Crash Course in Bipolar Depression

Want a crash course in Bipolar Depression? Experts are great, but they can only take you so far. Sometimes for a better picture of what life is really like with bipolar disorder, it’s better to hear from those who actually live with it.

Bipolar disorder is a serious, often misunderstood mental illness that causes dramatic shifts in mood, energy, and activity levels.

During BuzzFeed’s Mental Health Week, members of the BuzzFeed Community were asked about their experiences with bipolar disorder.  Here are their quotes as well as an interview with psychologist Vaile Wright, Ph.D., director of research and special projects at the American Psychological Association, to give a better picture of what life is really like with bipolar disorder.

  1.  Bipolar disorder usually includes manic and depressive episodes, but there can also be hypomanic and mixed episodes.

manic episode might include extreme overconfidence and happiness, and sometimes irritability or anger. Someone in a manic state may have racing thoughts, talk faster than normal, not sleep, or behave in impulsive, risky, or dangerous ways (like spending lots of money, having risky sex, stealing things, etc.). A hypomanic episode is similar to a manic episode but is typically shorter and less severe.

depressive episode can include feelings of sadness, loneliness, and low self-esteem. Someone in a depressive state may lose interest in things they typically enjoy, have difficulty concentrating, sleep less or more, or have suicidal thoughts.

mixed episode is one that includes both manic and depressive symptoms at the same time.

  1. There are a few different types of bipolar disorder.

Bipolar disorder is known to occur on a spectrum, says Wright. According to the Diagnostic Statistical Manual of Mental Disorders (DSM-5), there are four main types:

Bipolar I Disorder: When you have a manic or mixed episode that lasts at least a week, or is severe enough that it requires immediate hospitalization. Plus, this is usually accompanied by depressive episodes.

Bipolar II Disorder: When you experience both depressive episodes and hypomanic episodes, but without any full manic or mixed episodes.

Bipolar Disorder Not Otherwise Specified (BP-NOS): When you have symptoms of bipolar disorder that don’t technically meet the criteria for any specific type.

Cyclothymia: When you have hypomanic and depressive symptoms that don’t quite fit the criteria for mania, hypomania, or depressive episodes (and it lasts on and off for at least two years).

There’s also rapid-cycling bipolar disorder, where you have four or more episodes in a year. You can find more info from the National Institutes of Mental Health (NIMH) here.

  1. People with bipolar disorder are not “ticking time bombs.”

“After finding out, people treat me like a land mine. They walk on eggshells around me, because they think that if they do/say one wrong thing, I’ll explode. I am not a land mine. I am not a time bomb. I’m a 16-year-old diagnosed with several mental health disorders, working as hard as I possibly can to not let the negative sides of my mental health rule my life.” —Caitlin via email

  1. And they probably don’t fit the stereotype you have in your mind.

“We’re not all misunderstood ax murderers or manic pixie dream girls. We’re your siblings, classmates, hell, maybe even your significant other! Just like any other medical condition, bipolar disorder comes in all shapes and sizes. You might be surprised to learn that it’s not just classified by out-of-control highs or suicidal lows; a lot of the time it’s a mix of some pervasive melancholy in between. The other two certainly happen, but they aren’t always recognizable in day-to-day life for the untrained eye.” —Sara via email

  1. In the moment, a manic episode might feel like a super productive high.

“When I’m having a manic episode, I’m unstoppable. Mania inspires me to pick up new hobbies, like knitting or couponing, just to drop it all the second my manic episode has ended. In the beginning of a manic episode, it just feels like a productive day. It starts off with me doing everything I’m supposed to without much effort. But then I’m up at 3 a.m. reorganizing my closet even though I have to be at work early. When I’m manic, I don’t feel bipolar. My mania feels like success. It feels like I’m finally doing everything right and nothing can go wrong.” —Julia La Bonte via Facebook

  1. But mania can also be scary and unpredictable.

“Mania isn’t fun or simply being hyper and happy. There’s that ‘sweet spot’ you hit before everything goes out of control where you’re productive, extroverted, chatty, creative, you feel great and at the top of your game — but it’s not like that all the time. It spirals out of control pretty quickly. You’re irritable and angry and paranoid. You spend too much money, you drive recklessly, you put yourself in compromising situations, you act out sexually, you can’t stop talking. You don’t sleep. You become obsessive, you start to see and hear things. And going from such an extreme high to such an extreme low is exhausting.” —Anonymous via email

