Unfortunately most of the Indians feel that if a person is suffering from depression or any mental disorder is a mad or mentally abnormal, this due to the past social conditioning and stereotyping. Having a fear of getting judged, many people don’t even share it with anyone an In many instances According to a report of UNICEF, one out of seven young people between the ages of 15 to 24 in India always feels depressed or has little interest in doing things.
I myself am a patient of bipolar disorder which was diagnosed when I was just 13, I consider myself blessed as I have parents who are empathetic and supportive.
Here is a detailed description of my tough days like how it was detected, what I go through and how do I cope.
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- Understanding Bipolar Disorder
- My Early Warning Signs
- Symptoms I Experience
- The Diagnosis Process
- Daily Life with Bipolar Disorder
- Advice for Those Who Suspect They Have Bipolar Disorder
- Conclusion: Living with Hope
Understanding Bipolar Disorder
Bipolar Mood Disorder formerly called maniac depression is an episodic mood disorder characterised by extreme mood swings. These include emotional highs also known as mania and emotional lows also known as depression. In manic phases the patients feel over energetic, talk too much while in depressive phases the symptoms include low energy, feeling helpless, hopeless, not enjoying oneself. These mood swings do not happen every now and then, each episode can last upto weeks or months.
Let’s try to understand this in a more lucid way through the following graph-
Euthymia is a state of mind where the mood is absolutely normal, there is neither manic nor depressive mood.
The part above Euthymia represents maniac state which is further divided into hypomania and mania. In state of mania the patients feels extremely high on energy, become over talkative, take a lot of risk but in case of hypomania the instil of such feelings is comparatively lesser.
The green part below Euthymia represnts depressive mood.
Types of Bipolar Disorder-
Bipolar 1-
In Bipolar 1 the maniac episodes are more and depressive episodes are less. The patient goes to even mania where they have racing thoughts, feel extremely high on energy and they over talk. The depressive episodes in these patients are shorter lived. The orange curve in the above graph shows bipolar 1 disorder.
Bipolar 2-
On the other hand in Bipolar 2 the depressive episodes are more and maniac episodes are less. The patient feels low on energy, lose interest in things. The depressive episodes in these patients span longer. The blue curve in the above graph shows bipolar 1 disorder.
Seasonal Bipolar-
In this case the patients experience depressive moods usually in the fall or early winter months (late August to early November) and experience maniac moods in Spring and Summer months (March to early June). This is because the pineal gland in bipolar patients produces more serotonin hormone (a feel good hormone that uplifts the mood) due to bright sunlight in summer and spring and produces very less in fall due to cloudy weather.
My Early Warning Signs
I remember it was the time of summer vacation when I was in the 7th grade, I was feeling extremely tireless, I used to talk a lot of unnecessary stuff. I also covered long distances in by Avon Cruiser bicycle aimlessly. I was constantly having the feeling of doing something very exciting one day I opened all taps of our house and clogged all the water outlet points and bases of the doors with clothes, there was hardly any room for the water to escape, the water then rose upto 6 to 7 inches from the floor and I kept on playing in it. This was the manic phase I was going through.
My mother who was previously worried seeing my activities since last few weeks got even more shocked and took me to Apollo Hospital, Bhubaneswar where doctor Satyabrata Dash (who also treats my father with bipolar disorder) diagnosed me, seeing my family history he said it can be hereditary.
Symptoms I Experience
Symptoms during Manic/ hypomanic Episodes-
- Feeling Over Confident- I feel as if I can do every thing and I feel so confident that I go on ride for hundreds of kilometres, I keep on roaming till late in the night, which worries my family members.
- Taking too much Unnecessary stuff– There is very less rationality during this time and often I talk endlessly even things which aren’t required.
- Splurging or spending recklessly– I become very indecisive on what to buy and what not to, so I end up splurging on things that I never required.
- Feeling as if I am there on the top of the world– During maniac phase I always feel elated and excited all the time even without reason, get easily distracted, my head gets occupied with racing unwanted thoughts almost all the time.
- Decreased Sleep- In these days I feel less sleepy usually 4 to 5 hours a day.
Symptoms during Depressive Episodes-
- Difficulty in walking up- Getting up from the bed becomes a herculean task, even after waking up getting out of the bed becomes a challenge, I feel very drowsy and lethargic.
