Bipolar Disorder Sucks

So I had to use my shiny new FMLA paperwork for the first time today. I’ve been going up and down mood-wise since Friday of the week before, and yesterday it got really, really bad. Today isn’t any better. And all my boss had to say is “it’s Monday, but you’ve gotta do what you’ve gotta do.”

Yeah, because next time I’ll schedule my emotional breakdowns so that they happen on a nice, convenient Thursday. Preferably a Thursday that isn’t in tax season. How’s next August looking?

Of course, seeing as a 23 year old who never cries just spent 10 minutes crying because “oh my God, my boss hates me” maybe it’s justified that I’m not there. I had to be convinced while crying that I shouldn’t just go in and go to work and deal with the customers. Customers generally don’t respond well to crying CSRs. Or to CSRs who want to rip out their voice boxes and use them for an imromptu game of pool, which is where I am right this second.

This effing sucks. Posting in MPSISM because someone might have some kind of experience with this and might be able to tell me what to do.

Although I personally don’t have Bipolar, I’m good friends with someone who does. Yes, it does suck. The only advice I can give is to remember that it’s not you, it’s a chemical imbalance in your brain, make sure you’re taking the right dosage of medication, and if this happens too often, to see your doctor to make sure that you’re taking the best amount and kind of medication. My friend had to change dosages and medications many times before they found a good regimen.

Most of all, hang in there, and know that there are folks who love you and care about you.

I am going to give you an opinion since you asked. I am giving you this opinion because I have 12 years under my belt being the wife of a bipolar husband.

You made a big mistake calling in today. Why? Because staying home and allowing yourself too much time to think doesn’t help anyone especially not you. Keeping your mind busy does. If you are focusing on tasks that you are used to, you can find comfort and continuity there which may assist you in getting back on track faster.

If you are bad enough to be hospitalized today, sure, break out the paperwork and get your meds straightened out. If you are taking a “mental health” day, not a good idea because nothing is going to miraculously change tomorrow and you may just find it more difficult to get back to it.

I am not going to invade my husband’s privacy by telling too much about his circumstances but I will say this, every time, every SINGLE time, he went without work for a while, he ended up hospitalized. When he called in depressed or manic, I never knew if he was going to be able to get the strength to take that even harder step to go back the following day, or the following week, or following month.

This being said, your boss sounds a bit insensitive. However, it is a hardship being short on staff and he would probably say the same thing if you were puking your guts up.

I don’t know your circumstances but if you are rapid cycling like you are describing, you should let your doc know so you can have a med adjustment. In the meantime, my advice to you is keep your routine because you need it more than you know.

Good luck.

Wow. I’m bipolar, and both the previous posters have given you bad information.

To address those points first:

  1. Nobody knows what causes bipolar disorder. It is probably a physical, biological problem. However, to date, no one has been able to offer a theory with hard evidence to back it up. The problem actually could be structural, for all we know.

  2. Foxy40’s advice will likely have the result of making you feel “bad” or “guilty” over taking time off of work. It smacks to me of saying, “Get on with acting like a regular adult, indulging yourself just makes the problem worse.” While I can’t address her husband’s experiences, it is by no means a universal maxim for bipolar people that “unemployed=more depressed/manic.”

My own experience bears out that employment can be a very good or a very bad thing, depending on the job and your current state of health. In fact, I had my “bipolar break” while I was in law school. I kept struggling right along and took a very demanding job at a corporate law firm. The stresses from these things were so overwhelming that my depression went from moderate to severe to psychotic. Multiple doctors told me, “Leave your job and devote time to getting well, or you will never get well.” I insisted that I couldn’t leave my job and pressed on for 15 months. Over that time, I could never perform well at work because I was not only ill, but going through the very disorienting process of trying different medications.

Finally I threw in the towel and took a leave of absence from my job. I have private disability coverage. My doctors told me to take 6 months. I did. Unfortunately, I had a major manic episode around the 6 month mark. My employers didn’t want to hold my job for me anymore, and my doctors believed it would be a bad thing for me to go back.

So, after that, I have had periods of school/employment in activities that are not too stressful, and periods of unemployment. Sometimes the unemployment is necessary and beneficial, because it gives time to work out medication/treatment issues. It is very hard to do that while employed full-time. Once stable-ish, though, it has proved more beneficial for me to be working, because the human contact and activity staves off depression.

