Finding truth and freedom

and why bipolar is so much more than mood swings

CW: mention of suicide, eating disorders, mental distress

Two of the most common things I hear when I tell people I have Bipolar II are “is it to do with the menopause” and “isn’t that just all women”(!). Well-meaning friends have pronounced that they don’t think I have it (I’ve been masking very well since I was a child) and honestly I agreed with them. I didn’t think I could possibly have a proper illness, and I was probably over dramatizing or looking for attention. Bipolar isn’t really talked about with comfort and I think the realities of living with this illness are very misunderstood. I believe this needs to change.

Photo by Logan Fisher on Unsplash

What’s it like to live with bipolar?

In June last year, my dear husband gently asked if I’d ever wondered if I had Bipolar disorder. I had often wondered this, but I didn’t think it was possible because I never experienced the kind of extreme manic episodes that I knew were part of it. What I did know was that something needed to change. I was at yet another point of crisis, exhausted by trying to be ok and trying to stay alive. I’ve lived with these feelings for most of my life and although I’ve had help in the past it hasn’t worked. The grind of trying to get through, to carry on living with intent, to carry on living at all was exhausting and frightening. I’d reached the point of thinking that this was how life was – all the help and medication I’d had in the past hadn’t worked, so how could there be any hope?

I talked to my GP, who explained that treatment for depression and treatment for bipolar are very different animals, and that there was real benefit in investigating my suspicions. I settled on to a waiting list and had my psychiatric assessment in January. I was pretty relaxed about it – I’ve had lots of therapy (more about that later) and have told my story many times.

When I began to talk I could sense something was different. Maybe it was the psychiatrist’s manner, maybe it was my sheer desperation to be free, maybe a combination of both. I included things that I usually miss out – details about the extent of suicidal ideation and details about the extent of the paranoia I’ve experienced for most of my life, and how this has impacted relationships, major (and minor) decision, how every aspect of my life was trapped by these behaviours. I remember telling her how very tired I was, about the exhaustion of keeping going, how I hated the way I couldn’t trust people, how I never felt safe even with those who loved me most. How I hated being me. When my psychiatrist gently said, well yes, I think you do have bipolar disorder, more than anything I felt relief. There was some fear, some sense of “this is real” but the hope of getting help that worked ran way surmounted them all.

What are my symptoms?

I have Bipolar II. This means that the highs I experience are not as extreme as someone with Bipolar I. Until visiting my GP Bipolar I was the only type of bipolar I knew about, and one of the reasons I dismissed my suspicions for so long.

What do the Highs look like?

High is a misnomer to be honest. For me episodes of hypomania mean I experience extreme paranoia, agitation and make bad decisions. I feel extraordinarily able to complete tasks and I feel unable to stop to the point where I exhaust my mind and body. I develop an obsession about the most innocuous thing, I spend money I haven’t got and cannot enjoy being anything other than frantically busy. I fall out with people imagining them to be deceiving me, or deliberately trying to make me feel inadequate. This is in my mind – never tell them because I know it’s not true, but I can’t stop the feelings so I withdraw entirely. In recent years I’ve experienced auditory hallucinations, where I’ve physically heard people saying things about me and confronted them. These symptoms are scary. I know they’re happening, and recognise that something isn’t right, but I can’t stop it.

What do the lows look like?

The lows in Bipolar I and Bipolar II are often similar. I describe it as a constant dragging sensation, a feeling of being pulled down. Thoughts of suicide have been an almost normal part of my life for over forty years. Fighting it is exhausting. There is commonality with other types of depression – feelings of uselessness, feelings of wanting to stop. It’s a horrible way to live and I honestly don’t know how I’ve hung on. Without the love, care and patience of my husband and friends I wouldn’t have been able to.

What is the impact of these symptoms ?

Living with this has affected every area of my life. I couldn’t form relationships at school or in adulthood because of the constant sense that people were deceiving me, I couldn’t function at work because my behaviour was so unpredictable I was horrible to work with. My belief that I was useless meant I put barriers around myself that stifled who I really am and made me afraid to put myself forward for anything in case I couldn’t play the game I perceived was necessary. I didn’t go to university (twice) because I was scared of what would happen and terrified of the idea of sharing living space with other people in case they saw behind the mask. I self harmed, developed a binge-starve relationship with food and damaged my body with abuse of painkillers (such a foolish name, I always think). More than anything it’s meant I’ve lost friendships that meant a lot to me, hurt some of the people closest to me and exhausted myself by pretending to be ok.

Why wasn’t it diagnosed earlier?

I honestly don’t know. My first diagnosis of clinical depression was at 21. I was given the option of medication but was persuaded against it. At the time I was part of an evangelical church, who advised that Christian counselling would be the best option. It didn’t help much – all I remember from it is throwing away my collection of George Harrison records, because it was the devil’s music as well as a necklace they felt bore the image of a goddess. I carried on as before but with the added belief that this was somehow my fault. And possibly George Harrison’s.

I had two more major episodes of depression, at thirty and at forty-five. For both of these I was given SSRI’s as well as CBT and talking therapy. An additional diagnosis of cPTSD meant I was prescribed EMDR therapy. I wanted all this to work so very much. It didn’t. I mustn’t be trying hard enough. (Apologies for all the abbreviations in this sentence by the way I’ve included links if you’d like to find out more about these things.)

Life continued. I went through menopause early and hoped that would be the end of it, that it was all down to my hormones – we all know the origin of the word hysteria. There was no change. Masking was becoming more and more difficult, two episodes of grief brought additional pressure, and additional reasons to believe my symptoms and behaviour were nothing more than an inability to cope with life the way other, better people could. A gentle conversation over dinner is what saved me.

What treatment am I having?

My psychiatrist offered a choice of medication, therapy or both. I’ve been nervous of taking medication, because of its ineffectiveness and the odd feeling of being almost immune to myself. I took a week or two to talk it over with those closest to me and decided to give it a try. I’m also on the waiting list for therapy, but this is very, very, very long.

Where am I now?

Better. During my follow up appointment I explained to my psychiatrist how much lighter I felt, how I hadn’t realised that life could be like this. I no longer feel such distrust, I no longer feel people are out to harm me. I can rationalise when people do something that makes me cross, and I don’t feel people are trying to be unkind to me or make me feel unsure of their friendship. When I am told I am loved I can receive it. This is an amazing thing. Crucially, have fewer suicidal ideations and urges to self-harm, fewer thoughts of wanting to disappear and the sense of dragging, of walking through heavy clay, has almost left me. I can rationalise when people do things I don’t like. I have fewer incidences of believing a people are being deliberately unkind or trying to make me feel jealous and unsure. I am able to be honest about how I feel. For the first time I am able to enjoy life.

Are you cured?

A week or two ago I’d have said a resounding yes. Recently I’ve noticed old patterns creeping back, idle thoughts about whether drowning might be the least painful way to die, planning for the worst possible events, seeing enmity in actions that are innocent. These are not extreme, and I’m pretty sure they will pass as soon as the increase in medication begins to have effect. What I’m most pleased about is that I feel less suffocated by myself. I have a solution. I have help. I have hope.

Why are you writing this?

Recent pronouncements about mental illness have concerned me. The idea that there is an “overdiagnosis” of mental health conditions rather than just an increase in all kinds of mental health concerns (a global pandemic and cost of living crisis will do that) is incredibly unhelpful and harks back to the “pull yourself together” attitudes of my parents’ generation. It’s also important to me that people understand that living with bipolar involves so much more than mood swings and is so very different to other types of depression. It can’t be solved by exercise and getting out in nature (although these help of course – you know how much my garden soothes me), it can’t be solved by talking therapies, counselling, by simply choosing to be happy. Most of all I want people to know that these feelings and behaviours are not something that they have to just put up with. By being brave, being open (I’m still not sure if I’ll publish this) and telling my truth I hope to illuminate the realities of living with bipolar for those who have not experienced it, offer a glimmer of hope to those who do and may not be confident to seek diagnosis. Ultimately, I want to celebrate my freedom.

Thank you for reading

Until next time

Kathryn

xx