What is bipolar disorder?
December, 2009
Joe talks to us about life with bipolar disorder. He describes his hypomanic and depressed episodes. These are the details of daily life as a depressed person.
Question: Hello Joe, how are you doing today?
Joe: I'm coping, I'm ok. I got up, I made the effort to be here, so that's a good thing. I feel good about being out of the house. It has cheered me up a little.
Question: Beyond today, if you look back over the past few weeks and months, how have you been doing?
Joe: How can I put this accurately? [Joe pauses as though lost in thought for a few moments] To be honest, it has been awful.
I get nothing done. I don't work, I have no plans to work, I can't even map out in my head what I would need to do in order to find work. The last time I did regular work was, oh, about 10 years ago. I have no money, that's a huge worry, I have debts ... but the big feeling, the overwhelming feeling I have is that I have wasted my life, thrown it away.
I had a pretty good time as a young man, hobbies, interests, a good job that I enjoyed, but I just let it all slip away. The present is horrible and empty, and the future, it's so frightening, so terrifying I can't even think about it.
Question: I think our readers would really appreciate it if you put some detail on this feeling of hopelessness. What do your days look like, what do you do?
Depression locks you into your own small world, and there seems no hope of escape (Model: Actor Jeremy Irons)
Joe: Most days I don't do anything. I mean, I do the basics: I get up, not too late, I get dressed, shave, have coffee and breakfast. While eating breakfast I might have some plans to go to the store, or make some phone calls, deal with some paperwork, but then this blanket of fatigue falls over me and even making a phone call becomes an impossible mountain to climb. So I go back to bed and I sleep until noon or later. I have no energy or enthusiasm.
Question: Does that feeling lighten? Are there days when you are able to tackle mundane tasks?
Joe: There are bad days and then there are truly horrible days. That's what it's like.
Question: When you say you have thrown away life's opportunities, what do you mean?
Joe: When I look back I see I had so much going for me, such a bright start to adult life. Then I made one disastrous decision after the other -- one door after the other closed, never to open again. I had a naive belief that life and opportunities were endless, that there would always be time to correct mistakes.
Question: How have you survived 10 years of unemployment?
Joe: I've had odd jobs, I inherited money from my dad, I didn't have a lot of debt, no big loans.
Depression can turn an bubbly, outgoing person into an anxious wreck without hope
Question: Do you have friends? Are you involved in any social activities?
Joe: I had a couple of close friends years ago, but my depression wrecked those friendships. Today, I don't have many friends, one or two perhaps. I rarely go out. I'm not involved in any social activities. I used to be very interested in local history and walking, but I don't bother with that anymore.
Question: You have no one to talk to?
Joe: No, I have no one really. Well, I talk to people now and again, nothing deep or serious.
Question: Are you involved romantically with anyone?
Joe: No, I have not been on a date for many years. I have no contact with women. And I don't try.
Question: Not even online?
Joe: No, meeting someone online, chatting, that stuff does not interest me.
Safety of the couch. Weeks at a time can be spent curled up on the couch
Question: You don't take part in discussion groups, forums?
Joe: No, I can't build up any enthusiasm for that. I don't really want to meet someone, it would be such hard work. I have no money, I'm miserable company, I have no ambitions, no patience. It would never work.
Question: Are you aware of any history of mental illness in your family?
Joe: My father was a moody, unhappy man. That's how I remember me. At weekends he wouldn't get out of bed until 1 or 2 p.m. It's not that he went late to bed. I am pretty sure he was depressed, but I never heard him and my mother talk about it, nor was he ever treated. I can't remember him taking any pills, not even for headaches.
My father's brother killed himself when he was a young man. That was hushed up. We never talked about it. All I know is that he took an overdose of pills and cut his wrists.
Question: Have you ever sought professional help?
Joe: Oh yes, I saw a psychiatrist some time ago. I was told I had bipolar disorder, the sort that's characterized by pretty deep depressions and only minor manic, not proper manic, episodes. The doctor talked about chemical imbalance. I was put on anti-depressants, Prozac I think. I didn't find that they helped. I later hear good things about Cymbalta, but didn't try that. But it was kind of helpful to know there was a name for what I had.
Hypomania: bipolar sufferers can experience periods of intense interest and enthusiasm in a subject or activity
Question: Tell us about those mild manic periods.
Joe: In my case, they're called hypomania, I think. They're just periods where I feel enthused about something or other, motivated to do something, doesn't have to be anything major but it can occupy all my attention for a while, it can affect my sleep because I'm too agitated to sleep well. It passes as quickly as it comes. There's usually some small obstacle that ends the enthusiasm, and I see it's pointless to get worked up when nothing is going to change.
Question: Can you give an example of something that has enthused you?
Joe: It's usually nothing very special. Some time ago, I read that exercise can help you deal with depression. I looked into it, did some reading, thought about quitting smoking, cutting back on my drinking, walking regularly, building up to jogging. I had it all laid out in my head, and I felt good thinking about it. I could see the steps very clearly in my head, I stayed up very late, sometimes well into the morning, reading about the links between aerobic exercise and feelings of well-being and contentment. Exercise is supposed to make you fit in mind and body. I was interested for a while but it went nowhere.
Question: Why did it go nowhere?
Joe: At first I postponed giving up smoking and reducing my wine and beer consumption. It was always "Tomorrow's the day I'll start". I'd feel pretty hyped up about tomorrow, then tomorrow came and I'd convince myself the day after was a better day. Finally it fizzled out. I was never going to quit smoking or start running the streets. What's the point?
Friends and social activity can bring you out of isolation
Question: Did a period of depression follow that?
Joe: I see myself as almost permanently depressed. Obviously it varies from day to day, or week to week. At its worst I can't leave the house, well I can't the leave the couch actually. I can be inert for two or three weeks, just eating a minimum, going to the bathroom, but not really taking care of personal hygiene.
Generally it's not that bad but just a feeling of life being pointless, that it's come to an end for me with no hope of improvement. I'm a spectator of my own life. It's frightening being alone with no prospects in your 50s.
I have no inner sense of worth, I'm not proud of the decisions I've made. I have very low self-esteem and no joy, no sense of worth. I avoid people because every one of them is a success story compared to me.
Loss of a loved one and your sex partner can plunge you into a deep, gloomy depression
Question: Have friends or family tried to help you?
Joe: In the past, people have recommended books or told me I should see a doctor. Others have mentioned the benefits of positive thinking, the need to look on the bright side, as though you can just pull yourself out of this by willpower alone. Thing is, when you are down, you are incapable of seeking help. You just endure it.
Question: Have you ever had suicidal thoughts?
Joe: Suicide demands planning and effort, doesn't it. That's too much for me. Where would I buy the pills? What would I put in the suicide note? Who would even notice? No, suicide is for more ambitious people than me.
Question: Can you say anything at all about the future? Will you try again to seek help.
Joe: I can't think about the future. If I did, I would never sleep. I have no money, no future, no life. I might seek help, I really don't know. I can't make any promises about anything.
Question: Thank you, Joe.
Joe: You're welcome.
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