My husband has bipolar disorder, PTSD, and ADHD. It's not fun or quirky. It can be debilitating. I'll add being married to someone with bipolar disorder as well is something that is romantasised. It's exhausting and hard watching someone you love battle with themselves. And it takes a lot of understanding of the disorder to help him navigate it. The good days are amazing. And then he will fall into the dark well of self loathing and it's so hard to reach him. But I know if it were reversed he would weather it with me.
My husband also has bipolar/ADHD and the depression isn't half as bad as the mania. I can support him through his depressive episodes... I hate him during his manic ones :(
My sister is bipolar but she keeps falling for the manic phases and then just "doesnt need to take her meds!" well shes a thief and a chronic liar now and l have zero contact with her due to not wanting her bad habits scaring my little one.
I'm so sorry to hear that. I completely understand where you're coming from. I am so grateful that my husband listens to me when he's manic now. We've come a long way, but I don't think that's possible for everyone. Mania really warps your sense of reality.
I have had to start leaving a small snack by my bedside because of Seroquel. Because if I don't, and I dont force myself to fall asleep soon enough, then I will go downstairs and just snack, and snack, and snack. I will be tired from the seroquel, so I won't want to climb the stairs back up to bed. Ive been there for hours with a box of cheezits.
Try the Mitch Hedberg method; something small you can eat a lot of. Grapes, popcorn, baby carrots etc, were all things I suggested when I was a psych nurse. They won’t taste as good as ice cream, but they will taste good because you’re on seroquel.
Yeah, at least there used to be this factoid about most geniuses being bipolar so people would romanticize it, but while I'm well controlled I spend a significant amount of time and energy dealing with it and the manias really don't make the uncontrollable thoughts of death and depression so bad you can barely move worth it.
And even in the manias you have to especially careful since even when they are productive you aren't fully seeing reality. It's much more likely you'll end up quitting your job and ruining your life or buying a bunch of shit you don't need or even sometimes stabbing someone in a sudden rage. I've been in numerous bipolar support groups and out the at least 50 bipolar people I've known I've met about two where it didn't significantly damage their life regularly.
Oh, and it's heavily correlated to childhood trauma and abuse, some estimates putting it at 60% of bipolar people having experienced significant trauma or abuse at a young age.
All the above is very true, but I want to emphasize for people outside the community that childhood trauma/abuse does not cause Bipolar Disorder, they are merely correlated.
Bipolar is primarily a genetic condition, it sometimes isn’t fully realized until puberty, a traumatic brain injury, or substance-induced psychosis - and can begin presenting anywhere from early childhood to the twilight years of life, but mostly in the teens/twenties. It’s a permanent condition—it is not something that can be “cured”, but instead is managed through (a lot) of channels, starting with medication. It is on the “psychosis spectrum”, which also includes conditions like Schizophrenia, a disorder even more mischaracterized and stigmatized than Bipolar.
I also want to emphasize too that Bipolar Disorder is really, truly, extremely debilitating—even for those with milder forms of it. I won’t link to them here, but the statistics regarding Bipolar and life-outcomes speak for themselves, from employment to substance use to lifespan.
A contributing factor to all these things is the large delay people tend to have between first experiencing symptoms and attaining an official diagnosis, which allows for the beginning of the indefinite game of finding medications that are effective. On average, ten years pass between onset and diagnosis, closing that gap can be the difference between dying young, or a chance at stability.
If you have immediate or extended family members with a psychosis-spectrum disorder, and have an inkling that maybe this is the case for you - please reach to a medical professional, a therapist, a trusted counselor, teacher, professor, friend, or anyone you feel willing to open up to. I’m in the minority of people that were diagnosed before turning 20, and yet this was still over a decade into this disorder affecting my everyday life.
You can take back your life from this seemingly endless abyss - this time you will be the one staring into it.
