Bipolar disorder is something I come across very often in my line of work. I am a psychiatric nurse who works at both an involuntary inpatient unit and an outpatient county facility. A good part of our patients are diagnosed with Bipolar disorder; some are suicidal, some have no reason to live, some become so manic that they get psychotic. We have had perfectly "good" people go psychotic and threaten those whom they love, or perform bizarre acts in the middle of the road. We've had people who tried to commit suicide by cop, or hanging, or overdose; we've had them go off of their medications so many times that they got conserved.

But that's not all that bipolar disorder is (as if that wasn't enough), there's another form of bipolar disorder called bipolar 2 that is not so easily diagnosed. Some people with this disorder have months or years of depression followed by variable times of feeling good, or feeling great, or feeling really great. These people often seek treatment when they are depressed, and, unless questioned properly by a psychiatrist can get diagnosed with depression. This is a problem for multiple reasons, but the main reason would be that misdiagnosis and treatment with antidepressants can cause a person with bipolar 2 to go into a manic state, or do nothing at all.

Well, says you, why not just tell your doctor you get hypomanic? That's the funny part, most people don't know what hypomania is. It turns out that hypomania can cause people to have excess energy, cause racing thoughts, increased sex drive, lack of sleep, and agitation; among other symptoms.

The thing about bipolar 2 though, is that after weeks or months or years of depression many people with bipolar 2 welcome or look forward to a hypomanic episode. They think that's how they should be. One example would be a person who has been depressed for three weeks, then all of sudden they feel happy, really happy, so good, euphoric, their mind is going at the speed of light, they are horny, they feel so good. This can only sustain for a period of time before the person crashes. Like a meth crash; depressed, tired, doesn't want to do anything. Another example would be a person who has been depressed for awhile, then one day grows energetic but irritable. Everything someone does and says pisses that person off, the anger is irrational, nothing is different but the person's mood, but they can't change it. Often these people isolate, at times they grow verbally or physically abusive. The crash always follows at some point. Our energy will only sustain for so long before it is decimated.

Why do I write this, you ask. Well, considering that I am human and American it is purely for selfish reasons. I was diagnosed with depression when I was 15 and put on antidepressants that made me manic, I stopped them because I felt "wrong", then proceeded through two more rounds of antidepressants that either did nothing or caused mania/agitation. I want people to be more informed.


I now chart my moods, I didn't like any of the apps available so I developed a rudimentary system of keeping track of my moods via an old fashioned calendar. On the back I made a key of possible emotions (M-manic, H-happy, HO-horny, D-depressed, T-tired; and so on). I write the initials that correspond to that day every night, since starting this I have found interesting things. Apparently I cycle almost weekly, this is called rapid cycling bipolar disorder. I have gotten less agitated and more euphoric since starting fish oil supplements. I will bring this to my appointment with a psychiatrist when I find a psychiatrist I don't work with; this should help with any diagnosis. Another thing that I realized is that I have no concept of my prior moods. I started this calendar after months of just weird moods, but nothing I could pinpoint. What I realized is that when I come down from hypomania I later negate the symptoms "oh, I was just happy", when in reality I ran circles around my doctor and talked incessantly (I am not a big talker). When I am out of the agitated state I decrease the symptoms to myself, "it was a bad two days", "maybe I was within three weeks of my period and feeling hormonal". When I get out of the depressed state I just feel good and tell myself it's over.

The point of this massively long post is to encourage people to track their moods to help gain self-awareness. Even if you are not bipolar it can help you get to know yourself and what might make you upset.


Also, just because this is a mental health post: