Monday, March 26, 2012

Episodes and Coping Strategies for Bipolar Depression: Moodswinging through Life, An Abnormal Monologue for an Abnormal Psychology

Imagine for a moment that you suffer from bipolar disorder. How would you deal emotionally with the periodic episodes and the fallout from those episodes?

It's a difficult thing to imagine. While I have read the chapter, the only thing that really makes it possible for me to imagine what it's like to live with bipolar disorder is that I have a friend who has struggled with the disorder throughout her lifetime. I am not close enough to this friend to know the day-in-day-out reality, but she is very open to talking about how it affects her life. From what I have observed through my interactions with her, the manic periods definitely stand out from her usual dysphoric state. I have only witnessed one manic period that I was aware of, during our friendship. The depression, for her, is chronic but is interrupted by the manic episodes. The depressive episodes, which debilitate her and are much worse (far more intense) than the chronic state of depression, are noticeable and distinct. Her functioning during the depressive episodes is severely impaired - she can hardly leave the house, she disengages from all activities, she cries a lot, she struggles with persistent thoughts of suicide, she loses her will to get up every day and survive.

During the periods between the episodes, she still struggles with milder depression but the depression is not so overwhelming that she cannot force herself to engage with life (taking her dog for walks, going to church, meeting friends out to socialize, going to jazz clubs to listen to music, going to see her therapist, etc.). The one manic episode that I got a glimpse of was distinct to me because she was unusually outgoing, careless about taking care of her house and animals, a little unaware of her surroundings, less self-conscious and more reckless. The night that we were staying at her house during her manic episode, she was quite scatterbrained and desiring social interaction. I told her multiple times that I am allergic to cats and I don't like to sleep in a bedroom with cats because I don't like an animals jumping unexpectedly on me in the middle of the night while I am asleep. I told her several times, but she did not seem to process what I was saying. She continued to put the cats (she has many of them) INTO the room I was going to be sleeping in. At first I thought she was mad at me for not wanting the cats in the room and was trying to punish me by bringing them in and setting them on the bed I would be sleeping on. I tried to make myself clear, but I was not getting through. I soon realized that it was a matter of absentmindedness. It did not seem that she had any ill intention, she just seemed to be forgetting or unable to listen and process what I was telling her.

Later that night, while I was sleeping -or, trying to sleep- in a room with a bunch of cats, she went out to a jazz club. We heard a commotion in the middle of the night (close to morning), but did not check into it because we were just glad to hear that she had come back home. In the morning we found out that she was pulled over for a DUI and then was subsequently arrested for being ornery with the police officers. They asked her to walk in a straight line and she refused. Then she argued with the officer - that is what she told us when we talked to her in the morning. She wasn't as upset about it as I would imagine her to be. And she wasn't as upset about it as I would have been. During her depressive episodes, which I am more familiar with because she occasionally has reached out to me during her lowest times, she is extremely sad and emotional. She does not talk about the bad things in her life or blame any specific thing for her sadness, she just cries and talks about how sad she is and how she doesn't want to live. She's such a loving and kind soul; it's so hard to see her struggle to make it through the days of her dysphoria. She has not worked in years, because the disorder has affected her life so profoundly. She sees a psychologist and psychiatrist regularly. She had been on and off many different combinations of medications. A couple of years ago, she voluntarily tried ECT; and after not finding it particularly helpful in the longterm, she received vagus nerve stimulation ( I haven't been in touch with her in a while, but last time I talked to her she seemed to be stable and handling her moderate chronic depression pretty well.

Since reading about bipolar in our chapter doesn't quite translate into being able to imagine the experience - I rely on my observation of my friend's experience. I think, like my friend, I would do my best to function as normally as possible. My decision with regard to medication would depend on the severity of the depressive episodes. I would want to avoid medication if it were at all possible to do so and still function. As long as the manic episodes weren't causing me to put myself or others in danger (and as long as they were not interfering with my daily functioning), then I imagine I would try to channel the manic episodes into serving as a vehicle for creative productivity and expression...since I am, at times and in general, highly energetic and prolific in my creative expression. I have felt moments of great sadness during relationship struggles and family deaths, but I tend to move in and out of grief, anxiety and struggle pretty adequately on the whole. I can feel terribly, even dramatically sad, and yet not reach the point of hopelessness. I can feel immensely strong emotions and then carry on with other daily activities. It is hard to imagine not being able to do so, but I think it would feel terrible to not feel like I had any control over myself or to be a prisoner to dysphoria. I must see hope in the world, hope for enjoyment, laughter and pleasure, because even in my darkest times I have never felt completely separated from those things (from hope). I guess I can only imagine at a very superficial level, because I am basing it on my own experiences with dysphoria that have never been debilitating. I can only imagine from my limited perception. I would rather listen to and learn from others who struggle with the experience of bipolar than suppose based on my limited understanding. Even though I have some experience with some of the elements (mild dysphoria, hypomania, etc.), I'll always be on the outside from the experience in its entirety.


Anonymous said...

thoughtful & interesting (and NOT too long!)

Jess Mason McFadden said...

I could say the same about your comment... Ha ha...

You're rewarding me for getting off of Facebook by commenting on here.

You aren't my wife, are you?