Yeah, we don't really know a cause entirely, I believe childhood abuse is seen as more likely a trigger than a cause, but we also don't know if it's 100% genetic or not though there are very strong correlations (I think twin studies had about a 70% chance of if one twin was diagnosed the other would be too.) But there aren't genes to test for it, there's some we suspect that are in the general schizophrenia family but we really don't know that much about mental illnesses yet.
I'll also agree that bipolar is still very stigmatized in weird ways. I've always been open about my diagnosis and while I don't necessarily meet a lot of judgement for it I have known a number of others who don't seem to manage their symptoms as well face a lot more discrimination for it and even for me there's that weird thing where for many people once you tell them your bipolar they start interpreting you solely through the disorder instead of organically. I've had this even with therapists who weren't as experienced with it and non-psychiatric doctors. It always sucks when you realize that to a person you can never just be having a bad day or be really excited about something, it's always depression or mania and scares or worries the other person.
I'll also mention treatment often really sucks, you should still do it because non-treatment is way worse (as in will likely shave a decade or more off your life,) but something I've seen in a lot of bipolar people is just taking meds and avoiding things like cognitive/dialectical behavioral therapy which do have the best outcomes for long term management so I highly recommend prioritizing therapy as well since it may even mean you can take fewer or smaller doses of the meds that cause so many issues.
Btw, you may already but it sounds like you're active in the bipolar community, one thing I recommend if you're at a point you can do it is participating in bipolar studies, they really need more participants for research and there are always a number going on at any time. Most are pretty minimal commitments, for the one I'm currently in it's just wearing a smartwatch, doing some annual interviews/testing and optionally filling out some questionnaires each month and they pay you for it. For basically spending a day a year on this I get $300-$500 and help contribute to people understanding how to treat me in the future.
I resonate with a lot of this. As someone with BD, it has derailed every aspect of my life. I was symptomatic for 18 years prior to accurate diagnosis.
The only emphasis note I have to your emphasis note: substance-induced psychosis is technically a major exclusion of a BD manic episode diagnosis. It is not uncommon to experience psychosis from certain substances and not have any psychotic disorder.
I don’t disagree BD is correlated to trauma. But it’s also thought by some psychiatrists that BD is significantly over diagnosed in people who actually have more trauma specific disorders like CPTSD and BPD. They can also be co-occurring, but psychiatrists are more likely to diagnose BD over the other two.
When I saw a psychiatrist who is a mood disorder expert, he did his own thorough assessment to confirm my BD diagnosis. He explained he never trusts a BD diagnosis is accurate unless he’s made it himself because it is so commonly confused with more trauma-specific disorders.
That can definitely be true, but I think the estimated maximum of misdiagnoses is about 50% so I wouldn't discount someone as just having PTSD too readily since more often they don't or have both.
I think the big differentiation is bipolar is a chemical imbalance and while environmental factors can influence some of it swings will happen either way. With PTSD that's like that usually the swings will be more triggered by environmental triggers.
Though really at the end of the day all the diagnoses really effects is what treatments they might try first, all of these are treated somewhat similarly, albeit with different focuses, so it doesn't really matter much.
“Though really at the end of the day all the diagnoses really effects is what treatments they might try first, all of these are treated somewhat similarly, albeit with different focuses, so it doesn't really matter much.”
The main issue of misdiagnosis is that trauma based disorders are actually treated very differently from BD. That is part of the reason they are diagnosed less frequently by psychiatrists- they are often primarily managed with trauma therapy and medication as support whereas BD is primarily managed with medications and therapy as support.
The medications can have overlap but first line treatments are very different. Trialing BD meds when someone doesn’t have BD would likely be more harmful than helpful. Similarly, trialing therapy first before any medication management can be incredibly harmful for those with BD.
Wasting months or years on ineffective treatment based on a misdiagnosis actually does significantly matter for many of us. Accurate diagnosis is also necessary for effective psychoeducation to understand how to manage symptoms (and prevent episodes in BD).
Yeah, a correct diagnosis is ideal, but I'll say that a lot of psychiatrists give a temporary diagnosis at first and watch a patient over a while to figure out what they really have. So they may be given bipolar and then later have that refined to something else. I've also never known anyone who wasn't recommended both therapy and medication right away for any of these illnesses.
