I was diagnosed with Bipolar Type I when I was 29 years old. I was sitting in my psychiatrist’s office, in a private psychiatric hospital in a leafy Glasgow suburb with the late summer sun peeking through the window. It had been a long, arduous road from my very first symptoms at aged 14 to diagnosis at 29, having ‘officially’ entered the mental health system at 18. Bipolar UK recently recognised that it takes on average 9.5 years to get a correct diagnosis of Bipolar Diagnosis. This is agonising and largely due to misinformation around the illness, stigma, fear, and I think the comorbidity of other psychiatric conditions.
So what is Bipolar Disorder, well, Bipolar isn’t just singular one illness. It is categorised as,
Bipolar I – Someone with Bipolar I will typically present with at least one manic episode and episodes of depression. Episodes of psychosis can be present in Bipolar I too.
Bipolar 2 – Someone with Bipolar II will typically present with episodes of hypomania and episodes of depression (lasting at least 4 days)
Cyclothymia - Someone with cyclothymia will have experienced both hypomania and depressive mood episodes over the course of two years or more. Their symptoms usually aren't severe enough to meet the diagnostic criteria of bipolar 1 or bipolar 2.
Rapid cycling bipolar - Someone who experiences rapid cycling may be told they have bipolar 1 or 2 'with rapid cycling' if you've experienced 4 or more depressive, manic or hypomanic within a year. This might mean: they have experienced episodes of mania or hypomania, followed by episodes of depression. They may feel stable for a few weeks between episodes. For example, they may cycle between manic episodes and stable periods. They may experience episodes that last months, weeks or days.
Bipolar, in whichever form of diagnosis it takes can be debilitating and life altering for the individual who has received the diagnosis and their immediate family and friends, colleagues and the professionals who care for them. Everything is affected by the diagnosis, from emotional health, the very incapacitating changes in moods themselves, to physical health (mostly from medication side effects), to the lifestyle changes that you must make to have the best possible chance of stability and remission. For example, improving or changing sleep hygiene which might mean an end to multiple boozy nights out, and the beginnings of bed by 10pm, clean and sober and the reduction in caffeine, stimulants, and energy drinks. You might find that your social circle begins to change and contract, and that you start to see a therapist more regularly to keep your boat buoyant. If you are prescribed lithium (like I am) you will be in and out of blood labs quarterly getting your blood levels checked to make sure you’re not toxic (which I have been – and it’s not so enjoyable). Then you have the challenge of navigating travel (whether that be for work or pleasure), telling the DVLA about your condition which might mean a restricted medical licence and if you plan on going further afield, then travel insurance just got way more expensive. A Bipolar Diagnosis affects everything!
Being Bipolar however, I have grown to appreciate, through long-term therapy and deep and significant conversations with my closest friends has given me more than it has taken. I am a highly adaptable and spontaneous person, who although admittedly is complex at times, I see the world in layers of colour and light that I believe is uniquely down to being Bipolar. I am highly creative, sensitive, an over-thinker and analyser with a remarkable ‘gut-feeling’ intuition about situations and people. Sometimes, these layers of complexity mean I bite off more than I can chew, even in periods of remission and stability, however, more often than not they have added experiences, learning, value and people to my life that I wouldn’t swap for a minute of ‘normal-ness’.
I do not for a single, fraction of a second minimise how difficult having an episodic illness like Bipolar Disorder is. I live it, every day, watchfully waiting for the other foot to fall wondering if I’ll enter a depressive or manic episode and if my relatively stable life will crumble. What’s more I know that the people who love and care about me watch for signs of impending episodes too. So, it’s doubly hard, not only reassuring yourself, but others too, that you’re doing OK.
There is no secret. I learned only recently and 6 years after diagnosis, that you must be altogether honest with yourself, your professional team and those who care about you. If you hold anything back, and try to navigate these waters alone, then no one can prevent or intervene before you’re fully in an episode. Not even you.
On this Bipolar Day 2022, be open, be honest, be kind to yourself and allow ALL the sides of your Bipolar to be seen and heard. You deserve it.