Depending on the nature of the disorder, it may also not be that they “don’t remember” depression and suicidal impulses, but rather that depression and suicidal impulses don’t have as great a role in the way the disorder manifests itself.
As Q.N. pointed out on page one, Md Biplor folks and mD bipolar folks will have the pendulum resting more on one end of the spectrum.
I don’t get full blown manic very often and I very rarely fall into the weighty, long depressions. The hysterical darkness of a mixed episode is what I get (lucky me) I have had the heavy duty depressions, but most often if I’m going to feel like a squashed cat turd it will be part of a mixed episode.
But that is something we haven’t addressed in this thread (what a downer).
The suicide rate of those diagnosed with BPD freaked me out when I first read it. In general BPD literature, the cite a figure of something like biploar folks having a 19-20% suicide rate. Which would mean 1 in 5 is dying by their own hand? :eek:
But then, if you look at the data more in depth you’ll find the casual way that figure is tossed around doesn’t quite necessarily match the average bipolar person. Little clues like one tiny sentence that says “Rates may be lower in never-hospitalized patients, however.” And the figure is also skewed a bit towards Bipolar I which is the most severe form. So more run-of-the-mill cases that have never required hospitalization may not have a risk rate that is so high.
Still, any such risk is bad news IMHO.
Other factors affecting the “mortality rate” of the disorder are comorbid substance abuse (it complicates things when BPD sufferes drink a lot or do drugs to feel better/differet/whatever and substance abuse is pretty common for the mentally ill) and the risk that you’ll do something really stupid while manic and get yourself killed through reckless behaviour.
Lithium has been known to cut the rate of suicide attempts by more than a six-fold. Yay! But the bad news is, if you miss the hypomania and quit taking the lithium, your suicide risk can increase a 15 to 20-fold. Doh!
And a lot of people do stop taking their meds because they miss the mania and hypomania – it’s hard not to. For someone who has been manic or hypomanic, “normal” is kind of like needing glasses but not having them. You can still see, but you might be missing 25% of the visual world – all the nice details and sharpness, everything is a bit blurry and mushy – you’re not getting as much out of the visual world as you would if you had glasses.
Hypomanic with everything seeming bigger, brighter, clearer, more textured it really is great, or at least you perceive everything to be “great”. When I’m NOT hypomanic, I feel like I’m only getting about 75% of the experience of what the world has to offer.
(Actually, sometimes I wonder if mania or hypomania is kind of like a mild hit of the drug Ecstacy. Never done it? The last thing I need is a drug that’ll screw up my BPD. But as it’s portrayed on TV, hypomania looks like it would be like a teeny weeny hit of Ex.)
Because I get mixed episodes so easily though, I’m happy with the trade-off. My hypomania and mixed episodes go hand-in-hand so that they’re practically inseperable. Even though I like the “feel” of the world when I’m hypomanic, I associate it with a lot of negative stuff too. And I find being “on” all the time to be distressing. So I’m happy to say “no more hypomania ever” if it means not being in a mixed state ever again.