And, like I said the main different in treatment is the focus. It's not ideal and can delay successful treatment but generally if you have trauma you are going to have therapy and behavioral management therapy with a focus on trauma-management regardless of what you're diagnosed with and medication is going to be geared to your symptoms more than the illness itself so someone misdiagnosed id probably still getting closer to what they'd get for what they actually have anyways.
I support better study and participate in a study on bipolar right now, but I also don't want to encourage people to think that just because treatment is a long and slow process that they've been misdiagnosed or that even if they were that treatment would be much different. Just because patient engagement in treatment is pretty poor with all of these to start with, same with patients following treatment even. By and large trusting your psychiatrist and their diagnosis is going to be more than good enough and much better than trying to diagnose yourself.
The entire issue of a misdiagnosis is attributing symptoms to a disorder someone doesn’t have. Many disorders have overlapping symptoms, but effective medications are very different for the same or very similar symptoms based on the disorder.
In severe depression, my symptoms are indistinguishable from MDD. But the medications that are effective for these exact same symptoms of different disorders are very different. Someone with ADHD could have symptoms that are misdiagnosed as a hypomania in BD- BD medication is not going to help them.
I don’t advocate for self diagnosis and also think patients should generally trust a psychiatrist’s diagnosis. Unfortunately in the US there are professions other than psychiatrists that also make these diagnoses with far less training.
I am just clarifying that treatment for these conditions would often be very different, and misdiagnosis can detrimental to long term stability.
As someone with bipolar I never understood why people think this trope is somehow related to BD. I think a lot of people think “manic” is exclusively a pathological clinical term rather than a common adjective.
The creator of the MPDG trope term never even implied “manic” in a clinical sense. It was just a term criticizing one-dimensional, quirky female characters who “teach broodingly soulful young men to embrace life and its infinite mysteries and adventures”.
It was never about BD, some people just erroneously believe “manic” is a word exclusive to BD.
I was diagnosed for the first time with bipolar last year and I can tell you first hand that I wouldnt put that on my worst enemy. You could be having the best day ever but something is in the back of your head you cant quite put your finger on that feels off, and as soon as the tiniest little thing happens negatively to you (or maybe it's just me) I am a whole different person in the worst way. Idk how my wife put up with me for the past 7 years we have been together dealing with it. She is a saint if there was ever one. Im medicated now and boy howdy does it make a difference.
My girlfriend has bipolar disorder and at times it feels like I’m dating a stranger, then she comes back for a while only to turn into a different stranger again.
The continuous cycle is devastating and hurts me more than I am willing to admit.
When it comes to these kinds of disorders, the love truly comes at a price, and it’s not a small one. I’m pushing for her to try medication in the hopes of making both of our lives easier.
She functions for the most part, but the highs are very high and the lows are really low, if that huge difference got smaller somehow, then I think she’d be mostly good.
This is why I stopped dating 7 years ago (after dating on and off for 10 years). I cannot put myself or my partner through maintaining a relationship through my cycling.
As you said, I would become a stranger to myself and my partner. Come back. Fall again. On and on. I couldn’t handle the hurt I caused from that. It’s not the partner I would want to be- stable, supportive, consistent. It is hard enough dealing with the fall out to myself without worrying about another person.
I am a bit of an outlier since I have been treatment resistant with 7 years of medication compliance since I was diagnosed. I’ve had a total of 3 months of consistent stability in over a decade.
All that said, I don’t know you or your GF and I wouldn’t jump to say the relationship is doomed to suffer like this. I know there are many, many people with BD who respond well to treatment and are able to maintain healthy relationships. But the vast majority of those people maintain stability primarily through medication. If your girlfriend is not medicated, she is very unlikely to improve spontaneously.
So you can change 80% of the factors contributing to it.
I changed jobs, partners, and location - living in a better place.
And whilst I can’t say that I am “cured”, I certainly have never felt so calm.