My advice would be to listen to what your doctors have to say. If you have doctors you trust and respect, it is a pretty good idea to listen to their recommendations about whether you should be working or not. Although, frankly, your current condition and your current job do not sound like a good mix. And if you cannot perform well at your current job without receiving some medical treatment, then you probably should take the time off.

Staying at a job you can’t do well is a lose-lose situation. I used up all my energy to keep working as a lawyer. It meant I couldn’t focus on my treatment. It made me too stressed-out to begin to heal. Meanwhile, my employers didn’t appreciate the sacrifice I was making. All they saw was that I was not performing up to the standards of other employees. Bad performance reviews just increased my stress.

Take time off, get squared away treatment-wise, and take it easy. The “take it easy” part will undoubtedly look indulgent to some healthy folks, but it’s necessary to recover a stable mood state. Return to work when you feel ready.

Also, if you don’t feel like your current job is a good situation for someone with bipolar disorder, look around for something more compatible (when you feel up to it). I am currently doing some technical writing. The job is flexible about hours, and I work only four days a week because I need one weekday for medical appointments. Yet I get my work done and my bosses are happy.

I’m happy to answer any questions you have–I’ve been dealing with this for the last 7 years or so.

No one is trying to make anyone feel “bad or guilty”. I was giving an opinion from my own personal experience along with extensive research, couples therapy and reading into this disorder. Yours may be different to be sure. However, the OP asked for opinions which I gave and from an outsider looking in, maybe a little less self indulgent than someone with the same disorder. There is a very good book that I recommend families and the afflicted read. Loving Someone With Bipolar Disorder

It talks about how to cut off a crisis before it becomes one and emphasizes that routine is a good thing for the bipolar loved one. Many things are triggers and the key is to avoid any changes that could make them worse.

Again, I am not a physician but only an onlooker that has seen the suffering and tried to be supportive for many many years.

Yeah, that’s not a negative judgment at all! Foxy40, with all due respect, in past threads when you mention your ex-husband, your disdain for him is clear. It is not unreasonable to assume that your negative experience with one bipolar person has strongly colored your judgment on the issue.

I should add that I am not only bipolar, but that I trained in psychology and at one time pursued becoming a psychologist, though I did not ultimately go that route. I’m active in my local NAMI, and in local groups concerning bipolar disorder and other mood disorders. My advice is based on education, my experience, and on the many other bipolar people I’ve met over time. Almost all of them had to take some time off of work or school to tend to medical issues.

There is not one psychiatrist or psycologist I’ve ever worked with that would say, “Taking time off when you are not hospitalized is self-indulgent and bad for your recovery.”

I should have added, the book Foxy40 recommends is alright. It seemed strongly geared toward spouses of bipolar patients who tend to get really out of control–irrationally manic or really angry when depressed. I can’t tell from your post whether that describes you or not.

You should probably be aware, before passing that book on to your husband–the last chapters have a strong focus on deciding when “enough is enough” and divorcing a bipolar spouse. I thought I would mention this because even though I’m not married, I found those chapters jarring when I read the book. I’ve seen your posts around the Dope for long enough to know that you’re married (I think), so I think it’s fair to warn you that this section of the book could be very upsetting for you to read, or for your spouse to read, and might bring up conversations you don’t want to have right now.

Foxy, I work with customers. Way I am right now, if I go in, I’ll probably do something that will cost me my job. And while I’m not a big believer in routine, I do kinda like getting paid. I know I probably should’ve gone, but I couldn’t, and I didn’t want to screw up things worse than they already are.

Also, I needed to go to my doctor, who gave me samples of an antipsychotic (which I don’t get, but whatever, she’s the doctor, not me). Right now I’m still in the phase where they’re trying to straighten out my my meds because I was just diagnosed last September.

And it’s one freaking day, okay? It’s not like I’m calling in for a month or something. Though at least I was smart and bought into the LTD last year before I was diagnosed.

Q. N. Jones, how do you find a job that’s more compatible? I was screwed up when I graduated college, and just kind of took the first job that came along, which was customer service. I’m really good at it and I get paid all right, but I don’t think it’s making things any easier. And, I mean, I think I have the writing skills, I don’t know, but I’ve never gotten to use them

This really is something you will have to manage carefully. One aspect of your life will always be trying to gauge whether it’s less damaging to your career to go to work when you can’t perform well, or to take the day off. Only you, and maybe your spouse and co-workers, can judge that (or help you judge it).

Foxy40 isn’t wrong that a routine is helpful for bipolar folks. Most books will tell you this. My quibble is that the books talk about things like waking up and going to bed at the same time every day. I’ve never seen a book talk about the importance of going to work as much as possible.

