the susie solution

Imagine you are driving on a very, very wet freeway going 60 miles an hour, with traffic in every lane ahead, behind and beside you.  Suddenly you realize you are hydroplaning – your tires no longer in direct contact with the pavement, but instead floating on a cushion of compressed liquid.  You may need to stop – but find you can’t.  You may want to turn – but instead find yourself launching off the road.  You may want to go straight – but instead find yourself spinning ‘round and ‘round.  Until and unless your tires reconnect with the pavement, you are at the mercy of the laws of physics, utterly helpless.  If your tires have good tread, you may gain traction again fairly soon.  But if your tires are bald…..   Welcome to the world of bipolar.

Although I have mentioned a number of times in this blog that I have Bipolar 2, I’ve never talked about precisely what it is, or what it is like for me to live with it.  However, since my diagnosis happened three years ago today, this seems a good day to talk about it. 

My BP2 first evidenced itself in high school, but went unrecognized.  I was diagnosed manic-depressive by a psychologist at college, but after a few sessions to give me some coping strategies, I was sent on my way, and I thought I was “all better now.”  But although the particular presenting symptoms changed over time, I continued to struggle with what I felt was a monster inside me for over 30 years before being diagnosed and put on medication.  (Although the usual expectation is that it may take 18-36 months trying half a dozen or more meds before finding one that works well with the fewest side effects, it took only 6 months and the 3^rd med I tried before we hit on a success that not only works very well but has no apparent side effects for me – for which I am exceedingly thankful!)  With my medication, things are very different now, but although the meds help, they don’t cure.  I will ALWAYS, short of a divine intervention, have BP2.  Meds put some tread on my tires, but it’s the difference between bald and barely legal.  And the pavement is always going to be wet; it’s just a matter of how deep the water is.  Skidding at any moment will always remain a real possibility.

Bipolar – BP – like most mental illness is a brain disorder that causes certain areas of the brain to become hyperactive, while others become under-active.  Why it happens is not known, although there is some genetic predisposition involved.   Bipolar is broken down into 2 levels.  Type 1 is the more commonly known version, and what most people think of when they hear the term bipolar; it is this version that ends up with patients doing horrific things that make headlines, although it is only a very, very small percentage of BP1 patients who commit such acts.  BP2 is a milder version that doesn’t go to the extremes BP1 does, a difference of scale rather than substance.   Like most mental illness, much of what either version goes through is not unlike what is known by the rest of humanity, but it is exaggerated far beyond the normal experience – far beyond what the normal coping mechanisms can deal with.  (Just as cancer takes a normal process, the growth of cells, and sends it wildly out of control with no “off” switch.)  One analogy for BP is to picture it like waves on an oscilloscope.   “Normal” (i.e. non-mentally-ill) folks have waves that go up and down, but they fluctuate only so far from the baseline norm.   The waves of a person with BP1 go way, way, way up and way, way, way down – from manic highs where she may not sleep for days, to suicidal depression.  The swings may take months, or moments.  For those of us with BP2, our symptoms and sufferings are the same as BP1 except that our waves don’t go all the way as high up or all the way as low down.  Our highs are exhilarating, but not manic, and although we may have periods of deep depression and even suicidal thoughts, we are not nearly as much at risk for actual suicide.  We generally tend to have more periods of relatively normal behavior than a BP1 as well.   

For normal people, moods tend to be influenced heavily by life circumstances (and influenced by personality, of course.)  If you have BP?  Forget it.  You’re stuck with the mood swing gumball machine – “oooo, what mood did you get today?”  For some with BP, the swings happen slowly, and the stay in a mood may last months or even years; for others, the swings are mercurial.   The causation of our moods may have little or no correlation with our life circumstances, but our moods have an overwhelming influence on our perspective on those circumstances.  We don’t need anything to be depressed “about”; but when we’re depressed, as in any other depression, everything in our life will be a cause for despair because that will be the lens our brain is looking through.  Highs are just as unrelated to life as are our lows, but when we’re up, then EVERYthing is wonderful and beautiful and we can do anything.  (Although highs are exhilarating and can, admittedly, be rather fun, and bring on periods of tremendous creativity and inspiration, they are just as much a problem as lows because they are still warping our perception of reality.)

But mood swings are only a part of the package.  They’re the most obvious, and certainly the symptom most likely for even a layperson to identify, but there’s much more to BP.  The area of the brain that is involved affects other aspects of thinking and emotions.  Although the precise constellation of symptoms will be different in every patient, they tend to be differing expressions of things that are common among us. 

The BP brain has difficulties with impulse control.  It is common for BP patients to be in constant financial trouble because they cannot resist buying anything they see that they want.  Substance abuse of all kinds is common, as are gambling and risk-taking adrenaline rush activities.  Many BPs are sexually promiscuous – even those who find it morally repugnant.   We may tend to say inappropriate things, since the filter agent in our brains isn’t working. 