  1. Depressive episodes are similar to major depression, and they can happen again and again.

“The depression inevitably comes to break up the party, and when it does it feels like the worst it’s ever been every single time. When you’re manic it’s hard to even remember you could possibly have been depressed before because you feel so good in that moment, and when you’re depressed it’s impossible to believe you’ve experienced happiness in your life.” —Reese Smith via Facebook

  1. Mixed episodes aren’t just erratic mood swings — it’s feeling several emotions all at once.

“Mixed episodes are a special kind of hell where depression and mania are happening at the same time. They’re terrifying and they’re dangerous (suicide risk is highest during mixed episodes because you’ve got suicidal thoughts and you’ve got the energy to act on them). I used to get really bad mixed episodes and I didn’t know what was going on — I didn’t know mixed episodes were a thing so I just assumed I was losing my mind. I thought I was uniquely fucked up and defective and undeserving of help, and if I’d known about mixed episodes I would’ve felt less isolated and desperately alone.” —Justine via email

  1. Having bipolar disorder is more than just highs and lows.

“There are also delusions and hallucinations and really bad paranoia. There are so many symptoms that people don’t know are associated with bipolar.” kirstens4bb5adb45

  1. Being moody or indecisive isn’t “bipolar.” Bipolar disorder is a serious mental illness.

“I hate when people throw around the adjective ‘bipolar’ for someone who is moody, snappy, or having a bad day. I can’t tell you how many times I’ve been around co-workers who complain about a colleague being bipolar. It’s hard because all of me wants to set them straight by saying, ‘No, she’s just emotional,’ but I stay silent because I don’t want to out my own mental illness.” —Jessica via email

  1. And it isn’t something you can just beat with sheer will.

“My best friends asked me if I even want to get better. I don’t know how to describe the desperate need to get better, the scrambling and the weight of it all, and knowing that at the end of some unknowable amount of time, it’ll start all over again. I wonder if everyone is secretly thinking Are you even trying to change? when the war between my moods is absolutely trying to debilitate me at the deepest level. I’m tired as hell.” —Jessica Hudson via Facebook

  1. Not every emotion or mood swing is a symptom of bipolar disorder.

“I would love for people to know that sometimes I actually do feel normal. Sometimes a sad thing happens, and I feel sad, or a good thing happens and I get excited, but it’s just being sad or excited, it’s not always depression or mania. I’ve done fun and impulsive things and had my friends say, ‘She must be off her meds.’ … And it’s taken a lot for me to not punch those people.” —Megan Jones via Facebook

  1. But sometimes even people with bipolar disorder will wonder if a random feeling is actually the start of an episode.

“You know you will have swings again and you question every emotion or rough night of sleep. Is this normal sadness or am I getting depressed? I feel confident about the things ahead — am I getting manic? It becomes a battle to determine what is real and what is bipolar. At times, you lose who you are.” —Shannon via email

  1. Episodes can last for days or weeks and change in an instant.

“A lot of people assume if you’re bipolar you’ll go through a myriad of emotions in a single day. Some people do. But there are weeks where I do everything I need to, weeks where I feel like I can and will get all the things I want out of life. And then in what seems like an instant, I tell myself I should just commit suicide already and be done with it because I’ll never amount to anything. Logically I know it doesn’t make sense, but saying ‘you shouldn’t feel that way’ doesn’t work on anyone ever.” —Destiny Kruse via Facebook

  1. Having bipolar disorder isn’t like the romanticized images you see in TV and movies.

“I’m excited to tell my story because it isn’t a story that gets told often, at least not without the polished glamour of Hollywood. Bipolar disorder isn’t cured by love, as indicated in Silver Linings Playbook, nor are the psychotically manic highs quelled with one pill and a nap, as in Homeland.” —Beth via email

  1. And bipolar disorder does not make someone inherently violent.

“I wish people knew that we’re not violent. In fact, we’re much more likely to be victims of violence than perpetrators of it.” —Morgan via email