And you also usually hear about routine as something to maintain when things are going pretty well, or mostly OK, as prevention against “losing it.” Once you’ve slid into major problems, though, I’ve never seen “continue your routine or it’s a big mistake” said by any doctor or treatise.

Most (if not all) of the new atypical antipsychotics, like Zyprexa, Geodon, Abilify, Risperdal, Seroquel, etc., are also used to treat bipolar disorder.

Can I ask what meds you’re on? I did study some psychopharmacology, and have kept up on it. One of the things the studies and the knowledgeable doctors all pretty much say is this: lithium and the traditional anti-convulsant mood stabilizers like Lamictal, Depakote, Tegretol, Trileptal, etc. are, on the whole, have a much stronger track record in treating bipolar disorder.

If you got diagnosed in September, well, that’s recent. Really recent. Because it usually takes awhile to find the right meds. It took me about a year after I was diagnosed properly for that to happen. You definitely need to be seeing your doctor frequently until you are stable.

Do you have a psychiatrist, or just a GP? A good psychiatrist is really what you need. I also really recommend a good therapist. Bipolar disorder may be a medical problem, but it wreaks havoc in your life. My therapist helped me with so many things–managing anxiety without pills, making workable plans to change my life (work and living arrangements), got me in touch with support groups and good psychiatrists, etc.

That’s it, really–it’s just one day, not some “big mistake.” You’re not doing well right now. The adjustment phase is rough, both in terms of medical adjustment and physical adjustment. You are probably going to have periods where you feel like you just can’t do it, that you can’t take it anymore, that you aren’t getting the help you need, that you’ll never find the right meds, etc. Those days are all about just hanging in there.

One thing I found helpful was dialectical-behavioral therapy. I didn’t do it formally, just got the workbook (by Marsha Linehan) and my therapist got me the videos. It helps suggest ways to cope with stress. I found it really helpful when I was going through the phase you’re in now.

And thank God you have LTD insurance. That stuff is a lifesaver. I don’t know what yours is like. Mine was through my company and is very generous. It gave me the chance to leave my job, take time for recovery, go back to school, etc.

Q. N. Jones, how do you find a job that’s more compatible? I was screwed up when I graduated college, and just kind of took the first job that came along, which was customer service. I’m really good at it and I get paid all right, but I don’t think it’s making things any easier. And, I mean, I think I have the writing skills, I don’t know, but I’ve never gotten to use them

For me, it was a lucky thing. I worked for a small environmental consulting firm when I was in college. One of the employees is my dad’s friend, who knew I was out of work (and kind of knew the reason). The company was way behind in its work and knew I could handle it because of my previous experience with them. They called me. And really, now that I’m in this situation, I would say that if you have any connections like this at all, it can be a really good way to get work with a flexible schedule, or to get people to hire you for things you’re not qualified for (on paper, anyway).

I really feel for you. I remember what a confusing and scary time it was right after I was diagnosed. If you have any questions at all, feel free to email me.

My disdain for my ex husband? You mean the man I just gave 1/2 of a quarter of a million dollars, despite having a prenup which allowed him nothing? The man I supported for 12 years while he was in and out of hospitals and was only a functioning human being when we were in therapy and he was able to stick to a routine that benefited all of us? The man that refuses to take off his wedding ring even though we live apart because I am the only one in his life including his parents that ever give a crap about him and his illness? Yup, hate that man with a passion. I am sure lots of men would like to be “disdained” that much. This illness can be a monster and very draining. I armed myself with as much information as I possibly could and am happy to spread any of that information around if it can help another.

Oh and he is not my EX husband as of yet.

I am very sorry if the only thing you got out of my post was a perceived insult that certainly wasn’t meant as one. It is an accepted premise that someone can see more from the outside looking in than the person who is actually mentally ill and having an episode. Bipolar suffers are self indulgent for self preservation and I am very surprised with your background, you aren’t aware of this.

That being said. I stand by my advice. Of course you have the right to disagree which is what a public forum is all about. However, keep the personal attacks to yourself. They do nothing but devalue your position.

Angel of the Lord…sorry for this post. I will ignore all other personal attacks and wish you great success in overcoming your illness and being able to function in the way you would like to.

Not really. Every doctor I’ve ever seen–and there have been about a dozen now–has said that it is very important for me to tell them everything that I’m thinking/feeling, because they can only see so much from their point of view. They have always said it’s important for me to take their advice and apply it as I think is best, given that only I can know the full picture of what my life is like.