- Loss of appetite- The person going through depressive phase usually feels very less hungry, in these days I become very fussy with food.
- Increased sleep- Unlike in manic phase, during depression, I often feel sleepy and drowsy. I sleep upto 16 hours in this phase.
- Feeling low on energy- I spend most time of the day just laying on bed and doing nothing and feeling useless, worthless, believe me the feeling is the worst I have had in the World.
- Having a lot of anxiety and Negative Feeling- The person gets many negative feelings, often the heart beats abnormally fast, In my case I feel as if I will lose my dear ones and feel very afraid .
- Having loss of interest in everything- The person going through depressive episodes doesn’t feel like doing anything, for me it becomes even more painful if such an episode comes during exams. As I lose interest in everything, I don’t feel like interacting with anyone or going to social gathering or hanging out with friends but I feel lonely and left out at the same time, I know it sounds weird but that’s how it is.
The Diagnosis Process
Bipolar mood disorder unfortunately cannot be diagnosed with help of a blood test or any imaging studies like X Ray, ECG or MRI etc. In psychiatry there are no biological markers as yet for diagnosing a disease or disorder.
The doctors have to largely rely on the information(such as symptoms) given by the person going through bipolar mood disorder i.e the patient or the people living around him who know the person well. This information is then compared with the list of criteria that have been agreed by mental health professionals across the globe. Then those symptoms are matched with the list of criteria and if they match it is inferred that the person is suffering from bipolar mood disorder.
Daily Life with Bipolar Disorder
Life with bipolar mood disorder is really challenging there is every possibility to have strained relations with your near and dear ones, at work place, with seniors or colleagues.
During maniac phase I often disappoint my elders with whom I end up talking disrespectfully while in the days of depression, I displease my friends as I do not turn up to go any where, I intentionally do not receive their calls or reply to their texts.
Productivity is gravely hampered both in maniac as well as depressive episodes, procrastinating is very common during these extreme phases.
- Understand the disorder– Knowing the disorder is like winning the battle which can be gained through psycho education or counselling from an experienced mental health professional. Once the patient knows about the disorder he can go to seek medical help or start medication on his own if he is experienced.
- Keep taking your pills regularly– The medicines are to be taken regularly even if you feel absolutely fine, you should never discontinue the mood stabilisers. Anti depressants or anti manics can be taken when required as per the symptoms. Discontinuing the medicines can result in withdrawal symptoms like panic attacks or severe depression etc. Some times the patient may feel tempted to overdose the medicines especially the sleeping pills (sedatives)(sleeping pills are prescribed during maniac phase to induce sleep) as they have a relaxing effect, so people living with the patients are advised to keep check on them.
Advice for Those Who Suspect They Have Bipolar Disorder
Consult a Mental Health Professional-
The first and foremost advice that I would give to anyone suffering from any mental health disorder or their relatives/ friends or well wishers of the patient is to break the taboo. Speak up about it, go to a mental health practitioner and seek medical help, otherwise the things will get even worse than being better.
Terry Cheney aptly wrote in her bestseller, Manic: A Memoir that “The disease feeds on shame, shame feeds on silence and I will not be silent anymore.”
There is massive amount of stigma prevailing in the country. There is a vicious cycle of stigma, shame and silence which needs to be broken.
Acceptance-
If you feel ashamed or awkward for visiting a psychiatrist, ask yourself is it your fault? If you had asthma you would have asthma you would have taken albuterol, if you had heart issues you would have taken blood thinners then why do we treat any disorder with brain differently from other physical organs? You don’t deserve to suffer, this is absolutely natural (may be genetic).
Conclusion: Living with Hope
1.5 to 2% of the population have been diagnosed with bipolar disorder. As mental health is considered taboo in many societies, many suffer silently without informing anyone or hardly there is any awareness about it, otherwise this data would have gone significantly higher. So you or your loved one is not alone in this.
Although bipolar is not curable but it can be controlled through proper medication and empathy, the person going through this can lead an accomplished and harmonious life.
In my case, especially now a days, is not able hinder me from leading a normal life as I know the symptoms well and begin the medication when required, end it when required in consultation with my doctor. I consider myself to have got such empathetic parents who are a constant support through all the dark phases of my life and doctor with a Midas touch whose diagnosis and counselling worked like magic for me.
Sushreep
Simanchalp