Love and Mental Illness
I have written openly on this blog about many things: relationships, gender, sex, religion, and even my own battle with Major Depressive Disorder with a side of General Anxiety Disorder. Mental illness is something that still carries an enormous stigma in our society. To an extent, there has been a certain element about mental illness that has made it trendy, as long as one is not too mentally ill. Upper middle class people discuss their anti-depressants like they would their favorite scotch, because really they are only "a little" depressed. Psychiatrists even refer to those things as "the diagnosis du jour."
D told me on our first date about his bipolar disorder. Normally that doesn't sound like first date conversation, I know. But remember we'd spent hours upon hours on the phone prior to that first date, and he felt the need to explain something. As with most everyone who is bipolar, he takes lithium. One of the major side effects of lithium is a tremor in the hand and arm, which is exacerbated when one is nervous or anxious. That was very apparent as we were sitting down to that first glass of wine, waiting for our table. I didn't ask about it; he offered the explanation so I "wouldn't think he was an alcoholic or something."
Initially, it was no big deal to me. Okay, he's bipolar. I'm MDD/GAD. Who doesn't have a mental illness these days? I knew the basics of bipolar disorder and thought, "I can handle this." We had many conversations about his illness, treatments, and how they were sometimes similar to my own issues. We even take one of the same medications. The conversations were frank, honest, open, and without judgment, because we both knew we were talking to someone who just knew. Unless you've had those crazy thoughts run through your head, unless your brain has gone wacky and you know it's wacky but you can't do a damn thing about it, you just can't understand what it is like. We both did.
When he broke up with me, he said it was him, not me. I knew ever since he and I started dating that he'd been worried he was about to have another episode. He even made an appointment with his doctor/therapist for a "check in" because he was worried about it. She adjusted two of his medications and told him she was glad he was dating; she thought the timing was perfect.
A year ago plus, when J broke up with me, I thought it was all me. After all, I was going through a particularly difficult round of depression, caused by a horrid chemical reaction in my body from an injected medication. I read up - again - on my illness. I read up on the drug that had sparked my worst episode in a decade. And I read up on vulnerability, on relationships, on interpersonal dynamics.
Book smart and street dumb, that's me.
But all that reading did help me realize that it wasn't completely me. He, J, had his own issues. Huge issues. The books I read, thanks to a dear friend, helped me with all that.
Remembering that, I made an impulsive stop at the library today on my way home from work. Topic: bipolar disorder. D had said he wanted me to meet his therapist and talk with her some about his illness, because she could explain it better than he could. Since that's not a possibility right now, I went to the second best thing: published books on the subject which include information on how the friends and family of affected people should help.
I've finished the first book, and already I feel so much better. Mental illness is not an excuse for anything, but it is an explanation. I'm not going to espouse my semi-yet-basically-uneducated thoughts on what is going on with him, but here are some insights that are helping me:
Bipolar disorder affects 1-3% of the population, depending on which sources you consider. Like any mental illness, there is no clear-cut cause although genetics are being shown to play a role. It is difficult to diagnose and is trending towards a spectrum-like system of classification, similar to autism. The basic forms of bipolar are bipolar I, bipolar II, and cyclothymic; those are in order from most extreme to least. By extreme, I mean the severity of the swings. Bipolar II is the most common form of BPD, affecting up to 45% of those diagnosed.(1) Most people with a basic understanding of bipolar disorder think it is just these swings, that someone with BPD goes from super happy to horridly depressed and that is that. It is much more complicated than that, as episodes can be mixed; a combination of manic or hypomanic behaviors and depressive ones.
A manic episode isn't just being overly happy. People experiencing and manic or hypomanic episode may become excessively talkative, engaging in conversations with rapid and unexpected subject changes where they talk very rapidly and rarely let the other person interject. They have a tendency to spend money to excess, and become hypersexual, even engaging in risky sexual behavior. In a manic episode, they may have grandiose thoughts and dreams that verge on the unrealistic. They may also abuse drugs and alcohol.