I lived with my parents through the worst of my disorder. My doctors did not believe my family knew better than I did what was best for me. Ironically, they took the most exception to my father’s view that I should not take time off from work for rest and recovery.

Yes, sometimes a bipolar person is so impaired that they can’t really have a clear view of their own best interests. This is not always the case, though. Sometimes the symptoms do not impair judgment about how they should be handled. Also, there are many outsiders whose view of a bipolar person during an episode of impairment is so biased that their judgment cannot be trusted.

What my background has taught me, primarily, is that there are few absolute truths in the treatment of bipolar disorder. Experienced doctors and therapists won’t make absolute statements about how to best treat the disorder. Treatises do not give many firm answers, especially not about day-to-day living. So I am highly skeptical when a person on a message board offers such absolute advice as you have done.

I’ve read all the major treatises on the subject, and I’ve never seen this stated anywhere by any specialist in the subject.

What does that mean, exactly? “Self-indulgent for self-preservation”–? Most people are pretty damned self-indulgent; bipolar patients don’t have some special capacity for being self-indulgent that I’m aware of. I hope you will explain this. It’s a pretty offensive statement.

Actually, it wasn’t a personal attack, in that I referred only to statements you have made on this message board in the past–which are fair game for comment–and not you personally. If you think I have made an impermissible personal attack, you should report it to a moderator. I have not done anything wrong under the rules of the board.

I hesitated many hours before saying this, but I want to explain. In my mind, when I see a poster’s name, usually I associate past posts with it in remembering who they are. And, frankly, when I came into this thread and saw your name–before I read your post or had reason to be argumentative with you–I thought, “Oh, Foxy40, she’s the woman getting the divorce who talked about her husband like she thought he was a lazy bum.” Threads I was thinking of:

Marriage Advice?

I Am Leaving My Husband. Help!

I think it is pretty fair for me to say you have said things on this board that indicate disdain for your husband, especially as concerns work and money issues. Maybe you don’t realize these things could sound ugly to the ears of an outsider, but they did to me, long before I had reason to quarrel with you and long before I knew your husband was bipolar.

I realize that posting those links may cause an ugly scene. (Which I hope we can take elsewhere if it does occur.) But I do think your bias here is both great and relevant. Again, if you feel this is an improper personal attack, please do report it to the mods. It’s not meant to be an attack on you as a person. Simply a qualification of the basis of some of your advice in this thread, from information you volunteered here on these boards.

Angel, I’m sorry that your thread has been hijacked by this. I strongly disagreed with Foxy40’s advice and thought it was important that her bias be exposed. I am sorry that this has (inevitably, I suppose) led to a dust-up.

I suppose there are probably a number of jobs out there that could have some or all of these characteristics, but the following job traits are things that I have either found helpful, or that have been recommended to me by doctors/therapists:

Flexible hours. The job I have now has a given workload, with deadlines, but I’m not required to be there during all the regular business hours. (It’s a very 8-5, Monday-Friday business.) I have trouble with mornings, so I work from 10-11 in the morning until 5:30-6 on most nights; I work later on average maybe one night per week, but that’s up to me. I only work four workdays per week, and I schedule all doctors’ appointments on the fifth workday. Since I have appointments every week, this has helped me establish some regular expectations at work for when I will be there. As long as the work is done on the deadline, and I am available during most business hours, it’s all good with my boss.

Low pressure on deadlines. It’s funny that I say this because my new job is deadline-driven. But the deadlines are pretty easy to deal with, since I get ample time to do the work. I rarely have pressure on this issue. A lot of deadline pressure was a problem for me as a lawyer. If I had one bad day unexpectedly, that usually blew at least one deadline and upset at least one of my superiors. At my new job, it is not a big deal if a client gets a report one day later than expected. Most of the time, they don’t even care. But in many jobs, deadlines really are deadlines. That can really make a bad episode escalate due to stress and anxiety.

Fewer hours. I’m (sort of) lucky, in that I make a pretty fair annual salary at my job even though I work only about 30 hours per week. I could use more money, but the reduced hours are worth taking a salary reduction. I have never had to “call in crazy” to this job, so I can be there consistently. More hours and more pressure equals more stress and more likelihood that I will have an episode.

