And Now For Something Completely Different

I haven't written in some time about my bipolar condition. The medications have calmed me down considerably and evened out the highs and lows. This has come at a cost. The brain fog that the medications induce is great. It is harder to get fully awake in the morning, and too much concentrated brain work in too short a space of time causes a serious function crash.

Since I last wrote seriously about my condition, I lost a temporary job because of this. I signed on to work eight hour shifts for 3 consecutive days without a break, instead of 6 hour shifts over the same schedule, because I really could have used the money. The money was really good, but the task was very mentally demanding. Trying to work 8 hours at a stretch was a mistake. With the drugs, I have, I discovered, no more than 20 hours of work at that concentrated level before my performance deteriorates precipitously. After that, I must have a minimum of a one day break to return to full function.

During the last four hours of the 24 that I was trying to do for this company, the function crash occurred, and my performance deteriorated so swiftly and so completely that by the end of the project I had failed to meet the minimum overall standards to be invited back. Such is the roller coaster that the morale of a mental health client is always riding. You feel better and you try to push beyond your limits, you fail, and then you must deal with the objectively induced depression (as opposed to the mere brain chemistry depression). It has taken me several weeks of dealing with this before I could even attempt to write about it.

How can you tell the difference between the two, you might ask? You can be pretty sure you have a brain chemistry problem of some sort if you are not depressed about anything particularly: if the depression is severe, extended, free-floating, and tied to no objective event. I knew for years that I was clinically depressed, but establishing the bi-polarity was much harder. The highs simply don't appear to be a problem and you and the GP end up medicating the depression only.

Bipolarity can be diagnosed fairly readily if your high is so great that you become delusional. Unfortunately, at this level of crisis, the transition to treatment, and then from treatment to functional recovery can be extremely, and unavoidably, destructive to the individual involved. In the treatment phase, it usually involves at least some physical restraint or confinement and forced medication.

The scars of this, and the lingering resentment that it leaves the patient with, often result in the patient's non-compliance with the need to medicate in the recovery phase, a relapse into delusion, and the need to put the individual under court order to take the medication when recovery is attempted once again, after a second confinement.

But even this, at least, can eventually have a good outcome, though the road to it can be rough. A bipolar such as myself, though, who never loses grip on reality can subsist for years being medicated incorrectly for depression alone. One indicator of this, which I learned after finally being diagnosed, is when several specific anti-depressives in succession simply cease to work to relieve the depression.

The non-delusional bipolar individual can, as I did, run through an entire spectrum of medications, one after the other, with the GP, only to have all of them fail in the end. Apparently, what occurs is that the manic and the depressive phases each act as a compensating feedback mechanism for one another. If you intervene chemically with only the depressive half of the problem, this feedback process slowly adjusts the brain chemistry to adapt to the intervention and resume the depression that compensates for the mania.

If you are depressed, under medication, and finding that several different medications consistently lose their potency to combat your feelings, ask your GP about a self-reporting set of oral questions which can indicate the possibility of a bipolar condition, and make every effort to get a referral to a medical professional specializing in psychiatric medicine if this questionnaire comes out positive.

Whatever the drawbacks of medication, I can testify that the unmedicated alternative is far worse, particularly when, as in my case, it goes on for years with repeated failures to treat the depressive condition reliably. I made it through, but only because I started out with a will of iron and an active religious life. I very greatly fear that many others don't make it and are eventually pushed into either overt or covert suicide. I came close.

I will say no more about it, but I came close.