that a Psychopharmacologist spends extra years of education focusing on how medication and the brain work. It can be difficult to find one.
I thought my doctor didn’t like me for a long time. Over time, I learned how to talk to him, and now he’s like family. You don’t have to like your doctor if they listen and share details about the drugs and answers to your questions, and you trust them, keep them as your doctor.
Personal Experience
The backstory starts with the DEA, which is limiting the amount of medication each pharmacy receives each month. This is an experience I have been dealing with for the past year. This month, my pharmacy only had 25 pills, and I had to wait 3 weeks for a refill because they had not received a shipment. Pharmacies are NOT making these rules. Get to know your pharmacist; they may be able to help you through this crisis. Don’t take your anger out on the Pharmacy. Until the DEA backs off, this problem will continue.
Here’s one of the challenges I face. One medication is what I call my anchor medication. This past month, it took 3 weeks to get my medication in stock. In those 3 weeks without the medication, it is no longer in your system. After going three weeks without the medication, my body has to start over. So far, I have not been able to see if it works because I can’t take the medication long enough to work.
My new Psychiatrist is cutting my Xanax to 3 per day, not the 4 per day that I have been taking for so long. The bottom line is I’m in withdrawal as my body adjusts to only 3 a day. You stack that on top of the problems with refills; it’s frustrating. This means my anxiety is higher during certain hours when I don’t take my Xanax. It’s a very addictive medication, and one of the worst withdrawals I’ve been through.
It’s important to have someone that you can reach out to if you need help.
This happened two evenings ago due to my anxiety being very high. To better communicate, you can say certain words to help them understand where you are at and when you are falling into depression or higher than a kite.
I was so truly happy, and I haven’t been happy in so long. I was soaking in every moment because my mood could change. Feeling joy in my heart felt so good, and I didn’t want it to end.
My husband said I was jacked up, and I said I knew. The key word here is I KNOW. For me, that means I know and am keeping tabs on your mood. If it’s a problem after that, I’ll let you know.
I went upstairs to get ready for bed, and when he came into the room, I continued the conversation in a combative way. I was jacked and angry, raising my voice much higher and even pointing my finger at him. I could not believe what was coming out of my mouth and my behavior. In the last 22 years, we’ve had a handful of fights.
We have established words to use when my mood changes and is concerning. When he tells me I’m jacked up, the keyword is I KNOW, which means I’m keeping an eye on it. When I’m feeling suicidal, I let him know. This is how we communicate about my Bipolar Disorder when he observes a behavior change.
If you are newly diagnosed, be patient. When you start the journey, it can be rough and frustrating.
Don’t obsess over your new diagnosis; learn the basics of your illness and symptoms for now. The most important thing I can say is to only read about your illness or symptoms of Bipolar Disorder from trustworthy websites. When you read anything else, you risk getting the wrong information. It’s critical to read a respected source. Right now is not the time to read the wrong information. On my website, there is a pull-down menu called Organizations That Can Help. There, you can find resources under Mental Illness. In the beginning, you may feel overloaded; remember this is a long journey.
https://www.nimh.nih.gov/health/topics/bipolar-disorder
Melinda
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Hi Melinda,
I came across this, as someone diagnosed with bipolar disorder in the last year, I want to learn as much as I can. I find comfort knowing that there are others who experience the same struggles, with medications, with relationships and such. I look forward to reading more of your blog posts as I see this one is from last year. Keep sharing your truth. You never know who you will inspire.
Ella
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So glad you stopped by. I know how hard it is in the beginning, finding the right meds, dealing with side effects and determining which med is not working if you take more than one. There are many post in the archives on bipolar, depression, suicide and surviving. What has the first year been like for you? I’m here if you have a question. :)
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Thank you. Maintaining relationships has been hard. Friends I opened up to about my diagnosis, those I thought would stick around, didn’t. My marriage is upside down. I’m coming up to the anniversary next month. Any tips you have on getting through a hurdle like one approaching is greatly appreciated. Thank you.
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Knowing that the upcoming reminder will be extra hard. Plan something to go to with your friends and/or family. Go do something that will create a good memory. You may want to spend some time remembering your marriage, and focus on the future. I’ll be thinking of you. My father died in 1992, it takes what it takes to grief. Have a great day.
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Thank you for sharing your personal experience with bipolar disorder. It is both informative and inspiring. I especially appreciate your advice on communication. It is so important to have a support system of people who understand your condition and can help you to communicate your needs. I also appreciate your reminder to be patient and to only read information from trusted sources.
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Bipolar is a serious mental illness and requires putting in effort to keep yourself level. Thank you so much for the feedback. Thank you for sharing your feedback, that helps me know what stood out. You are the best, thank you so much for providing me with great feedback and visiting often. :)
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You are welcome
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I was unable to find more information on your background. I knew it but with my memory problems, things go straight out of the window. :)
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I am a graduate in Psychology and doing my masters currently.
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I knew you were educated in that area.
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I was diagnosed with Bipolar 2 earlier this year.
I had been on Quetiapine for 9 years…and I tried to come off the medication, went insane, couldn’t sleep, and was constantly singing songs.
I ended up back on the Quetiapine (100mg) and the new diagnosis.
I’m OK with it. G.
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Are you on Lithium? For many people with Bipolar Disorder, like me, the medication protocol starts with Lithium and then builds from there. If you are not stable overall talk to your doctor about Lithium. The most important thing about Lithium is it’s a salt and can damage your kidneys over time. Also, you have to be aware of your hands, if they start shaking too much or you taste metal, the doctor needs to run labs to make sure there is not too much in your system. I’ve been on it for 32 years and now take the lowest dose. Bipolar 2 is a challenge because you can get too high very fast and Hypomanic/Manic feels so good it lures you to stay unbalanced because feeling on top of the world and smarter makes you not want to end the high. It’s a very bad place to be when it feels so good. :)
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No lithium, just Quetiapine
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What type of medication is that?
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Antipsychotic medication
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Here’s the main thing outside of the side effects, you have to be aware of Tardive Dyskinesia. I took Antipsychotic meds for 30 years and can’t take them anymore because of the Tardive. There is no time frame in which you might get Tardive, it could be 6 months or 30 years. My Tardive is in my mouth and my tongue moves around all my teeth and gums all the time. There are other places you can get it like in the hands, and a few I forgot. Just read about Tradive so you recognize the symptoms when they start. Take care. :)
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OMG. That’s very scary. Thanks.
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It will drive you crazy! I’ve had it for a year and even taking medication didn’t stop it. I would talk with your doctor about it.
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