Beyond the Label: What It’s Really Like Living With Bipolar Disorder

The risk of self-harm and suicidal tendencies are very common during episodes in bipolar disorder.

For a person diagnosed with bipolar disorder, it's way more than "mood swings" and it affects pretty much all the important aspects of their life.

(Photo: Parthavee Singh/FIT)

Trigger Warning: Descriptions of self harm. Reader discretion advised.

(If you have thoughts of self-harm, or you know someone who is in trouble, please show them your sympathy and call these numbers for local emergency services, helplines, and mental health NGOs.)

We all have mood swings from time to time, and that's absolutely okay. But what happens when those moods start taking over your life to the point where you lose control of yourself, unless you get help?

That's kind of what happens when you have Bipolar Disorder. Not long ago, I was diagnosed with it too.

Many people have different ideas about this mood disorder thanks to its inaccurate portrayal in movies and shows.

To date, the only show that did justice to what it really feels like to have Bipolar Disorder, in my perception, has been Modern Love, Ep3: Take Me As I Am, Whoever I Am.

Anne Hathway's honest, yet sensitive portrayal of a person with bipolar navigating love and life made me fall in love with her all over again.

The first most important thing to understand is that for a person diagnosed with bipolar disorder, it's way more than just 'mood swings', and it affects pretty much all the important aspects of their life.

On top of having to navigate around the disorder, taboo and stigma from those around them, even well meaning friends and family can sometimes make life harder for someone living with bipolar.

So, to explore beyond the walls of the diagnostic labels, FIT spoke to two experts — Dr Rachna Khanna Singh, Consultant Mental Health and Behavioural Science, Artemis Hospital Gurugram, and Dr Lakshmi K P, Clinical Assistant Professor, Psychiatry and Behaviour Medicine, Amrita Hospital, Kochi.

Let's Talk About Bipolar 'Episodes'

Manic, hypomanic, and depressed episodes can all be signs of bipolar illness.

A manic episode is characterized by tremendous energy coupled with great happiness, excessive gregariousness, or extreme impatience.

• The signs of a hypomanic episode resemble those of a manic episode. Having an abnormally high level of activity or energy. Feeling extremely happy, excited. Not sleeping or only getting a few hours of sleep but still feel rested.

But, during a manic episode, moods might quickly change from joy to rage, despair, or impatience.

• A significant depressive episode lasts for two weeks or longer. A depressive episode can make a person feel depressed or hopeless. They could avoid social settings. They stop finding enjoyment or comfort in the people and activities they are involved in, which they once liked.

Having inflated self-esteem, thinking you’re invincible. Being more talkative than usual.Talking so much and so fast that others can’t interrupt. Having racing thoughts, etc can all be subtle signs of Bipolar Disorder.

Sometimes manic and depressive symptoms have been known to appear at the same time. This is known as a mixed state or 'mixed episode', explains Dr Rachna Khanna Singh.

In other cases, there may not be any symptoms in between bouts, and attacks may be sporadic.

"Mood episodes, which are separated by intervals of days to weeks, are common for people with bipolar disorder and involve high emotional states."

Dr Rachna Khanna Singh, Consultant Mental Health and Behavioural Science, Artemis Hospital Gurugram

Some people experience mania and depression on a regular basis, which can be disruptive to all aspects of their lives, from relationships to their careers.

Relationships

"I am in a happy and healthy relationship for the first time, yet I have this constant fear of my partner will eventually feel that my emotions and I are a bit extreme to handle. I wanna look forward to a future but every good thing feels too nice to accept and I don't know if I'll ever be enough."

Anonymous

The emotional turmoil that those with Bipolar go through can often cause them to distance themselves from loved ones, and result in unhealthy interpersonal dynamics like breaking up with partners because you feel unworthy.

Relationships might be complicated further by self-hatred.

They often have trouble accepting compliments from others and being vulnerable in relationships as they undermine themselves.

Intimacy

"Patients with bipolar disorder can have intimate relationships. However, during the episodes, their logical thinking may be affected and this may result in interpersonal issues," says Dr Lakshmi K P, Clinical Assistant Professor, Psychiatry and Behaviour Medicine, Amrita Hospital, Kochi.

She goes on to explain, it is really important for a partner/caregiver to be patient enough and understand that it's the person diagnosed who struggling too, and even the simplest of emotions can get really overwhelming.

"When I'm having my episodes, the same touch that feels comforting can get really scary, thankfully I have a really understanding partner who gets it instead of taking offence and making it about themseleves."

Anonymous

Academics

A person with bipolar disorder can have academic difficulties during the episodes.

Dr Lakshmi explains that during a depressive episode, they may find it difficult to concentrate, they may have a reduced interest in these activities.

It's common to get tired easily. Moreover, they may feel that they are not capable of doing these activities.

"During hypomanic episodes, they may be more productive, there will be increased energy, however, the state may shift into a depressive episode or manic episode," says Dr Lakshmi.

During a manic episode, they may get distracted very easily by other thoughts, ideas and plans, and may not be able to focus on their academics.

But, that doesn't mean that people with bipolar are doomed to be poor performers.

"With proper treatment and regular therapy, these patients are capable of achieving academic excellence," says Dr Lakshmi.

"Caregivers should know about the symptoms, they should watch for behavioural changes in these patient and seek medical help as and when needed."

Dr Lakshmi K P, Clinical Assistant Professor, Psychiatry and Behavior Medicine, Amrita Hospital, Kochi

Self Harm And Suicidal Tendencies

The risk of self-harm and suicidal tendencies are very common during episodes of bipolar disorder.

During the depressive phase, the person may think that they are a burden to others. They may feel helpless, hopeless or worthless, and may think of self-harm.

"When a person expresses death wishes, it should be taken seriously. Close supervision is needed and steps should be taken to get medical help immediately."

Dr Rachna Khanna Singh, Consultant Mental Health and Behavioural Science, Artemis Hospital Gurugram

The specific sense of self-hatred that can develop during a depressed episode is less talked about, though. Self-hatred can be a powerful feeling.

Self-hatred, or low self-esteem that goes beyond normal or constructive self-criticism and awareness, may result from it. It may be so bad that you think about hurting yourself or even suicide. 

Some ideas that self-hatred can manifest as are,

"I’m not at par." 

"I’m unique compared to everyone else."

"I have no business being here." 

"My family has to put up with me. What is the purpose?"

What Can Be Done?

Patients with bipolar disorder can work and lead a normal life like any other person.

However, it is advisable that they make it a point to lead a healthy life, avoid illicit drugs, exercise regularly, and get adequate sleep.

Sleeping patterns can hugely affect the episodes that occur, too.

Medicines are helpful in managing bipolar disorder along with regular therapy.

"You can discover problematic thought patterns, attitudes, or actions that contribute to your sense of self-loathing with the aid of cognitive-behavioural therapy (CBT), a type of treatment," says Dr Lakshmi.

"You can also learn radical acceptance of your circumstances and feelings related to having bipolar disease through dialectical behavioural treatment (DBT), including self-loathing."

Dr Lakshmi K P, Clinical Assistant Professor, Psychiatry and Behavior Medicine, Amrita Hospital, Kochi

According to research Trusted Source, dialectical behavioural therapy (DBT) can assist people with bipolar disorder in learning to be mindful, and Increase your ability to deal with stress and emotional reactivity.

Although it may be challenging to conduct self-love exercises like journaling when you have bipolar disorder, practising journaling can help track and make sense of your moods oscillations, and behavioural patterns.