Living Bipolar (25 page)

Throughout history, creative individuals have suffered beyond what ordinary mortals endure, under the assumption that suffering is a prerequisite to creativity. The poet de Musset observed, “Those who afford us our highest intellectual pleasure and our sweetest consolations appear doomed to weariness and melancholy” (Hershman and Lieb 1998:197). Research has proven that writers and artists display higher rates of depression, manic-depressive illness, and suicide. “Yet there is strong scientific and biographical evidence linking manic-depressive illness and its related temperament to artistic imagination and expression. Biographies of eminent poets, artists, and composers attest to the strikingly high rate of mood disorders and suicide -- as well as institutionalization in asylums and psychiatric hospitals -- in these individuals, and recent psychiatric and psychological studies of living artists and writers have further documented to the link,” notes Kay Jamison whom is the premier authority of the manic-depressive illness in America (Jamison 1993: 240). Changes in mood, thinking, personality, and behavior, all occur at elevated levels in manic-depressives, and these characteristics seem to be the magic elixir which “add depth, fire, and understanding to artistic imagination” (Jamison 1993: 102).

Manic-depressive people have a high level of confidence, an inflated ego and inflated self-esteem. Furthermore, they are extremely grandiose, and therefore, thrive off undertaking complex and difficult projects -- projects which most sensible people do not even consider. Occasionally when a manic accomplishes the impossible, mankind takes a giant leap forward. Very often manic-depressive people are labeled geniuses, and their work has changed the course of history. Behind some of humankind’s greatest achievements, such as Beethoven’s 5
^th
Symphony, the invention of calculus by Newton, and Charles Dickens
A Christmas Carol
, the common thread for the unexplainable and the invisible hand is manic-depressive illness.

Remarkable therapist Cathy Guyer gives a telling and insightful interview which explains the value of why Bipolar people need therapy for recovering and living with the Bipolar illness.

Interview with Cathy Guyer

What’s the most important thing Bipolar people can do aside from medication?

I think lifestyle is a big part of that. The importance of exercise; proper rest, and proper diet. Recently I attended some workshops on the brain -- her brain versus his brain -- and the doctor emphasized over and over how the majority of Americans are sleep deprived. As a result of that we are over stressed, between that and our other obligations in the world and the more stressed we are the more cortisol we release into the brain. We are bathing the brain in cortisol, which is the stress hormone, and this causes other things in the brain to not function the way that they should. It increases the risk of Alzheimer's, and other kinds of issues.

The Bipolar illness is a biochemical issue that we are dealing with. Obviously, any brain chemistry issue that we create, by what we are doing, and what we are not doing, is going to affect that person’s ability to be stabilized on medication in order achieve the functional life they wish too.

Support systems are extremely important as well
. Not only the support system but having the people -- family members, friends -- the people around you that care about you, that are living with you with your illness, must really be educated on the illness itself.

The family members must be educated or the Bipolar person must be educated?

Both.
I think it’s very important for the Bipolar person in a lot of cases to be able to explain their illness to the people that love them, so that people around them understand exactly what it is the individual is going through
. I think that’s the hardest part about, because
one of the things about Bipolar illness that is key is its unpredictability
. You may be doing very really well, and then all of a sudden have a rough patch.
Some people have the illness more seasonal. Some people have it in cycles. Some are rapid cycles
. We have all kinds of different combinations.

But there is also those little surprise situations where you are doing really well, and then all of a sudden you take this noise dive and you're not sure why. So I think if the other people around you know what the signs and symptoms are, and know what your particular symptoms -- not patterns -- might be, they can sometimes head you off. Because by other people knowing the symptoms they are able to recognize it before you enter into a manic episode. As a person becomes educated -- as much as they can be for a lay person -- they can say, “You seem busier than usual. Or you seem to be on fast forward. Or you don’t look well rested to me.” These are different things people can bring to your attention, and help that person realize that, “Uh oh, something may not be right.”

Symptoms people would recognize would be…?

Decrease need for sleep, the person is hyper verbal…A family member that knows you well, a good friend who’s known you for a long time, they know the differences. Let’s say you have a person named John Smith, and John Smith is a person who works, comes home, and has a pretty set schedule in the evening, and by 10pm or 10:30pm he gets ready for going to bed. Starting at this time they sit around and watch TV or read a magazine, or anything else to start preparing for getting some rest. And all of sudden at 10 at night John Smith is starting to call everybody he knows, or trying to make plans to go to a midnight movie. And John Smith is all over the map. People are going to notice, and those are extremes, but
it’s the extremes that people pick up on. It’s the little sublet’s of changes with the behavior patterns that are a good indicator that something may not be right.

Can you give examples of the subtle changes that are not extreme?

The fact that John knows not to call people past 10 pm at night, and all of a sudden people are getting calls past 10pm, 10:30 pm, midnight, 1 am, I think that’s a subtle change that may not be extreme, or maybe going on a shopping spree, or really anything extreme, but you’re most panicked when he calls because it’s so out of the usual that you think, “Something must be wrong if John is calling at 10:30 pm at night.” And then you find out John’s just chatty and wants to talk, and you think this is just not normal. This is not his pattern of behavior.
Human behavior is usually patterns that we look for. That’s how we determine things. That’s how we get to know a person is through certain patterns that we anticipate in their behavior repertoire
.

Why is therapy crucial for Bipolar people along with medication?

I think that anytime, anybody is on any type of psychotropic medication that therapy is essential. And most of my colleagues that are on the psychiatric end of it are strong believers of this as well, for many reasons. I think one of the most important reasons when you are going through the throws of any emotional, psychiatric issue it starts to affect the person with the very depths in believing who they are.
It affects their self-esteem, thinking that somehow because of this illness there somehow they are less than.
There is a great deal of psychological turmoil, a lot of guilt in a lot of cases in things that they might have done or said in the throes of their illness.

