Do you have any experience of Bipolar Disorder?

[Janni]

I would like to educate myself about this illness, as my oldest friend has been suffering from it for a few years.

We lost touch for many years as I moved from her home town when I was 12, but she phones from time to time and I am going to phone her tonight and arrange to visit her.

What I am interested in finding out is: how does it feel to have bipolar? What can family and friends do to help? What do the mental health services have to offer? Are there any alternative therapies that are of any value here?

I should add that I trained as a mental health nurse but have not worked in the field for 12 years and it's not a condition came across much in my professional life.

I would be grateful for any insights people could offer so that I can support my friend.

[Janni]

In our most recent phone conversation, she said that she was on citalopram, that her CPN did not seem to be taking her seriously and that she had feelings of paranoia when out. She has been hospitalised a couple of times due to mania - I think she might even have been sectioned the first time.

She is a lovely person and I particularly want to be supportive because when she plucked up the courage to explain to a couple of 'friends' that the reason she still lived with her parents and could only work sporadically, was that she had this disorder....they disappeared and didn't contact her again!!

[ladylush]

I've got professional experience - am a CPN. I'm surprised you didn't encounter it much given your past profession - it used to be called Manic Depression. I'd have thought she would be on a mood stabiliser like Lithium or Sodium Valproate. People who have BPAD generally have better social functioning than those with schizophrenia, for example but it depends on the individual and how well controlled the illness is. It is sad how people isolate those with mental illness, as her friends have done. Some friends I would say just listen and be there for her, there is no single approach to take as the diagnosis is in many ways arbitrary - it's recognising the early warning signs and developing coping strategies that's important. She might benefit from doing some relapse prevention work with her CPN so that she and family, you etc will know when she is becoming unwell and hopefully help avoid an admission to hospital.

[Janni]

Thanks, ladylush, that's helpful.

(I didn't encounter it much because I specialised in eating disorders almost as soon as I qualified and although I do remember various patients with the condition, I was not really responsible for them).

[Janni]

Anyone else?

[Kammy]

Both the MIND and Royal College of Psychiatrists websites have lots of useful info, so worth having a look there.

[Janni]

Thanks, Kammy - will do so.

[ladylush]

Ah, I see. Eating Disorders very specialist. Did you like it? I knew someone who worked in that field as a student and lost tons of weight because of the environment.

[twinsetandpearls]

I am away for the day but you can cat me.

[Janni]

It was interesting, ladylush and as a nurse you had quite a lot of input, which I liked.
I had a personal interest in that I had previously suffered an ED but decided not to stay in the field because it felt like I couldn't 'move on' from my own stuff. I am planning to return to nursing next year when my youngest starts school, but have yet to decide in what capacity!

Twinset - thankyou, I will CAT you.

[ladylush]

Yes, I noticed that a lot of ED and Addictions nurses have some kind of personal experience. Must be good for empathy etc. but as you say, quite hard to move on from your own stuff. Glad you're planning to go back to nursing. Won't try and influence your choice! My background is all MH; supported housing, PICU and community. Just started the latter and enjoy the autonomy but the average caseload is 35 Still, I do really enjoy MH nursing and wouldn't change field for anything.

[northernrefugee39]

Hi Janni
I have experience of someone close who had manic depression. It now seems to have grown into sporadic bouts of slightly worse than usual depression, with few manic episodes. Proof I suppose that as an illness/diagnosis it can burn out.

During the worst manic phases, these people can be totally infuriating! Telling everyone how, improving the shining hour, spending money like water and taking huge risks- (generally with themselves, not others.)
But it can seem a very selfish way to behave, and when this friend was like this, I spent much of the time biting my lip....

The lows, depressions are sad and difficult, as is any severe depression I should think. And often the memory of their stupid behaviour on the "high" comes back to haunt them.

During the manic phases, of course, these people can seem attractive, exciting risk takers.

I would say that being there through all of it, not deserting them, and proving that they are worth your friendship how ever they have been or behaved, is the most important.

Obvious advice really, but if you want to cat me, i'm very happy to talk more. It was a difficyult time, helping this friend through, so i know how you feel a bit

[Janni]

Hi Northern. How are you?
Thanks for that insight - I'm definitely getting a clearer picture now.

Ladylush - I'm glad you're still enjoying MH. I might go back to it eventually, but I want to do the adult branch training too so that I have a broader scope.

[mylittlesubatomicparticle]

I live with it, cope with it (at times better than others) and muddle through as a single parent and WOHM. CAT me if it would help, too.

