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Absolutely Everything You Need To Know About Bipolar Disorder

Or, 'The Reasoning Behind Carrie Mathison from Homeland's Cry Face'.

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Bipolar disorder is a mental illness...

As defined in The Big Book of Mental (also known as the DSM-V). Bipolar disorder, bipolar affective disorder, and manic depression all basically mean the same thing.

...but don't worry, 1 in 4 of us will be affected by mental illness.

Mental illness still carries a lot of stigma attached to it, which sucks. People are worried about how they will be perceived, whether they will be fired from their jobs, or what their friends might think. It can still be awkward to talk about mental health.

Bipolar is an illness based on extremes of mood.

Just to be difficult, there are four variations: bipolar I, bipolar II, cyclothymia and rapid-cycling. Learn about the differences in depth here.

Despite what the media might say, these shifts in mood don't tend to happen extremely quickly.

Episodes of mood tend to last from a minimum of a few days to several months.

Bipolar disorder is characterised by a 'high' mood...

....which is known as mania or a manic episode. A less elevated version of this is called hypomania.

...and a 'low' mood...

...a.k.a depression, or a depressive episode.

However, sometimes mania and depression combine...

...this is medically known as a mixed episode. Although personally I prefer the term 'absolute emotional shitstorm'.

The manic mood can make you feel incredibly happy.

You can be filled with abundant confidence.

YOU ARE BEYONCE.

You might suddenly be super-productive and have lots of ideas.

You'll probably think these ideas are completely brilliant.

Which in doctor-speak is called delusions of grandeur. (Doctors are all French).

You might also be of the opinion that you are mega hot.

Who wouldn't wanna. GET. WITH. THIS?

And the likelihood is, you're not needing a lot of sleep.

You just want to stay up and have fun. All night. You take personal offence if people want to go home.

Your friends will try to reason with you.

But you won't listen.

A manic mood can also encompass supreme boredom.

Because everybody else is boring and nobody can keep up with your racing thoughts, ideas, and general zest for life a.k.a, annoyingly fast speech patterns.

You may well make bad decisions.

And say inappropriate things.

At this point people will be like, ARE YOU ACTUALLY FOR REAL?

But you're unrepentant and oblivious to rationality.

During a manic or hypomanic phase you are a whir of activity and ideas, creativity and charm. Mania can be frustrating too, because it is easy to get angry and irritable, but it feels like life is essentially on your side and nobody is gonna stand in your way.

But then, your mood drops.

Now you start to feel HELLA embarrassed and remorseful.

While manic, you might have done things you weren't proud of.

For instance.

You will look back on your behaviour, and be mortified.

Depending on the level of mania, you may well have been fired after having hit on your boss, got in trouble with the law after running from car roof to car roof, offended friends and family. Oh, you know, all fun stuff like that.

Now, depression kicks in.

You'll start crying all the time. Everywhere.

There is no place you will not cry.

You won't care about anything, not work.

Not socialising.

Not sex.

Not washing.

For real, depression does not care for personal hygiene.

In fact, the only thing you can do is sleep...

...sometimes for 20 hours of the day. Which means you pretty much can't function or live – so you can imagine what that means for work, relationships and friendships. The unemployment rate for chronic mental health conditions, including bipolar disorder, is close to 90%.

You will probably think you're the worst person in the world.

And you're convinced everyone hates you.

So you're feeling all defensive and alone.

Which, in a normal state of mind, you realise is incredibly self-absorbed. But you are not in a normal state of mind. You don't believe that you're worthless, you absolutely know it.

Or you will feel nothing. Just empty.

You try really, really hard to act like everything is ok, seriously.

But that's exhausting, so eventually you will hide yourself away.

You will literally ignore all forms of communication. Shout out to all of my lovely friends whose texts / voicemails / carrier pigeons I have ignored because I have been too mired in depression hell and didn't feel worthy of their attention.

People will say nice stuff, and even though you know they mean well, you will want to kill them.

Or some people might be less sympathetic.

