What is Bipolar Disorder II?

I was diagnosed with Bipolar Disorder II when I was twenty. Bipolar Disorder, also known as manic depression, is categorized as a mood disorder. The official definition from the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) is that: “Bipolar II Disorder is characterized by one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode,” (318). Essentially, the illness is composed of two main parts – hypomania and depression – ups and downs. But this doesn’t explain how the illness will interfere with a person’s life or what it’s actually like to be hypomanic or depressed.

Hypomania: It’s not just feeling happy 

Hyperbole and a Half

Original image from the blog Hyperbole and a Half by Allie Brosh.

Hypomania isn’t just about being happy – it’s excessive happiness. It can seem normal to people who don’t really know you, but for those who do they can distinguish between hypomania and happiness. When I’m hypomanic I feel more more creative, thoughts flow more freely and words come easily. I’m talkative, bubbly, and funny. I’m also extremely productive. I don’t know if I’m unique in my ability to funnel my hypomanic energy into productivity, but when I’m hypomanic I say yes to everything and overextend myself, which I don’t realize until later.

During my fall semester of grad school, I had a hypomanic episode and it was amazing what I accomplished in the same 24-hour period as my peers. I was weeks ahead in my readings. When they were stressed about term papers, I was writing PhD and grant applications because my papers were already done. I remember a professor asking me, “When do you sleep?” and I happily responded, “I don’t!” She thought it was a joke, I was dead serious.

I would be lying if I said I don’t enjoy being hypomanic. Depressive episodes are more common in Bipolar II, so for a short time hypomania feels like a relief; a breath of cool air on a muggy day. Except I don’t want to misrepresent hypomania because there is only so long you can function with minimal sleep before reality starts to slip away. The energy that was productive turns into anxiety and panic, which makes me irritable and hostile. I start thinking the world is out to get me. Those thoughts and words that were flowing transform from a steady stream into a pounding rush. My sentences come out in a frantic string and it’s like the dam between my brain and mouth breaks and I say all of those things that I would normally only think.

During the grad school episode I erupted on an unsuspecting librarian. The library had cancelled a book I had requested via interlibrary loan because they thought I had ordered the same book twice. The person who cancelled the request hadn’t noticed that it was two separate volumes. In a non-hypomanic state, I would have simply been frustrated, but in a hypomanic state this was akin to treachery. These volumes are the crux of my argument! I will fail because of your ineptitude! How hard is it to be a librarian? I’m a grad student goddammit! I was absolutely indignant. I may have even called the poor woman an idiot.

This isn’t my usual behaviour – my non-hypomanic self avoids confrontation and I would never belittle someone. But that’s the thing about hypomania, it transform you into someone else. These outbursts during hypomania can often make relationships very difficult and a lot of people lose their jobs.

Depression: It Sucks

The flip side of hypomania is depression. Unlike hypomania which is enjoyable (to a point), there is nothing remotely likeable or fun about being depressed. Depression isn’t just sadness. Depression isn’t an emotion. Depression is a heaviness in your brain and body. Depression is like trying to tread water with 100 pound weights tied to your ankles and as you’re struggling to keep your head above water, the voice of your elementary school bully is on a loop in your head urging you to stop trying and just drown already. You’d be better off dead anyway. It’s like your mind turns against you.

Toni Frissel, Weeki Wachee, Spring 1947

Toni Frissel, Weeki Wachee, Spring 1947

For the most part, I’m a functioning depressive. I’m still able to manage the day-to-day tasks that need to happen, but that’s it. Simple tasks, like showering or getting out of bed, are a struggle and exhausting.  After a day of work, all I can do is curl up on the couch in the fetal position and cry. I hate everyone and everything. But the thing I hate the most is myself.

Following my hypomanic episode during grad school, the depression set in hard by the end of the Spring semester. My 45 minute commute was filled with sobbing. I remember giving a presentation and bursting into tears in the middle of it. All I could think while giving the presentation was how stupid everyone must think I am. Clearly I’m an idiot and should just give up. There was no rationale for any of these thoughts. By the end of the semester the crying had stopped and the numbness set in – the scariest part of depression. I started to self-harm, something that I hadn’t done in a number of years and all I could think about was dying.  It wasn’t that I actually wanted to die, I just wanted to disappear. I would sit at my computer screen, trying to write my thesis, and just stare at the cursor blinking at me unable to string a sentence together. Eventually my partner noticed the cuts and forced me into the hospital.

Bipolar Disorder is a chronic illness that can’t be cured, it just goes into remission. I have been stable for the past 4 years due to the right concoction of medication and learning to recognize and accept my limitations (for the most part – I still struggle with saying no and overextending myself). It can be frustrating navigating my life around my illness, but I know what the alternative is and it’s really not an option. Unless my meds stop working and I come out of remission, I’m going to be as healthy and happy as I can be. But the most important thing I have learned is asking for help. No one should have to struggle alone.

This post originally appeared on Healthy Minds Canada.