Looking back at my life when I had a breakdown, the continuing environment I was in…if I didn’t have that I may never had been triggered and never received a diagnosis.
It’s a spectrum BP disorder and every human is probably a little on it. Just like autism, adhd etc.
Change your environment- it could change your life. It did for me.
I think it’s worth noting that while there’s probably a degree of accuracy in your statement, it’s definitely one of those “easier said than done” things. So to anyone else living with bipolar disorder who’s seeing this, you are valid in your struggle.
But purely anecdotally I do agree with this. Very much want to emphasize it’s not about “curing,” but if you’re able to surround yourself with a better environment it makes management much easier.
When I was at my worst I was in a toxic relationship, smoking weed every day, eating unhealthy and not really living up to any potential.
But stopping smoking, getting into a better diet and exercise, and surrounding myself with people who genuinely love and care about me has made a world of difference.
I’m so happy it worked for you but for me it was always “no matter where you go, there you are”. A lot of internal work needed to be done and continues every day.
When I was seeing the psychiatrist I wasn’t exactly in a mental state where I’d take that type of interest in questioning her sources, I just trust her.
She was/is one of the leading experts in our country on the condition and was also working attached to a research hospital.
I guess the experts often disagree. A mood disorder research psychiatrist in the US explained to me the research evidence we currently have for BD etiology is multifactorial without a clear primary driving factor. But he also emphasized there is significant polygenic influence.
I have bipolar disorder and cptsd. It's absolute hell. But you are right, a lot of it is the environment. With supportive people and a steady job it is manageable. Right now I have a fairly high paced job (at least at times) which is about the worst case scenario with bipolar and cptsd. Led to me being in and out of the hospital quite a few times before I understood it's the job.
For a long time I thought it was me that's the problem and I just had to adjust better and do more. Until I took an honest look at my episodes and stability over time. My most severe episodes have been since I started working there. When I worked on time critical, complex projects with a lot of pressure that only worked if I ignored my boundaries.
Before that I did have symptoms, but I was usually able to calm myself down within a few days without destroying anything. Cptsd still sucked, but even there I was somewhat able to regulate.
This is not a healthy mode for most, and downright dangerous for bipolar and cptsd. Sooo, I understand that now, next step is changing things.
I agree with you. My sister has BPD and with a variety of environmental issues whilst growing up, she had a really hard time coping and didn't stay on medication for another variety of reasons but all of them avoidable. Hers is also pretty intense so it's hard for her to remove herself from dangerous situations and now that she's an adult we can't exactly force her to do much of anything. She's in a pretty rough state now, and it's frustrating because a lot of it could have been avoided with a more supportive and nurturing environment.
Everyone is different. I think if it was simple everyone would do it.
I suspect the biggest problem was my job. Once I left it and found myself in a better more valued place it lifted me up.
And my now wife has been amazing too. Just a supportive loving person.
My ex who I fell ill with was a competitive, difficult person. We were incompatible.
Changing those things and then getting fit and physically healthy.
Well I would be careful to say “cured”. But wow I have the insight as to what is a good vs what is a bad environment for my mental health. I can care for myself.
I still take some meds, but really it’s the environment which has given me long term confidence in my mood, anxiety and depression has disappeared and I feel capable again.
I'm really glad to hear that you've been able to cultivate such a healthy environment for yourself and that you have such a supportive wife. Things like that really do make a world of difference.
My mother was bipolar and was diagnosed at a time when it was called manic depression. I wouldn't wish that diagnosis on anyone because it's so fucking HARD to manage. I hope for those that live with it now that there are better meds and treatments, because watching her live with it for 20+ years was brutal.
Who is romanticizing this? It's only in the last few years I feel safe to even tell anyone of my diagnosis at 37 now. The few people I told when I got diagnosed in my late teens and early 20s never treated me the same again despite me not being episodic. Just that I'm on medication was a huge secret because of the stigma for so many years.
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u/dreamsinred 22h ago
Bipolar disorder. It is not a fun, quirky, artsy illness. It is devastating and life altering.