Enjoyable, friendly workplace. This is probably underrated. I was still pretty depressed when I started back to work. Going into an environment where the people were friendly and easygoing and sociable really makes me feel better in general. The human interaction is good, and there isn’t pressure to act a certain way. When I was depressed at a job where I didn’t like my co-workers, it increased the anxiety about going into work and created days where I didn’t feel up to interacting with anyone, and I would avoid them due to the anxiety about not being able to “keep up appearances” (important as a lawyer). That’s a bad thing when you need to meet with co-workers for professional reasons. Going to work can make you feel better sometimes…if it’s the right job.

Work you don’t mind doing. Probably “work you love!” would be best, but really, I don’t love what I do. It’s enjoyable enough. Sometimes it’s challenging and even fun. At worst, it’s monotonous. But since I’m not time-pressured (paid by the report, not by the hour), I can socialize and surf the web a bit to break up the worst of it. But, going to a job where you feel like you’re not capable of being good enough really sucks. It can just fuel the anxiety that in turn triggers an episode, or makes one worse.

I’ve read a few times that bipolar people are often chronically underemployed, or that the conventional wisdom is that bipolar people get stuck in low-end jobs that don’t use their talents. Reading the above list, I can see why it happens–partly by choice (desire/need for fewer hours, less responsibility, etc.) and partly because it is hard to get a job when you have gaps in employment due to illness.

But I think it’s possible to find these things in a job that is not a “dead end job.” Basically, I’m a technical writer–certainly not a dead-end job! I think it’s just harder to find a challenging job that is also an easygoing one about time schedules. (BTW, the thing about flexible time schedules isn’t just from me–many sources say this is a problem for people with bipolar disorder, for the reasons stated before: need for time off, and anxiety problems.)

Just as an example: I’ve looked for jobs that would be compatible with my needs, but also with my goals. I’m applying for jobs at universities, assistant director of such-and-such sorts of things. It’s something I’ve been interested in doing for a long time. The good things I know are: stress levels I can handle, 40 hour or less work hours, good benefits, probably friendly and relatively low-stress work environments. I will have to deal with the 8am start times and how to schedule doctor’s appointments, but I don’t expect to find perfection.

One thing that is important to consider: benefits. You need to be able to either get good health insurance for work, or pay for it yourself. And your LTD benefits are really important too. Staying at your current job might be important–if you can handle it–just to hang on to those.

Just checking in to say that yes, I envy the grocery cashier. I own a business that does $1M+ per year and I wish I could just scan groceries. :confused:

Angel, keep an eye on trade journals for whatever you got your degree on, or maybe related to a minor… or simply to something that you think you can write about; is there a trade association? Not so much the ultra-specialized journals but the general ones: newsletters and similar.

To name two in my profession as an example, the Journal of the American Chemical Society doesn’t need writers. Reviewers, sometimes an editor. But Chemical and Engineering News does need writers quite often and writers/editors/ad people/copy editors for other ACS journals and newsletters usually get hired through C&EN as well.

Also, what the fuck is underemployed? Who is other people to decide what’s the right job you should be doing? So long as you’re qualified and you’re happy, that’s the point. Let me tell you a story.

A few years back, I got a job in a factory, weekend shift lab tech. I would not have gotten it if the hiring manager had known I had a higher degree than he did :stuck_out_tongue: and some people would tell me “oh, but you should be a manager!” Well, nobody was hiring me as a manager and I’m addicted to regular doses of food. My shift supervisor laughed when he heard that. He said “you know what? I’m an AgEng. So people tell me ‘oh, wouldn’t you rather work in the stuff you trained for?’ and you know what, I spent three years doing just that. I had between 100 and 600 workers, I traveled all over the country to different farms and fields, I got called names in half a dozen different languages by people who didn’t have the cojones to do it in Spanish, I saw my girl once a week. Now I have 5 workers who when they’re pissed call me things in Spanish, I see my wife every day, I take my kid to school four days a week and pick him back, and my heart isn’t standing in line for a transplant. Underemployed, misemployed? I’ll take happily employed and they can kiss my ass.”

I’m not sure what you’re trying to say here. I suppose this is sarcasm?

No, I’m serious. I’m just saying it’s sad that I would prefer to be “underemployed” for mental health reasons. And it sounds like I’m not the only one.

Oh! Sorry to misunderstand.

If you need a day off to get your mind together and see your doctor, then do it. Obviously you can’t make a regular habit of it, but you have no need to feel guilty for taking a day when you need it.

Back to the facts…

If “they” don’t know what causes it, how do they diagnose it? How do they determine that you’re bi-polar and not just depressed (not that I’m minimizing that, you understand). I’m just curious about how those of you who are diagnosed came to that conclusion. What’s the process?