The BP brain may fire thoughts and impulses that are weird at best, if not downright disturbing.  Thoughts of self-harming are common.  I don’t mean like those who deliberately hurt themselves as a physical expression of emotional pain, but simply as in random thoughts like wondering, as one is chopping up an onion, “What would it feel like if I put my fingers under the knife?”  Driving down the freeway, one may find oneself thinking, “What if I ran into that concrete barrier?”  Part of why I have an extreme aversion to standing on the edge of cliffs or on bridges is because I fight with the impulse to throw things off – my glasses, my camera, my purse.  The baby in my arms.   If you don’t understand BP, it’s easy to think that these thoughts arise out of some kind of subconscious desire to do harm, or a latent intent to do evil, but they don’t.  They come because our brain is broken and synapses fire in odd ways.  It’s that simple.  Only an exceedingly small minority of us with BP will ever act on any of those thoughts.  (For the record, I’ve never thrown actually anything off a cliff or bridge.)   It is as disturbing to us to have these thoughts as it is to you to think about having such thoughts.

In sleep, the brain sometimes gets even worse.  In our dreams, we may DO those things that are mere impulses we can dismiss in the day.  (This next is the hardest for me to write, but it was one of the greatest reliefs when I found out it was BP-related; there may be someone reading this who needs to know it, too.)  It’s not uncommon to have dreams that violate every moral value you hold and leave you blushing and humiliated and that may make it hard to interact with someone the next day while your brain is trying to sort out what was dream from what is reality.  You KNOW that the other person has no idea what you dreamt, but, still…   If you’re embarrassed to read that, think of how embarrassing it is to have those dreams – and how easy it is, if you don’t understand BP, to think of yourself as somehow evil and dirty for having such dreams, as if they arise from some subconscious desire.  But again, it’s a broken brain, not a moral failing.

The BP brain tends to fixate, like being on a hamster wheel: once you get going on a particular thought track, it can be virtually impossible for you to get off that wheel.  You may succeed in distracting yourself for a time while you do some task – making dinner, planning shopping, reading a book – but as soon as you are no longer engaged in that other, BAM! You’re right back on that hamster wheel as if you’d never left.   Hurts, frustrations, problems at home or work or church – anything and everything is a potential hamster wheel.  When we sound like a broken record going on and on about the same issue, we generally don’t even recognize that we’re doing it; it’s just giving voice to what we’re always going over and over and over in our own head.  (This was one of the most blessed reliefs of going on my med – being freed from that hamster wheel!)

Our brain also tends to escalate.  We get impassioned on a subject, and the more we talk or think about it, the more impassioned we get.   Combined with the impulse control problem, we may tend to speak out much more strongly than we might at a calmer moment.  We get agitated so that we cannot think rationally, or hear reason.  We go in the tank and may not even realize we’re there.   Anger is a major problem.  As a friend of mine put it, we can “go from zero to b**** in 5 seconds or less.”   Our brain is a minefield set with a hair trigger, and we do not always know what’s going to set it off.   Thinking back later, we may be just as surprised as the person who set us off.  (My meds help a lot here, too, but I still have to plead “guilty” on some counts!)

If you have BP and you’re aware enough to recognize your problems to any extent (which many or most BPs aren’t), because it’s a mental thing you may fall into the trap of thinking that somehow you “should” be able to think your way out of it, or pray your way out of it, or just try harder.  Sadly, it just doesn’t work that way.  That’s like a diabetic thinking they can will (or pray) themselves into making insulin.  If your tires are bald, it doesn’t matter if your engine is tuned and you have plenty of gas.  You still won’t have traction.    

So, what do I think would be most helpful for me – and probably others with BP?

First and foremost, remember that while our BP affects us, limits us, and to varying degrees controls us, it is not US.  We are more than our emotions, our moods, our behavior, our bipolar.  We are more than our disease, just as a person with cancer is more than their cancer.  For those of us who are believers, who we are is IN CHRIST.  Our spirits remain intact and whole in Him, no matter what our cognitive mind and outward behavior may manifest.  He holds us securely when we cannot hold onto Him.

Also of great importance:  Validate our condition for what it is – a physiologically caused mental disease -not a lack of willpower, a failure of character, or a weakness of faith.  As I’ve described already, it’s easy to feel as if we “should” be able to do better if we could just figure out how to try hard enough.  It’s easy to feel like a moral failure, or like a “bad” Christian.  If you hear us say anything like that, speak Truth against the lie.  Speak words of worth and grace to us.  If we’re down, encourage us with God’s faithfulness and gently remind us that we are wearing “Eeyore glasses” that won’t stay on forever.   Don’t be surprised or hurt if we reject it or argue about it, as we probably will.  If we’re on a high, don’t see it as a sign that we are “better” or that we are “making progress”, but instead caution us not to trust it, encourage us with God’s faithfulness, and gently remind us that our “rose-colored glasses” will crack sooner or later.  And don’t be surprised or hurt if we reject it or argue about it, as we probably will.  Always remember that our spirit is still listening, no matter how our cognitive mind and emotions may react!  I can’t tell you how many times certain of my friends listened to my repetitions of my woes during my son’s Hell years, and responded consistently with gentle, positive encouragement that, at the time, I rejected – yet it made a huge difference once I was able to calm down later.