  1. You won’t necessarily know someone has bipolar disorder until they tell you.

“On the outside, I’m a very functional mature adult and no one would ever suspect me having a story like this to tell. Mental disorders are real and should be taken seriously. Just because you can’t see it doesn’t mean it doesn’t exist.” —Shnay Patrice via Facebook

  1. In fact, manic episodes may even be mistaken for ambition.

“Who goes to the doctor or a therapist when they are ‘flying high’ or ‘so ambitious’?! My personality, activism, and academic career actually masked my manic episodes. I was applauded for being super driven, successful, and involved in everything. The experience was much different, though. I was propelled by fear, numbness, and guilt. Sometimes I felt like I was a tiny person looking down on my body, going to five meetings a day, partying all weekend, and drinking at lunch on weekdays.” —Robin via email

  1. Talking about your bipolar disorder can be really difficult.

“Now that I’m in a good patch of life (I always acknowledge that it can change at any time), when I talk about being bipolar I sometimes get a reaction like I’m being overdramatic or saying it to be trendy or something. If I talk about my disorder when I’m in the throes of it, I’m crazy, and if I talk about it with a clear head, I’m faking it. How can you win? It’s a lifelong journey, that’s for sure. I love myself though, and I am grateful that I have a VERY strong support system.” —Alycia Michelle Adame via Facebook

  1. When someone does tell you about their diagnosis, just listen and be there for them.

“I go and meet with my psychiatrist at least once a month and am stable on medications, but people look at me like I’m an unhinged crazy person when I disclose my diagnosis to them. I’m still me. I just know and understand what’s going on, and because of that, my doctors and therapists are better able to tailor my treatment specifically for me. So please, stop looking at me like I’m a ticking time bomb.” —Greta via email

  1. In fact, many people keep their illness private for fear of judgment or punishment in the workplace.

“I was once demoted from a management role and told to work from my home office after disclosing that I have bipolar to a VP. He said it was to help me. He kept my pay the same, but for many years I was petrified to tell anyone outside my immediate family for fear of repercussion. I wish I could say that I told my current company I have bipolar, but I still live in fear of workplace repercussion. I’m sure they will find out sometime. I need to gather the courage before an episode takes me away and I have to explain it from a hospital room.” —Anonymous via email

  1. Experts still aren’t entirely sure what causes bipolar disorder.

“The best science suggests some combination of genetics and biology along with environmental factors,” says Wright. “We know if a parent has bipolar disorder, the child is more likely to have it, but that doesn’t mean they will have it.” It’s currently thought of as a brain disorder, since research shows that the brain may function differently in those with bipolar disorder.

  1. The road to getting diagnosed might be a long and frustrating one.

“I have dealt with bipolar disorder for over half of my life (since I was 11, and I am now 24), but I was only diagnosed when I was 20. People don’t understand how hard it is to diagnose bipolar disorder. I went into my general practitioner, was diagnosed with anxiety and depression and put on some antidepressants. Unfortunately, that actually aggravated my bipolar disorder. I had no idea why every time I was trying to get better, I just got worse. It wasn’t until I saw a psychiatrist that I really started to get better.” —Thomson via email

  1. Treatment for bipolar disorder is not one-size-fits-all.

“Medications play a really critical role in assisting individuals, but that can look very different for different people,” says Wright. And one person’s treatment can even vary from time to time. For instance, the medications and therapy schedule for someone during a severe manic phase will likely be different from what their doctor prescribes during a maintenance phase, when they’re feeling stable and very aware of triggers. Every individual needs a tailored treatment plan, a high level of support, and ideally a very collaborative relationship with their treatment providers so that they can have these discussions about what works for them and what they feel like they need [at any given time].”

