And then it happened, he got sick again.
I thought, "right, that's how our life's going to be for the rest of our lives".
After that, I'm sort of always on guard, using my thinking capacity and trying to
keep one step ahead of him to stop him from doing things that would cause irreparable harm.
My alarm has worked, but it's draining my strength.
The untold story of living with someone with bipolar disorder.
The content of this video is intended to be educational, and the general guidance
should NOT substitute the advice provided by a physician or qualified health professional.
This video is simply meant to contribute to the conversation surrounding mental
health and caregiving, and challenge the stigma around bipolar disorder.
When someone is diagnosed with bipolar disorder, it's not uncommon for a close
family member to take on an informal caregiver role. At times, this role can be difficult
and may feel like a large burden. However, research has indicated that this perceived
burden can actually be mitigated through something called psychoeducation. Psychoeducation involves
learning about bipolar disorder, its symptoms, its treatment, and proper management options.
Bipolar disorder is a brain condition that causes extreme fluctuation in a person’s mood, energy,
and ability to function. These individuals have strong emotional states that involve highs and or
lows, that can last for days or even weeks. There are four types of bipolar disorders which include
Bipolar I, Bipolar II, Cyclothymic disorder, and Bipolar Disorder Not Otherwise Specified (NOS).
Each type exhibits a different mix of bipolar symptoms and episodes which have variable effects
on a person’s functioning and wellbeing. In order to best help your loved one,
it is important for you to know the four types of bipolar episodes. These include manic, hypomanic,
major depressive, and mixed episodes and they each have their own different signs and symptoms.
Manic episodes “A lot of times, when she’s manic
she’ll just take off period. Take the car and go and then I worry about her. She’s just racing.”
“I’ve had to watch his bank statements when he’s high - he has mini spend-ups.”
“But, when she’s manic, she’s, totally a different person…she’s very, very selfish,
only thinking of herself. Her mind is racing… she cannot, when she’s manic,
you can’t really reason with her. She cannot see the right thing.”
During a manic episode, a person feels intense euphoria or highs, while often also
being irritable. Signs of this type of episode include fast speech, racing thoughts, less sleep
paired with high energy, being easily distracted, having an inflated sense of one’s own importance,
and increased recklessness.
Hypomanic episodes
“At one time my wife had three jobs. But that could have been the mania.”
“Our marriage is a lot different than it would have been without the illness;
even when she's well, I’m vigilant for signs of illness all the time.”
Hypomanic episodes include some of the seemingly more positive aspects of mania such as increased
productivity and a sense of euphoria without some of the more outwardly negative aspects such as
recklessness and irritability; those negative aspects that tend to impede an individual’s
daily functioning. This milder episode can mislead people into thinking they can stop
their medication. However, that isn’t the case because hypomania is only temporary
and can quickly escalate into full-on mania or even be followed by a depressive episode.
Major depressive episodes
"He became remote and different. Answered in words of one syllable,
his voice was completely dead, and his body language was completely flat. He lay in bed
most of the time. I felt as though I was on the outside of something incomprehensible and unreal."
Someone in a major depressive episode experiences the hallmark symptoms of depression for two weeks
or longer and these include feeling down, losing interest in things they like; things
that typically brought them joy. Other symptoms that can occur include poor sleep or oversleeping,
poor appetite or overeating, difficulties concentrating,
feeling worthless, experiencing lower self-esteem, and suicidal thoughts.
When an individual presents with four or more of those symptoms, they are said to be in a major
depressive episode.
Mixed episodes
“Depending on what mood she’s in, if she’s in the manic mood or the depressive mood…
let’s just say her personality ah is altered, it's not the same person.”
When both mania and depression are present and cycle throughout the day,
the individual is in a mixed episode. Caregivers must be particularly wary
of this type of episode because the combination of depression with the
high energy from the mania puts patients at a much higher risk of committing suicide.
In order to ensure we have a holistic understanding of the issue,
we decided to consult Dr. Roger McIntyre. He is a Professor of Psychiatry and Pharmacology
at the University of Toronto. He's also the Head of the Mood Disorders Psychopharmacology Unit at
the University Health Network in Toronto. He's published more than 400 articles and
manuscripts on mood disorders including bipolar disorder.
How can friends and family help with managing bipolar disorder?
First thing is that when I'm asked by families and friends how can they be supportive,
it begins with education, more education, and more education because I think we need to have good
literacy on the illness and its treatment. And I think it's difficult to support someone if you
don't have sufficient knowledge on what they're going through and/or sufficient understanding
of what the treatments are. So you need to be equipped and fortified with up-to-date knowledge.
Secondly is that I encourage people to go to a group that is dedicated to families and people
affected by bipolar disorders called the DBSA. So www.dbsalliance.org. The Depression and Bipolar
Support Alliance is online. It's based in the US but it's international and it's an
opportunity to meet other families of people who live with bipolar... What do they find to be more
effective to support people with bipolar disorder? What did they find didn't maybe work as well??
And learn about the timing is right. Striking when the iron is cold, as they say.
How can friends and family help during a depressive state?
I think the key thing is during a depression, one needs to be aware of the fact that many people
with depression as part of bipolar do experience thoughts of suicide.
And I think there needs to be a recognition of that and of that. And if, in fact, the seriousness
of that escalates, I think that they should really encourage the person who's living with
the condition to seek out healthcare services immediately, whether it's the local physician
they see or, in many cases, going to the local emergency. And sometimes if the person is denying
or not wanting to seek out healthcare, there's serious concerns raised. I think we need to also,
in many cases, depend on family and friends to get that person to a local emergency.
As a caregiver, it is essential to encourage the individual to take their medications
to help them manage their episodic symptoms.
However, at the same time, it's important for you not to get overly involved as this can increase
the caregiver burden and may not be what's best for the individual themselves either.
Cautionary notice: family and friends are not the patient's doctor, not the person's doctor.
And they are not the person's manager typically. And we always need to really
respect the boundaries and the autonomy of the person who lives with the condition.
But, that being said, we certainly would welcome mentorship and advocacy, and support.
I've treated tens and tens and tens and tens of thousands of people who have bipolar and most
do real well. And so, you know, they're people you would know, they are well known in Canadian
and American societies. They are leaders in many different ecosystems and spaces.
“Accepting the life situation was difficult. It happened gradually.
I got help from a therapist, managed to put things into perspective, and re-established
my belief in myself. I saw that my husband was growing and that our life became more stabilized.
We have undoubtedly both grown from the experience.”