A friend of mine has s son who has been diagnosed as bipolar. His ups and downs are quite regular, and he has been prescribed medication to control this condition.
He complains that the medicine makes him into a “zombie”-tired and emotionless.
My question: do most people who have this malady enjoy the “high” phase of it?
The lows (from what I read) are pretty devastating-most people describe them as a deep mental depression. But are the highs actually a phase where they feel so good that they won’t take medicine?
Since I suspect we may get some personal experience concerning this, I’m going to move this over to IMHO.
Colibri
General Questions Moderator
Well, that definitely seems to be how a lot of people with that condition view it. The actor/writer/presenter Stephen Fry, who’s bipolar and made a documentary called “The Secret Life of the Manic Depressive”, commented in an interview:
I don’t know if they enjoy it, but I read an article about a jazz musician who found that his creativity suffered severely when he went on medication for bipolar syndrome. It was a couple of years ago so I can’t cite it but there are a lot of similar stories that come up in Google.
My long-term girlfriend was bipolar. I would say she was generally very happy during her “up” phase. She was into lots of activities which she very much enjoyed.
This did not compensate for the black pit of the “down” phase, though. The last time I saw her she was gladly and with great relief taking medication for this, even though she missed the up phase somewhat.
Other people’s experience may differ.
I have a friend who is bipolar. He got a PhD in mathematics in 1963 and, for ten years, produced some of the most amazing new mathematics I have seen. At this point he went off the deep end, lost his job, sort of recovered and has been taking lithium since, for around 40 years. In that time, despite working on mathematics all that time, he has done essentially nothing new. His life is on an even keel and he is still a fine mathematician, but a creative cipher.
Is it possible to take medication for the down phase and stop taking it during the up phase or is it an all or nothing deal?
To the best of my knowledge the same medications are used to treat both phases, so that if you were using it to treat the down phase the up phase would never kick in.
Most of the medications for bipolar disorder are to treat the manic phase, and therefore are never used for unipolar depression. Lamictal, though, is used to treat the depressive phase, and is also used off label for unipolar depression. You still take it all the time if you’re bipolar, but I think it works more on the depression, supposedly not CAUSING mania like some antidepressants can do, but I don’t think it completely eliminates it either. I could be wrong though, I take it for unipolar depression.
Key Redfield Jamison describes enjoying the mania.
A prior long-term girlfriend of mine was undiagnosed (as far as I know, that may have changed since) bipolar, and sorta enjoyed the up phases. Sometimes it would result in outcomes she enjoyed, but it also could result in irresponsible / impulsive behavior that she would feel bad about later.
The manic phase for me is somewhat pleasant, but it has the capability to spin out of control very quickly. I wind up seriously irritable, mentally and physically exhausted, and life just generally sucks until I crash. Of course, crashing is its special brand of suck. This is why I prefer to take medication.
Marya Hornbacher wrote an excellent book (called Madness) about her own struggle with bipolar disorder, wherein she very much emphasizes how much she loved her manic phases, destructive though they were.
The loss of creativity with medication is the one thing I hear consistently while researching information about side-effects. Since I am on the creative side, I’m always worried that my doctor will prescribe something that will change me like this. I would find that untenable.
I don’t know if the loss of creativity is more perception than reality, though. It could be that mania inflates your ego, convincing you that you’re a genius when really you’re putting out crap. Or it could be that creativity and mental energy are tightly correlated, and zapping out the latter gives you less steam to carry out the former. But research has shown that dopamine, the neurochemical that is disregulated in bipolar disorder, is in fact correlated with creativity. So I would not be surprised if creativity is sho nuff dampened when a person takes dopamine-eating drugs.
I knew a woman who occasionally enjoyed her manic phases – those characterized by hypomania were, as described, times of extraordinary energy, optimism, and other good things. Other times, she’d just go into full-blown mania; she couldn’t maintain a train of thought, was prone to angry outbursts and outrageous behavior, and couldn’t stop moving. After this phase had gone on for a few days, she would be exhausted and want to rest, want to sleep, and would have crying jags and shrieking fits over her inability to sleep, or even stop thinking.
One of the issues with any sort of psychiatric medication is managing the side effects and deciding which of those side effects are the most tolerable. For example, I’m on Lamictal. It works well and I’ve been on it long enough that any side effects are minimal.
On the other hand, if I had to change medications, my psychiatrist and I would have to have some discussion about which side effects I’m able to tolerate. This drug would be OK, but there is a risk of weight gain, which is unacceptable. That drug doesn’t cause weight gain, but it may cause other problems.
And, frankly, a lot of the time, mania is just grandiose thinking. I’ve turned out some real crap that I thought was just brilliant. I’m actually somewhat more creative on the medication because I can be more realistic about what I’m producing.
I have a couple of friends, both severely bipolar, one not being diagnosed until he ended up into serious financial trouble.
The friend who’s been on meds for awhile finally found equilibrium through them, enough equilibrium to hold a FT job without any serious repercussions. Hypomania is channeled through working intensely on a particular project.
The friend who wasn’t diagnosed for a long time went to hell and back – gambling during manic phases, then near suicide during the depression phases. Nothing mattered except what was being felt RIGHT THIS SECOND. People stayed away. Resisted meds for a very long time, then finally accepted them. Has been off them a few times since, always with disastrous results.