My Bipolar Journey

Some people’s depression is triggered by an event, a major loss or a tragedy. My first depressive episode had no inciting incident. It happened slowly and all at once. The sadness and dread was overwhelming. I couldn’t stop crying. I stopped going out. I stopped talking to my roommates. I hated everything and everyone. I skipped classes. I stopped eating. I thought about suicide and I started cutting.

For me, the scariest part of depression is when the tears stop and the numbness sets in. You start to wonder if you’ll ever feel anything again or if you’re doomed to walk through the rest of your life like a zombie. It was when the numbness had enveloped me that I cut for the first time.

I’ve been asked by my partner, my parents, and psychiatrists: At what point did I make the decision to cut myself? And honestly, I have no idea. I barely remember making that first cut, let alone the decision-making process that went into it. What I do remember is watching the blood pool to the surface and feeling relief as I felt the burning pain of the cut. I could feel physical pain. And so I made another, and another, just to remind myself what feeling was like.

The idea of self-harm goes against every rational thought and evolutionary cue humans have. We are genetically coded for self-preservation. But, then again, depression isn’t rational. It was over a week later, after accidentally rolling up my sleeves, that my roommate saw the multiple cuts along my arms, in various stages of healing.

Shocked and terrified by what I had done to myself and what I might do next, she begged me to let her call emergency services. Even depressed, I am stubborn, so I refused over and over again. Finally, we compromised and she dragged me to the university’s health services the next day. Then she did the one thing I never thought she would do, the ultimate betrayal: She called my parents.

It was months later that I realized that she had probably saved my life. To this day, despite distance and time rendering our friendship to an occasional Facebook post, I am incredibly thankful for her bravery and courage.

Because you can't be depressed with a bounding kitten! (Well you can, and that's okay.)

Because you can’t be depressed with a bounding kitten! (Well you can, and that’s okay.)

I’d like to tell you that this was the end of my mental health story. That I never experienced depression again, that I never cut again, and that I never thought about killing myself. Unfortunately, this was only the beginning of an ongoing struggle. Mental illness is insidious. It’s a monster that buries itself deep in your brain and rears its ugly head when you least expect it. And just when you think you’ve gotten to know the game it plays, the rules change.

After my first depressive episode, I enrolled in a university closer to home so I could live with my parents and have a stronger support system in the event that the monster returned. I started to excel in school again and reconnected with old friends. Life was good. It was a year before I experienced what I would later find out was my first hypomanic episode. A game changer.

The hypomania started with a simple idea: I was going to redecorate my bedroom. I bought the paint, moved all the furniture out of my room, and repainted. I moved like I was on speed and spoke faster than anyone could understand or follow. Then the anxiety started. I became agitated, volatile, and angry. Then I couldn’t sleep. My mind raced through all of these amazing ideas that I couldn’t keep track of.

Then I crashed.

In the span of a day, I went from hyperproductive to the languid darkness of depression. I couldn’t understand it. I took my meds religiously and maintained monthly appointments with my psychiatrist. It turns out he had misdiagnosed me. When I first saw him, I was only displaying symptoms of depression and so, logically, he prescribed me antidepressants. Those pills I had been taking regularly had caused the hypomania. Apparently, I didn’t suffer from depression and anxiety, like he originally thought. I actually had an illness that was much more difficult to spot: bipolar disorder type II. I left his office that day with a prescription for Lithium and orders to reduce the dosage of my antidepressants.

Lithium is horrible. It made food taste like metal, it made me nauseous and dizzy, and it required monthly blood tests. But it did level out my mood quickly, and the depression didn’t last as long. Unfortunately, there’s no cure for bipolar disorder — it’s a chronic illness. Meds can stop working, life can get too stressful, and suddenly the cycle starts again. I perpetually feel like I’m waiting for the other shoe to drop.

In total I have been through three hospitalizations. I’ve seen more psychiatrists and psychologists than I can count. I’ve taken anti-depressants, sleeping pills, anti-anxiety medication, anti-psychotics and anti-convulsants. I’ve gone through in-patient and out-patient treatment. I’ve hurt myself physically, I’ve hurt others emotionally, and I’ve thought about suicide way too often.

Bipolar disorder may be a chronic illness, but I’m no less capable than someone without it. I’m not deranged or dangerous. I just have to navigate my life a little differently, and despite my struggle with my illness, wonderful things have also happened in my life. I completed two university degrees. I travelled to several countries. I got married. I wrote a first draft of a novel. I moved provinces. I got a job I like and that I excel in. I’ve made great friends. I became a mental health advocate. And this year, I have started to share my story.

I have spent the last decade of my life hiding my illness because I have feared judgement. I have been afraid of losing friends, of being unemployable, of being an embarrassment, and of appearing weak. This year, with my work in the mental health community, I have been inspired by the courageous individuals who shared their stories of self-harm, hospitalizations, suicide attempts, relapse, and triumph.

Well, now it’s my turn. I’m adding my voice and story into the mix and maybe, if I’m lucky enough, I’ll inspire someone as much as these people have inspired me.

This was originally posted on Stigma Fighters and The Huffington Post’s Stronger Together.