One of the things that has annoyed me the most in my quest for mental health is all those people who tell me “oh, you can’t have bipolar, your moodswings are too fast.” Really? You’re serious? So I’m going fucking nuts because I can’t control my emotions and react in ways I don’t think I should and feel suicidal or angry or happy for no reason because …why?

Another great one I’ve heard less often was “you have to have the super happy with the depression, otherwise you’re not bipolar.” Wrong! Lies! Many people with bipolar affective disorder experience more of sensation of irritation or annoyance along with their invulnerability, instead of joy. I only get the “happy manic” (cheerful, over chatty, twitchiness, restlessness, unable to focus, even less than my usual no memory) when I’m hypomanic, once it scales up to full mania I’m angry and bitter until I shut down because I can no longer function because my thoughts are racing too quickly.

Wikipedia tells us:

Depressive episode

Signs and symptoms of the depressive phase of bipolar disorder include persistent feelings of sadness, anxiety, guilt, anger, isolation, or hopelessness; disturbances in sleep and appetite; fatigue and loss of interest in usually enjoyable activities; problems concentrating; loneliness, self-loathing, apathy or indifference; depersonalization; loss of interest in sexual activity; shyness or social anxiety; irritability, chronic pain (with or without a known cause); lack of motivation; and morbid suicidal ideation. In severe cases, the individual may become psychotic, a condition also known as severe bipolar depression with psychotic features.

Manic episode

Mania is the signature characteristic of bipolar disorder and, depending on its severity, is how the disorder is classified. Mania is generally characterized by a distinct period of an elevated, expansive, or irritable mood state. People commonly experience an increase in energy and a decreased need for sleep. A person’s speech may be pressured, with thoughts experienced as racing. Attention span is low, and a person in a manic state may be easily distracted. Judgment may become impaired, and sufferers may go on spending sprees or engage in behaviour that is quite abnormal for them. They may indulge in substance abuse, particularly alcohol or other depressants, cocaine or other stimulants, or sleeping pills. Their behaviour may become aggressive, intolerant, or intrusive. People may feel out of control or unstoppable. People may feel they have been “chosen” and are “on a special mission” or have other grandiose or delusional ideas. Sexual drive may increase. At more extreme phases of bipolar I, a person in a manic state can begin to experience psychosis, or a break with reality, where thinking is affected along with mood. Many people in a manic state experience severe anxiety and are very irritable (to the point of rage), while others are euphoric and grandiose.

Hypomanic episode

Hypomania is generally a mild to moderate level of mania, characterized by optimism, pressure of speech and activity, and decreased need for sleep. Generally, hypomania does not inhibit functioning like mania. Many people with hypomania are actually in fact more productive than usual. Some people have increased creativity while others demonstrate poor judgment and irritability. Many people experience signature hypersexuality. These persons generally have increased energy and tend to become more active than usual. They do not, however, have delusions or hallucinations. Hypomania can be difficult to diagnose because it may masquerade as mere happiness, though it carries the same risks as mania.

Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong. What might be called a “hypomanic event”, if not accompanied by complementary depressive episodes (“downs”, etc.), is not typically deemed as problematic: The “problem” arises when mood changes are uncontrollable and, more importantly, volatile or “mercurial”. If unaccompanied by depressive counterpart episodes or otherwise general irritability, this behaviour is typically called hyperthymia, or happiness, which is, of course, perfectly normal. Indeed, the most elementary definition of bipolar disorder is an often “violent” or “jarring” state of essentially uncontrollable oscillation between hyperthymia and dysthymia.

Mixed affective episode

In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously (for example, agitation, anxiety, aggressiveness or belligerence, confusion, fatigue, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, racing thoughts, restlessness, and rage).

Right. So where am I in all this? Medicated enough to only get mild symptoms, now. Or at least that’s what I tell myself.