In fact, you'll probably tell yourself that no-one really cares.

And even if you know they do, they are powerless to help. For you are in a black fog.

Basically, get used to spending a lot of time in a lot of mental pain.

Depression is absolutely horrific, just in case you were still in any doubt.

Sometimes, strangely, the manic and depressive symptoms merge in a 'mixed episode'.

This is horrid, and often takes the energy levels of the manic episode and merges it with the general thought process of the depression.

Which means you might get angry really quickly, and for no apparent reason.

Or you could get irritated by things that would never normally irritate you.

You have no idea why these emotions are suddenly jumping out at you, all you know is you cannot control them.

You may feel that you are going crazy with all of the contrasting thoughts and feelings in your head.

That's because you pretty much are going crazy. Sorry.

A mixed state is the most dangerous episode of bipolar.

1 in 5 people with the illness take their own lives. 1 in 5 people. Suicidal ideation is a key symptom of depression, but often people literally do not have the energy to harm themselves. In a mixed episode, the negative thoughts are still there, but also coupled with the energy to carry out any such plan. Vigilance is imperative. Here is a list of some UK and international helpline numbers.

Recovery from either a manic, depressive or mixed episode can be a slow process.

First of all, try not to be embarrassed.

One of the worst things about bipolarity is you can have very little control, and the illness is cyclical. So when an episode of mania or depression hits, it can be extremely embarrassing or disappointing and most of all, scary as hell, to realise it is happening all over again. Try not to beat yourself up – it is not your fault! It's a pain to have to pick yourself up again, but you can.

Find a brilliant doctor, one who you really trust and knows you well.

Remember that you have an illness, and it does not define you.

Sometimes, particularly when I am at my worst, I convince myself bipolar is a made up construct and that actually I am just a f*ck up. Then I look at the completely irrational but cyclical jumps in mood that happen in my life. Your brain chemistry is screwed, but that was never your choice. I've written about trying to accept this here.

Medication for most people is extremely important. But it's not a simple process finding the right one(s).

It can take a looong time to get the right combination and dose of medication that works well for you, unless you are very lucky. This is a very laborious and frustrating process. I have been through a lot of drugs, but hitting on the right combination genuinely saved my life. Keep at it. It's like wading through a selection box of chocolates without the menu.

Learn to live with your medication, and TAKE IT if it is working.

A lot of people with bipolar tend to stop taking their medication when they begin to feel relatively stable. This can be because people do not like the idea of taking medication, or because of the side effects, or because they simply feel they no longer need it. Stopping taking medication is referred to as 'non-compliance'. Taking meds is annoying, and expensive, but hey, if it keeps you stable, it is worth it. Read about some of the options here.

Exercise can help naturally boost endorphins.

And it might be best to make some lifestyle changes.

I love vodka. And sauvignon blanc. But I have to try and keep both in check because I know that alcohol is a depressant. Annoying.

It helps to have a wonderful support network.

I could not have lived with bipolar if it wasn't for my family, friends and now, work. XOXO etc.

Educating yourself about the illness and how you will deal with it...

...will ideally mean you get much better at catching it out.

Over time, and with enough empirical experience and reading, you hopefully begin to recognise an episode coming on, or at least try to have a better idea.

Getting on the road to stability is the best feeling in the world!

There is no better feeling than pulling out of a depression or mixed state and feeling genuine happiness again, or alternatively, knowing that you have grasped some semblance of rational thought and are no longer making a fool of yourself during a manic phase. Equilibrium is sweet.

You don't need people in your life who judge you for the illness.

You are not bipolar; you have bipolar. There's a difference. Yeah, sometimes your partner, family and friends will deserve a medal to put up with your, quite frankly batshit, behaviour, but they stick with you cos they know you are awesome, even when you're pouring prosecco from the bottle at 4am on a work night, in their house, without having been invited, crying from a vein in your forehead.

So remember, bipolar is a total pain, but you are still you.

Here's to health and happiness...

...more understanding, and less stigma.

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