The depressive episodes are what the public in general may be more familiar with: the sadness, lack of energy, giving up interest in things usually enjoyed, thoughts of suicide, an overwhelming desire to be alone, etc. The key to differentiating between BPD and MDD is the manic episodes, but since manic episodes can be mixed and include qualities of depression, the manic episodes can be difficult to identify. This is especially true if the episode is only hypomanic, meaning it doesn't have the extreme behavior. It is rare that someone has a clear full manic episode, and when they do, it usually requires hospitalization.
Many people refuse a BPD diagnosis, while others think they can handle it without the drugs and therapy. The best success for leading normal, functioning, and fulfilling lives comes from those who find the best combination of medication and therapy, therapy that may include one-on-one, group, and/or family. Frequently those with BPD who have learned to embrace their illness so they can get better over-analyze their behaviors. They fear certain ideas and thoughts are indications that they are about to have an episode. They may turn down great opportunities or new friends, feeling unworthy.
I am pretty sure D is bipolar II, although he may be bipolar I. 75% of people with bipolar disorder also have, on average, two additional mental illness that often go undiagnosed or are lumped in with the treatment for BPD. The most common of those, which I'm not going to say what it is because the name of it is very misleading, may commonly cause the affected person to "impulsively quit a job, end a relationship, or make an enemy out of a friend due to real or imagined fears of abandonment, disappointment, or perceived threats" when combined with bipolar disorder. (2)
Based upon our hours upon hours of intimate conversation, I have no doubt whatsoever that this is what happened.
I'm going to give him a few days to process. He's defriended me on Facebook because he couldn't take the reminders, but he has been sure to not delete me from his phone, and he told me that. Whether or not he is reading this blog, I don't know. I'm inclined to think he is not because that means being reminded. A few days apart may be what we both need. Then I'm going to gently reach out and let him know in terminology known only to us that I've been reading up on his illness and I'm not giving up on him. When he's ready, I'll be there, be it as a friend or something more. My last words to him in person, as I was leaving his house, were, "You're worth waiting for." I meant it, and I still do.
Sources
(1) "Bipolar Disorder: A Family-Focused Treatment Approach." David J. Miklowitz & Michael J. Goldstein. (c) 1997 The Guilford Press,
(2) "The Everything Health Guide to Adult Bipolar Disorder," 3rd ed., Dean A. Haycock, PhD. (c) 2014 F+W Media, Inc.
D told me on our first date about his bipolar disorder. Normally that doesn't sound like first date conversation, I know. But remember we'd spent hours upon hours on the phone prior to that first date, and he felt the need to explain something. As with most everyone who is bipolar, he takes lithium. One of the major side effects of lithium is a tremor in the hand and arm, which is exacerbated when one is nervous or anxious. That was very apparent as we were sitting down to that first glass of wine, waiting for our table. I didn't ask about it; he offered the explanation so I "wouldn't think he was an alcoholic or something."
Initially, it was no big deal to me. Okay, he's bipolar. I'm MDD/GAD. Who doesn't have a mental illness these days? I knew the basics of bipolar disorder and thought, "I can handle this." We had many conversations about his illness, treatments, and how they were sometimes similar to my own issues. We even take one of the same medications. The conversations were frank, honest, open, and without judgment, because we both knew we were talking to someone who just knew. Unless you've had those crazy thoughts run through your head, unless your brain has gone wacky and you know it's wacky but you can't do a damn thing about it, you just can't understand what it is like. We both did.
When he broke up with me, he said it was him, not me. I knew ever since he and I started dating that he'd been worried he was about to have another episode. He even made an appointment with his doctor/therapist for a "check in" because he was worried about it. She adjusted two of his medications and told him she was glad he was dating; she thought the timing was perfect.
A year ago plus, when J broke up with me, I thought it was all me. After all, I was going through a particularly difficult round of depression, caused by a horrid chemical reaction in my body from an injected medication. I read up - again - on my illness. I read up on the drug that had sparked my worst episode in a decade. And I read up on vulnerability, on relationships, on interpersonal dynamics.
Book smart and street dumb, that's me.
But all that reading did help me realize that it wasn't completely me. He, J, had his own issues. Huge issues. The books I read, thanks to a dear friend, helped me with all that.