Having a therapist as a support, and having that person to bounce things off to, and work through these painful experiences, the therapists will be able to reassure them that things will get better.
That yes we all make mistakes that we all do things, but we can heal and we can move on
. With proper medication, and treatment, someone with a Bipolar illness can be functional and have a happy life. If they make certain modifications, and then know where they have to tend to themselves maybe a little bit more vigilantly than someone else, a full recovery is possible.

I think it’s also the issue that the therapist has some of the responsibility to educate the individual on their illness, and to the symptoms and the behaviors and the whole spectrum of what they’re going through. I think also a lot of times the therapist is in touch with the individual more frequently than the medical doctors and that sometimes folks in my position are going to pick up on the beginning signs of someone starting to cycle, and going into an episode. Sometimes we can head them off, and have that patient understand that we are starting to pick up on some things that are of concern, and say
“When is the next time you are going to see the doctor again? How are you feeling? Are you noticing any major changes?”
Sometimes we help that person deal better going through an episode, assuming their episodes are not totally controlled by the medications.

What challenges do Bipolar people face with relationships? How can they improve their relationships?

Well, I think relationships are challenging on a good day for everyone. There are ups and downs. There are moods that we all go through. We’re all human. With the divorce reaching one out of every two couples, challenges with relationships is part of society to start begin with. Add into this the pressures of financing, housing, careers, life in general; as people are dealing with their families, these factors are present with the average couple. Put on top of that a mental illness which can rear its ugly head at any moment, any partner who may be as loving and as knowledgeable as they might even be of the person's illness is still in the position of understanding what the heck is this intellectually.

Understanding the illness and seeing it firsthand is totally different for a person who is living with this illness. It's difficult for them to deal with, “Oh my gosh I can't believe I did this or said that,” when a Bipolar person is in the throes of an episode, the partner might wander, “Where did this person come from?” The partner might think, I've never seen this side of this person, then they start to question different aspects of the relationship, because who they fell in love with is still the same person but there are the behaviors that come with that person during an episode that are very different when they are stable and the medication is working the way it should. I think that's the additional stress on the relationship and unfortunately there are a lot of folks who are not willing to stick it out for good.
That I think is part of why we have such high divorce rate, because folks just can't handle the work, and it's too easy to walk away and it’s not easy to work through the problems and to take the time to get to know a person and understand the full entire package that's on both sides before they make the commitment to go onto the next level which is marriage.

As a result of that all of a sudden they're like, “What did I get myself into?” and at that point they either need to walk away or do the work. Then there are the extreme cases of people who get into relationships with people who are Bipolar, and the Bipolar illness gets out of control, and the insanity becomes more than what the person can handle, and a lot of times that's when the person decides, “This is not what I signed up for!” and that's when they terminate the relationship. It’s not because they don't love the person, or care about the person, they don't know if they are the best thing for that person. I think it's also very true that if you’re with someone who's not stabilized with any kind of mental illness, that the people who are with them sometimes start decompensating emotionally themselves, because they’re trying to second-guess the person with the mental illness and the insanity and that just doesn't work.

If you're a love one of the Bipolar person what can you do to support?

Unfortunately, while we have Bipolar support groups for Bipolar people, I’ve yet to see anything out there supporting family members, and loved ones and friends of people who are Bipolar and I think that's a shame. I think that's something that's very much needed, because when you're in the throes of that as a partner, or a family member, you feel very alone. You feel as though you're the only one in the world that is truly going through this
. I think that loved ones of Bipolar people can get support in talking to other family members of Bipolar people, and form bonds with friends of Bipolar people, or partners of Bipolar people, and children of Bipolar people to learn designated responses to the illness.
I think sometimes for loved ones of Bipolar people their own therapy is the other kind of support they can get. There are 12 step meetings for support of alcoholism and drug addiction, and Bipolar folks tend to have lots of substance abuse and sometimes that's a matter of self-medicating. Al-Anonon meetings might be helpful and that would give those afflicted by the Bipolar illness a place to talk about what's happening with the whole spectrum of what they're dealing with. However, there's not a whole lot out there for the Bipolar community in terms of support. We need more of that to help everybody afflicted with the illness and by the illness.

If I'm in a relationship and I'm Bipolar what can I tell the other person to help them understand me? What can I do as a Bipolar person to help make the relationship better?

I think to be very up front about it very soon when you're in a relationship
. Not to scare people off but because they notice a difference in the mood, that one day you are more moody than others, or that you're a little bit more fatigued on a given day which could be a result of the medication. Dealing with some of the pressures of the disorder can be a lot of different things,
but right from the beginning the Bipolar person should educate the other person in a very loving way about what you're living with
. It’s the same as someone who is living with someone who is diabetic. As a partner of a person who is diabetic you want to be darn sure what they have to eat, when they have to eat, and if the person starts to get headachy, or confused, the partner better know to get that person a piece of candy, or fruit, to bring that blood sugar backup or down.

You do all this through getting to know the person, and to know the condition of what they are dealing with. That's one of the ways that you can support the person and help that partner to be part of your life in a healthy way. Not that you're trying to get into the relationship to have a caretaker. This would not be the purpose if you're in a spot where someone has to take control of a diabetic high or low. Sometimes diabetes disorients you to such an extent that you can't make the correction yourself, but if someone else is aware of it, sees it before it happens, and gets a piece of cheese, or whatever to help the blood sugar stabilize, then you can relate to them what you need.