[Janni]

Wow, mylittle, that is amazing. My friend has pretty much always lived at home and really struggles to hold down a job so respect to you girl!

[mylittlesubatomicparticle]

I'm lucky I think, by being very well between episodes. I am sure your friend is doing her very best as well, it can't be easy as I think work of some sort, something interesting or worthwhile, is actually really good for mental health. I didn't mean what I said to come across as arrogant or competitive. And the hardest thing for me is how the feelings aren't related to facts that much. I wonder if I'd "get" depression that is related to, say, a break up, bereavement, redundancy... but sometimes, all is good, and then 'bang', you're going downhill at speed.

Recently my depressive episodes have become psychotic and the drug side effects are really rough too that make the symptoms better. Am here if I can help... not too bad at the moment, but am on holiday this week so that helps!

[ladylush]

My cousin has it and managed to qualify as a midwife and holding down a very stressful job. I'm not supposed to know about it She's on Lithium and I presume it's keeping her stable as she hasn't had a relapse in ages.

[Janni]

My friend is the youngest of four children and although she is now in her forties, she has always been seen as the baby of their family. They are a very close-knit Irish Catholic family and they would, I think, overprotect her rather than challenge her. She has not had children or any significant relationship. She loves animals and I could really see her enjoying a job eg in a vets, or as a professional dog-walker or something. I understand what you mean, mylittlesub about interesting work being helpful to your emotional stability. I will talk to her about it and I know her parents will ask my advice, because I used to be a nurse and they think I know a lot more than I actually do (but this thread is helping!!)

[northernrefugee39]

Hi Janni Trundling along... hope your dc's are ok at school?

Hi mylittle
my friend took lithium, but felt it was a continual reigning in, if that makes sense. They are now drug free, and the ups and downs are very less marked. They really feel it has worked through their system a bit, burnt out. And they did have it quite badly 20 yrs ago or so- psychotic episodes and all... restless legs with those drugs.
I admire you hugely for talking about it and coping/living with it.
Some great creative people have or have had it haven't they?

[ladylush]

Yes there are many gifted people with BPAD

[ladylush]

The restless legs thing sounds more like side effects of anti-psychotics e.g. Haloperidol. It's called akathesia (sp?)

[SofiaAmes]

I have had several very close friends with bipolar over the years. The biggest problem with all of them is that when the disease first started manifesting itself (early 20's for all of them), no one really had any idea of what was going on, and all of them but one self medicated with street drugs. It's my understanding that this is fairly common. Unfortunately, it exacerbates the problem and makes it worse and much harder to treat. And in fact, today I am going to the funeral of my best friends little brother (44) who ended up committing suicide in a hospital where he had been for 6 months being treated for bipolar and drug addiction. I don't know what the solution is, but the one of my friends who seemed to have some control over the disease was living with a very supportive, and seemingly always present, mother. In fact, I would often call the mother for a reality check to make sure that the manic reactions I was getting from my friend were just the disease and not me being a bad friend. You may want to asses how supportive and understanding your friend's family are of her and her disease and use them as a tool to help her.
Good luck.

[zippitippitoes]

i agree with sa

there is a pretty wide spectrum of how it affects individuals and many people manage very well and have jobs families etc

also it is quite responsive in good and bad ways to lifestyle

it can take a long time for a diagnosis and it isnt always definitive

i think the figure is 1 in 100 people but many people never get diagnosed

many self medicate with drink and drugs which exacerbates the effects

and lots of the associated behaviours manifest themselves as addictions of one kind or another

surviving with bipolar is challenging many people do commit suicide..i think it is one of the higher incidences of life threatening diagnosis for suicide

for some people it is possible to self manage without medicvation but that is a very demanding path and really needs mental health support which isnt easy to get

because things can change quite rapidly self awareness is paramount

stress can bring on episodes and relapses

work is beneficial and routine because it forces you into a pattern and diversion from thinking is good

[northernrefugee39]

Zippi- good post.
Self awareness and a very supportaive partner/family.

As to work- it is quite difficult- my friend's exoerience of cv's with gaps and very unhelpful suspicious employees. My friend is self employed which, as they have a family to support too, has it's own streses and strains obviously.

[zippitippitoes]

i wouldnt disclose to an employer if i could avoid it...

[northernrefugee39]

Well- no - I agree. This friend can be brutally honest though... maybe part of the condition? Gult? I don't know- but a kind of kamikaze opennes which makes me wince sometimes. I would... be economical with the facts personally...