Don’t patronize us or dismiss us when we’re upset about something.  Just because we’re BP doesn’t mean there might not be a very valid reason for us to be upset.  Non-BP people get upset, too.  The fact that our response may be over the top doesn’t automatically negate the validity of the reason we’re upset in the first place.  Even if you don’t think the reason is valid, even if it comes because our BP brain is seeing something askew, acknowledge the reality that we are upset. 

Don’t demean our BP by casually flinging the term about at people who are just moody, or get angry easily, or don’t deal well with stress. 

Don’t take personally the accusations a BP brain may come up with.  Since the BP brain is looking through a warped lens, it cannot judge rationally.  Accept that the accusation is our brain’s reality at the moment, and try not to react with your own anger or with defensiveness. The real us does know better, even if our cognitive mind doesn’t.  Try to respond emotionally to the real us while dealing rationally with the BP us.

Does being a BP mean we should get a free pass on behaving abominably?  “She’s BP, so you just have to excuse her smashing up your car with a baseball bat.”  Um, no.  When we’re in the tank we need you to understand, yes, but that doesn’t mean you have to just stand by and let us do damage.  If things are just too intense, and you need to protect yourself, then say, “I think my being here isn’t helping, so I’m going to leave now.  We can talk more later.”  We each have our limits of how much toxicity we can take; it is nothing to feel bad about if you simply can’t handle someone’s BP episodes.

You can help empower us by helping us figure out what we can and can’t exercise control over.  It’s easy to feel totally helpless, but there may, in fact, be some factors we CAN do something about, or some triggers we COULD avoid.  Just as there may be certain signs that a diabetic is getting low on blood sugar, there are sometimes certain “tells” that indicate something is brewing with a BP.  Just as certain flashing lights may trigger an epileptic seizure, there may be situations that tend to trigger BP episodes.  We just generally can’t recognize them ourselves, though, so it may be helpful if you point them out.  I know one of my “tells”, and often cues me in to the fact that I’m feeling stressed long before I would become cognitively aware that “Oh, this is very stressful.”

One thing I’ve struggled with is that I usually can’t tell when I’m getting too worked up talking about a subject I’m upset about.  If someone just listens and says nothing, it actually tends to escalate me as I try to get a response.  Now that I’m on meds It helps for someone to ask, “Are you sure it’s worth getting this upset about?” or “OK, you’ve explained the problem.  What do you think you could do about it?”        

One of the biggest problems for most BP patients is that they won’t stay on their meds.  I am in the small minority who are self-aware enough to recognize that it is only my meds that enable me to function as I do now.  Most BP patients, once they get feeling better, decide that they no longer need their meds and stop taking them, with predictable results.   If you know someone with BP and are in a position of enough trust, don’t let meds be a taboo subject.  Meds are like an artificial leg for an amputee – you can walk as long as you’re wearing it, but it doesn’t make your leg grow back.  Our meds don’t “fix” our broken brain, they simply enable it to function more like a healthy brain.  There is no cure for BP. 

My greatest fear now is that of my medication losing its effectiveness.  That is unfortunately the way of psychotropic drugs; the brain gets used to them eventually.  I may be able to stay on this drug, and even at this dose, for years.  I may need to up the dose; I am at a mid-level dose now, so there are two more steps up I could increase to.  Once that threshold is crossed, however, which will happen sooner or later, I will be back to playing medication roulette.  There is no way of predicting how any person will respond to any particular medication.  There is no one medication that is the preferred “first line of defense”.   It truly is trial-and-error, and those errors can be pretty terrifying.  The second drug I tried shattered me to pieces; if not for God’s grace, some of which came in the shape of a couple of dear friends, I’m not sure I’d have made it through the experiment.  If I have to play the game again, I know God will be with me – but I will freely confess that I am still afraid of going to that dark place again. 

When I received the diagnosis of BP2, it was world changing, like shifting a kaleidoscope and getting an entirely new picture.  I can’t describe what a relief it was to have a name and explanation put to that monster in me.  I wasn’t a terrible person, a bad, angry mother – I was a person with a broken brain. I wasn’t guilty so much as I was a victim.  I hadn’t been deliberately slamming my car into others; I was hydroplaning.   I know – ok, I suspect – that I have lost some friends over the years because of my BP.  (Or maybe they just didn’t like puns.)   Especially in the last 10 years before the diagnosis, I was very, um, intense, shall we say, and it’s not really surprising that some people pulled away.  What amazes me, what I am so very, very thankful for, are the friends who stuck with me in spite of it all, who never saw me the way I saw myself.  They have truly been ministers of God’s grace in my life – and BP or no BP, I hope that I may also extend that same grace to others.

So, there you have it, if you’ve actually read through this whole ridiculously long post!   If this helps even one person to understand the world of BP better, elicits compassion from just one person for the BP in his life, helps one BP to feel like she’s not alone, then it’s been worth writing.  God’s grace to you all, and to God be the glory.