February 3, 2014

Bipolar

I have type II bipolar disorder.

Type I is what you probably think of when you think of bipolar. It’s also called manic depression, describing the swings between the highs (mania) and the lows (depression). In extreme cases, the swings can be “rapid cycling,” going from the highs to the lows several times in day.

Bipolar II is milder. The highs are a less high – they’re called “hypomania” instead of full blown mania. The lows a less low. The cycles less frequent. War has been described as long periods of boredom punctuated by moments of sheer terror. My bipolar could be characterized as months of despair and lethargy punctuated by days of intense enthusiasm and productivity.

My guess is that bipolar started kicking in during my early 20s. Most of my life felt like I was trying to climb up a steep gravel incline and no matter how hard I spun my wheels, it was impossible to gain any ground. Everything felt heavy. Doing the simplest task felt like walking through a swimming pool. Getting out of bed was damn near impossible. Getting off the couch only marginally less so. In the depths of it, if I could get out of bed before noon, make it to work, and feed myself, that felt like a good day.

And then, every month or two, the hypomania would hit. Sometimes it’d be triggered by an external event – a good night of poker perhaps. Sometimes it seemed to be triggered by an all-nighter, though it’s possible that the all-nighter was triggered by the mania. Catch me on those days and I’d speak quickly with lots of hope and enthusiasm. I’d get a flood of ideas, and I had to do them all tonight. Whatever I was working on before this was no longer important because of this brilliant idea that I absolutely have to do now because it’s better than any idea I’ve ever had and if I don’t launch next week then someone else might do it and Oprah might want to mention it on her show and I need to find an accountant to help me with the taxes on the $100,000 that I’ll probably generate in the next three months and how soon is too soon to put in my notice at work?

If they could bottle up mania and sell it as a drug, they’d call it “cocaine.”

I’d stay up as long as I could, 36-48 hours, until I passed out from exhaustion. I’d sleep four hours, and wake up a little bit slower, but still with most of the push. But after a few days, sleep deprivation would catch up to me. I’d crash for 12 or 16 hours, and begin my slide back down into depression, another half-started project never to be touched again, and another dose of self-flagellation for not living up to my potential (not everyone is blessed with these amazing ideas and talent!).

Mania feels great. It’s euphoric and confidence inspiring. It makes you feel like you’re better than everyone else after months of feeling like a lazy sack of shit. It feels like a superpower. When I went to the psych for the first time and he described the symptoms of hypomania, I said, “Yes! How do I keep just that?”

Unfortunately, (hypo)mania can be quite destructive. It short circuits your decision making process and gives way to impulsivity that wrecks work, relationships, finances, and health. Sleeping around, gambling, and substance abuse are par for the course, often followed by musings of “That’s so unlike me…”

For the last five years I’ve taken 150mg a day of a mood stabilizer called Lamictal (Lamotrigine generically) which has, for the most part, stabilized my mood. I still have days when I’m up or days when I’m down, and I never want to lose that. It’s part of the human experience.

But when the bad days come, they last days, not weeks or months… and I’m no longer crippled by them. And my bursts of productivity have been replaced by a measured, sustainable pace that actually leads to getting things done.