  1. Finding that perfect treatment plan can take a lot of trial and error.

I tried over 14 different combinations of antidepressants and antipsychotics over a period of three months. It was a roller coaster of emotions and frustration and feeling lost, but today I’m on a medication that works for me, and feeling better than I have in a long time.” —Anonymous via email

  1. Once someone finds a treatment plan that works, it can be a struggle to actually follow it.

“If I let myself forget, I know I’ll start to listen to the constant undercurrent that tells me I’m blowing everything out of proportion and the medication isn’t actually necessary, because come on, you’ve been fine for almost three years now — surely those doctors must have been making a big deal out of nothing. And that’s the danger, for me. If I stop taking care of myself, if I’m not constantly vigilant…well, I won’t relapse right away and I know that. I’ll probably be OK for a little while. For months, maybe even years. Or maybe just weeks. Or maybe tomorrow. I really never know.” —Robyn Ostrokol via Facebook

  1. It’s not uncommon for someone with bipolar disorder to decide to stop taking their medication.

“This is something that seems difficult for people to understand: why you would stop taking your medication and put yourself at risk. It’s hard to answer that question, and I’m sure the answer is different for different people. For me, I guess I just didn’t like to deal with the unpleasant side effects of the drugs and at the same time there was certainly a sense of denial about my diagnosis. I was sure it had to be wrong, sure that I was just going through ‘normal’ adult changes that come with big life stressors. It became clear that this wasn’t the case. I started a new medication regimen a few months ago and my mood has been stable since then. There are still difficulties, but I try to take them in stride.” saraw13

  1. And some people may turn to drugs and alcohol to self-medicate.

“Getting off of cocaine and retiring my habitual marijuana use (which is extremely common among people with bipolar disorder) was one of the hardest things I’ve ever had to do. For anyone who suffers from bipolar disorder and addiction (dual diagnosis), I encourage you to seek help. Chemical dependency programs exist and they’re awesome. I’m 90 days clean now and it couldn’t have come at a better time.” a4538e3f66

  1. Making an effort to understand this disorder is one way you can be there for someone you love.

“It’s incredibly frustrating when loved ones don’t take the time to read up on bipolar disorder, and don’t try to communicate in a way that isn’t overly aggressive or condescending, or if they don’t make a concerted effort to avoid your triggers. I’ve heard ‘what do you have to be depressed about?’ or ‘you don’t seem crazy’ about a thousand times from even my closest family and friends. Calling me crazy is offensive, but I refer to myself that way sometimes.” —Chelsea Thomas via Facebook

  1. Bipolar disorder, like any other serious illness, does not define you.

“We need to change the way we think as a culture about certain illnesses. We don’t say, ‘Hi! I’m Diabetes!’ Or ‘I’m Cancer.’ Or even ‘I’m Depression.’ So why do we say ‘I’m Bipolar?’ You are not your disease. You have a mental illness, it does not have you.” —Martamary via email

  1. Patience and understanding are deeply appreciated.

“Even though there are periods of time where we seem cruel and selfish and irritable, or reclusive and negative, we do still care about you and your feelings, too. And we appreciate the people who stick by us and try to understand during these episodes. Many of us are learning as we go, and we are thankful that you’re there with us.” saraw13

  1. Bipolar disorder is a treatable illness, and it is absolutely possible to lead a fulfilling, productive life with bipolar disorder.

“To people like me out there, bipolar disorder isn’t who you are. Bipolar disorder is a chemical imbalance in the brain that we were born with. Despite popular belief, bipolar patients can have a normal life. They can have a spouse, children, and a successful career. I achieved all of those things through cognitive behavioral therapy, medication, and an indomitable spirit. And you can, too.” —Anonymous via email

  1. Please, don’t be so quick to judge someone with bipolar disorder.

I’m not crazy. Something in my head just works different than yours.” —Angelica via email

I am not broken. I am not insane. I am strong. I am independent. I am me.” —Sydney via email

“Living with my diagnosis proved to me that I was stronger than I could have ever thought. I am strong, I am worthwhile, and I can and will live through this!” —W. via email

“I would urge anyone who is struggling with bipolar to find someone you can talk to. Surround yourself with people who accept you for you because YOU ARE AMAZING. Not broken, not flawed, your brain just works a bit different, and that is OK.” —Hannah via email

Responses have been edited for length and clarity.

* * *

To celebrate the release of my new book, Stay With Me, and commemorate Mental Health Awareness Month, I will be posting articles and links on the subject through the month of May. Please share this with your friends and family. And don’t forget to get a copy of my book. Go to for more information.

‪#‎mhm2016 ‪#‎MentalHealth ‪#‎StayWithMe



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