“Hi Glen. Thanks for volunteering to tell your story. To start with, can you just tell me a few details such as your age and diagnosis.”
Sure. I’m 32 years old. I have been diagnosed with Bipolar 2. I started getting symptoms at age 20 and was initially diagnosed with severe depression. It was only when I was 25 that I got diagnosed with Bipolar 2.
“It sounds like getting accurate diagnosis was an issue for you for quite some time. Tell us a bit about it”.
Before 2005 I was attending uni and feeling that life was ok. I was shy and a bit socially isolated but certainly not depressed or particularly unhappy. In November 2005 I started to feel different. Something had fundamentally changed. I looked up the symptoms of depression. (I am an economist and researcher and intellectually curious so have always sought out information about my health). I went to a GP and started trying medication hoping it would fix it.
I read books and academic literature on depression and felt it was a biological problem for me, not something caused by social factors. I had some social anxiety though and was not willing to acknowledge it much at first. From my reading I recognised that I had melancholic type depression (from within, not environmental, slowed down body and mind).
In 2006 I was feeling physically and mentally slow. I could not get pleasure from anything. Medication wasn’t really working so we kept upping the dose. I was still doing well at uni because I had nothing else pleasurable to distract me. Later in the year a lack of motivation and concentration started to severely affect my performance at uni. After a while, pleasure started to come back for some things but I still had poor motivation overall. Then I went through a period of numbness, not feeling emotion. I felt bored and slept a lot. I became agitated at times and had what I now recognise as mixed episodes.
I was still living at my family home then. I was private about the suffering I was going through and felt ashamed about my illness. I didn’t know how to talk about it. My mum and sister knew I was depressed but did not have any idea of the severity of it. When I was very agitated I hit the towel rack in the bathroom out of frustration and broke it. I am very gentle and calm and this was so out of character that my sister realised there was a bigger problem. She still did not get the extent of it as I was self- harming and not talking about it.
At this point I was both numb and agitated. This was a dangerous combination and I would definitely put myself in hospital now if I felt that way. But at the time this would have required telling people the things I was thinking. I started seeing a psychiatrist and tried a new medication called Abilify. I became over-sedated and stopped taking it after 2 weeks. By this stage I was actively suicidal. I didn’t directly tell this to anybody but I obliquely mentioned it to the psychiatrist. 50 per cent of the time I was thinking about death and suicide. I was feeling hopeless and my mood just went down further and further. I felt a complete loss of hope. By late October 2006 I had lost my memory of happier times. I couldn’t remember what it felt like to be happy. I felt utterly dead inside. I had no expectation of being alive in a few months. It felt like a matter of time. That was in late October 2006.
By mid-November 2006 I was feeling 90 per cent better. I am not sure if that was due to the new medication I was taking or just a natural progression of the Bipolar Disorder cycle. That was the first time I’d come out of a depressive cycle so it was a huge but highly welcome shock. I went on a four week holiday to Asia not long afterward and had fun.
Three months later I moved to Canberra to work in a graduate job at Treasury. This was the first time moving out of home and it was also in a new city and first time working in a fulltime job. But I handled it well and the contrast from six months previous was huge.
For the next 3 years I was moderately depressed about 25 per cent of the time. In 2010 I had constant severe depression for 6 months. I was not actively suicidal but I was having suicidal ideation. There was a clinical psychologist on staff at my work who I started to see a few times a week for 20 minute sessions. The psychologist recommended I see a psychiatrist. I was suffering from psycho-motor retardation (slow movement, flat face, monotone voice and foggy thinking and memory). It was an effort just to hold my head up so I frequently rested my chin on my hand.
I’d raised the possibility of bipolar 2 disorder with a psychiatrist in 2009 but I’d effectively been laughed out of the room and forgot about it. But in 2010 my GP said she thought it might be bipolar 2. I argued with my new psychiatrist that this was correct and he slowly became more confident. It became crystal clear when I had a hypomanic reaction to an antidepressant.
I saw this psychiatrist for a couple of years and we tried many different medications. I was rapid cycling every 2-3 weeks. This made it hard to tell if medications were working. We tried most medications that might work but had little success. In hindsight it was a mistake to not give the mood stabilisers more time to assess their effectiveness.
We talked about ECT on quite a number of occasions. I would become barely functional for weeks. I couldn’t work, struggled to do everyday things and had barely enough energy and alertness to drive. ECT works well for these symptoms. However, I was worried about the memory problems as memory and alertness is very important for my job and my main hobbies. We were about to make a decision a couple of times but then I’d come out of a very bad six week spell and be fine for awhile.
“How are you now?”
Pretty good. I work full time and enjoy it. I am well paid and have work for an organisation that is understanding. I have lots of friends who I see quite a bit but I’m not in a relationship. My stress is minimal.
I struggle to push my life in a direction I want. I get momentum with a goal for a month and then depression stops the momentum both due to lack of motivation and difficulty in doing things that are hard. Bipolar Disorder still has a big impact on my life.
“What would you advise others going through a similar experience?”
Track your mood each day. I have been rating my mood daily for the past 2 years. It helps me assess if medication is working especially if I am rapid cycling. I went off Lithium towards the end of last year and for the next two months I had more cycles. The mood tracking helped me see the impact Lithium was actually having. I wish I’d done mood tracking from the start.
Take a long-term approach.
Medication has been the primary thing for me. Try and find a medication that’s right for you for life.
Take a “recovery” approach and move forward in life. Take responsibility for it. It’s not our fault we have Bipolar Disorder but we need to take responsibility for how we deal with it.
Support groups. Knowing others that have Bipolar Disorder. It’s great talking to people who understand. Particularly when other people get a specific thing you’re going through that you doubt anyone else would understand.
Keep hope. Life can get better. Knowing people who are doing better than they were and seeing how they handle their bipolar is helpful. It helps with hope for the future.
Learn as much as you can about your illness and your triggers.
Do something meaningful with your experience. In Canberra I talked at a few Psychology university tutorials about my experience with bipolar disorder. Try to use a negative experience in a useful way. Finding a way to do that can help both you and others.
“What medications are you currently on and how are they helping?”
I’ve taken Epilim for three years. This has been very good for the psychomotor effects of Bipolar Disorder. I haven’t been so severely slowed down since then that it’s been hard to function. The psychomotor problems make it harder to work than the mood problems as it means I can’t think clearly or focus.
I’ve taken lithium for a couple of years. This seems to slow down the rapid cycles and kept me out of hypomania.
I take Lamatrogine. This is regarded as the most likely to work for Bipolar 2 depression. It’s hard to evaluate if it’s working for me. We may remove this if it’s felt I need to try something new.
I take a small dose of Seroquel for sleep. It makes me really sedated and I never get used to it. So I could never raise it anywhere near a mood stabilising dose but I can use the side effect to help. It wears off after about seven hours so I don’t have the morning grogginess. However, I do get insomnia if I miss a dose.