Remembering that, I made an impulsive stop at the library today on my way home from work. Topic: bipolar disorder. D had said he wanted me to meet his therapist and talk with her some about his illness, because she could explain it better than he could. Since that's not a possibility right now, I went to the second best thing: published books on the subject which include information on how the friends and family of affected people should help.
I've finished the first book, and already I feel so much better. Mental illness is not an excuse for anything, but it is an explanation. I'm not going to espouse my semi-yet-basically-uneducated thoughts on what is going on with him, but here are some insights that are helping me:
Bipolar disorder affects 1-3% of the population, depending on which sources you consider. Like any mental illness, there is no clear-cut cause although genetics are being shown to play a role. It is difficult to diagnose and is trending towards a spectrum-like system of classification, similar to autism. The basic forms of bipolar are bipolar I, bipolar II, and cyclothymic; those are in order from most extreme to least. By extreme, I mean the severity of the swings. Bipolar II is the most common form of BPD, affecting up to 45% of those diagnosed.(1) Most people with a basic understanding of bipolar disorder think it is just these swings, that someone with BPD goes from super happy to horridly depressed and that is that. It is much more complicated than that, as episodes can be mixed; a combination of manic or hypomanic behaviors and depressive ones.
A manic episode isn't just being overly happy. People experiencing and manic or hypomanic episode may become excessively talkative, engaging in conversations with rapid and unexpected subject changes where they talk very rapidly and rarely let the other person interject. They have a tendency to spend money to excess, and become hypersexual, even engaging in risky sexual behavior. In a manic episode, they may have grandiose thoughts and dreams that verge on the unrealistic. They may also abuse drugs and alcohol.
The depressive episodes are what the public in general may be more familiar with: the sadness, lack of energy, giving up interest in things usually enjoyed, thoughts of suicide, an overwhelming desire to be alone, etc. The key to differentiating between BPD and MDD is the manic episodes, but since manic episodes can be mixed and include qualities of depression, the manic episodes can be difficult to identify. This is especially true if the episode is only hypomanic, meaning it doesn't have the extreme behavior. It is rare that someone has a clear full manic episode, and when they do, it usually requires hospitalization.
Many people refuse a BPD diagnosis, while others think they can handle it without the drugs and therapy. The best success for leading normal, functioning, and fulfilling lives comes from those who find the best combination of medication and therapy, therapy that may include one-on-one, group, and/or family. Frequently those with BPD who have learned to embrace their illness so they can get better over-analyze their behaviors. They fear certain ideas and thoughts are indications that they are about to have an episode. They may turn down great opportunities or new friends, feeling unworthy.
I am pretty sure D is bipolar II, although he may be bipolar I. 75% of people with bipolar disorder also have, on average, two additional mental illness that often go undiagnosed or are lumped in with the treatment for BPD. The most common of those, which I'm not going to say what it is because the name of it is very misleading, may commonly cause the affected person to "impulsively quit a job, end a relationship, or make an enemy out of a friend due to real or imagined fears of abandonment, disappointment, or perceived threats" when combined with bipolar disorder. (2)
Based upon our hours upon hours of intimate conversation, I have no doubt whatsoever that this is what happened.
I'm going to give him a few days to process. He's defriended me on Facebook because he couldn't take the reminders, but he has been sure to not delete me from his phone, and he told me that. Whether or not he is reading this blog, I don't know. I'm inclined to think he is not because that means being reminded. A few days apart may be what we both need. Then I'm going to gently reach out and let him know in terminology known only to us that I've been reading up on his illness and I'm not giving up on him. When he's ready, I'll be there, be it as a friend or something more. My last words to him in person, as I was leaving his house, were, "You're worth waiting for." I meant it, and I still do.
Sources
(1) "Bipolar Disorder: A Family-Focused Treatment Approach." David J. Miklowitz & Michael J. Goldstein. (c) 1997 The Guilford Press,
(2) "The Everything Health Guide to Adult Bipolar Disorder," 3rd ed., Dean A. Haycock, PhD. (c) 2014 F+W Media, Inc.
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