2) Phases of Bipolar Disorder (My experience of bipolar disorder, first posted November 2014)

First, the science bit.

This condition is called ‘bipolar’ because it encompasses two poles, or opposites, usually described as ‘depression’ and ‘elation’. The other term for the ‘elated’ stage is ‘mania’. In between these two, as well as periods of ‘normality’ (or being symptom-free), is a condition called ‘hypomania’, which is like a lesser form of mania, and which can also take 2 forms: euphoric and dysphoric. Euphoric means happy, and I assume dysphoric means the opposite, but it’s not a word I’ve come across elsewhere.

There are 2 main types of bipolar disorder, as well as lots of minor variations. Bipolar II is characterised by recurring deep depressions, interspersed with periods of hypomania, but never reaching acute mania. Bipolar I (my kind) has less frequent and less severe depressions, and has to include at least one major episode of acute mania.

Both severe depression and acute mania can include psychotic symptoms, when you believe things that aren’t real, and may experience hallucinations or hear voices. These symptoms are very similar to those of schizophrenia (which was the illness suffered by John Nash in A Beautiful Mind), and some scientists now believe that the 2 illnesses may have a genetic link.

Got that? OK, here is a medical description of the main symptoms of the different phases of bipolar disorder (again from WebMD):

The word “manic” describes the times when someone with bipolar disorder feels overly excited and confident. These feelings can also involve irritability and impulsive or reckless decision-making. About half of people during mania can also have delusions (believing things that aren’t true and that they can’t be talked out of) or hallucinations (seeing or hearing things that aren’t there).

“Hypomania” describes milder symptoms of mania, in which someone does not have delusions or hallucinations, and their high symptoms do not interfere with their everyday life.

The word “depressive” describes the times when the person feels very sad or depressed. Those symptoms are similar to depression, a condition in which someone never has manic or hypomanic episodes.

In bipolar disorder, the dramatic episodes of high and low moods do not follow a set pattern. Someone may feel the same mood state (depressed or manic) several times before switching to the opposite mood. These episodes can happen over a period of weeks, months, and sometimes even years.

How severe it gets differs from person to person and can also change over time, becoming more or less severe.

Symptoms of mania (“the highs”):
Excessive happiness, hopefulness, and excitement
Sudden changes from being joyful to being irritable, angry, and hostile
Restlessness
Rapid speech and poor concentration
Increased energy and less need for sleep
High sex drive
Making grand and unrealistic plans
Showing poor judgment
Drug and alcohol abuse
Becoming more impulsive

During depressive periods (“the lows”), a person with bipolar disorder may have:
Sadness
Loss of energy
Feelings of hopelessness or worthlessness
Not enjoying things they once liked
Trouble concentrating
Uncontrollable crying
Trouble making decisions
Irritability
Needing more sleep
Insomnia
Appetite changes that make them lose or gain weight
Thoughts of death or suicide
Attempting suicide.

I would agree with most of that, apart from the very vague description of hypomania, which I’ll come to later. But what I want to do is describe as clearly as I can what these states actually feel like TO ME. Everything is different for different people – we’re all individuals, with our own histories and our own chemistry, and we feel things our own way. No list of symptoms on a page can convey what it’s like to actually suffer from those conditions.

I’m going to put that bit in a separate post, because this is already long, and my bit will be even longer.

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