They say normal is a setting on the washing machine.
My normal is a constant swing from feeling irritable, and then feeling energized and talkative, and then collapsing into depression again.
A Sample Morning
I’m feeling chipper, so I decide to bake up a storm for the upcoming Yom Tov (holiday). I pull out the mixer and pile the ingredients on the counter. I’m enjoying the special time with my children, singing and even hugging them spontaneously. I feel so energetic and it’s great, but it’s beginning to feel unsteady; I’m flying too high. I squeeze my daughter in a hug, noticing that it’s a bit too much for her. It’s getting too much for me too. Something in me feels too high, too energetic. It’s painful.
An hour later, the mixer is mixing a second batch of cookie dough and the energy in me is spiraling out of control. Instead of the earlier joy, I’m now feeling irritable and explosive. I’m lashing out at everyone around me, frustrated at the amount of work left. I still need to roll the cookie dough into balls, the second batch needs to be remixed, and I forgot the vanilla extract. Never mind the cleanup job waiting to be done.
Mostly, I am frustrated at how quickly my good mood dissipated. I spend the rest of the day in bed, crying, trying to sleep, and feeling so low.
Finding My Diagnosis
When my journey into mental health began, I was prescribed anti-depressant and anti-anxiety medications. Over the years, I’ve seen quite a few psychiatrists, all of whom diagnosed depression and mood instability. I was prescribed every anti-depressant and some mood stabilizers and anti-psychotics too. None of them were helpful and the side-effects were terrible. It felt like one psychiatrist thought I was his lab rat, putting me on a new med every couple of weeks with the idea that there is always something else to try.
I found a new psychiatrist who asked me questions about my symptoms, which I tried answering honestly. She seemed different than all the others. Her questions were pointed, and she seemed to have a real grasp of my mental health issues. In passing, I mentioned a weird situation I had once.
I awoke one Sunday morning feeling horribly depressed. I stayed in bed all morning, crying a lot and feeling lower than ever before. I’ve had depression, but I was never so down that I would ignore my childcare responsibilities. Somehow, I forced myself to take a bath. A few minutes on the phone with my therapist helped. Then, in the evening, I got a burst of energy and tackled the Shabbos dishes in the sink. All the while, the music was blasting, and I sang along. I never like blasting music, but I needed it now. When the dishes were done, I got the mop and washed the kitchen floor. I’m not someone who washes their floor every night. But the music was on and the energy in me was pumping, so I figured why not? It was 2 A.M. by the time I was done. I would have liked to start on the bathroom cleanup, but reason got the upper hand and I went to bed.
This new psychiatrist recognized what no one else had seen. This was an episode, or a “flip”. A quick switchover from depression to mania. A clear symptom of Bipolar 2.
Bipolar 2 is similar to Bipolar 1 in that it swings between depression and manic. The differences are many. Depression in Bipolar 2 can be deeper, but mania in Bipolar 2 is lighter. That is why it’s referred to as hypomania (a milder form of mania). Because of these differences, Bipolar 2 can go undiagnosed or misdiagnosed. Many people – even sometimes professionals – are simply zeroed in on the mania of Bipolar 1.
The Phases of Bipolar 2 and Me
When I am feeling super-powered to bake, or be the best mom, or even to talk a lot, it’s the hypomania in action. I know because these things have never left me feeling good. One might ask what’s wrong with talking a lot? Well, firstly, when I walk away I have this feeling of all the energy leaving me and I feel so down. But secondly, there is also the problem that I have no inhibitions, so I’ll talk about stuff I’d rather not share. The energy in my brain is too strong, too quick, and I don’t have enough time to weigh and measure my words. When I choose to bake up a storm, I’m not being realistic about timing, cleanup, and whether the decision is coming from a natural place of self or from high energy that thinks I can be what I’m not.
For me, after the hypomania I get irritable. On a lighter level, I find myself eating a lot, reading/avoiding, and generally feeling a sense of unease. As it gets more intense, I feel a tightness all over and pressure in my brain. I’m snapping at others, screaming, and acting in ways I’d much rather control. Inside my brain, it feels like everything is pushing outward. All that brain mass is fighting to break through my skull. I want to hurt myself because the pain inside is immense. Sometimes, I bang my head on the wall.
Depression rolls in after this period of hypomania. During this time, I’m crying in bed and feeling alone and unwanted. I believe myself to be a failure and I can’t depend on myself for anything.
It is not just the unpredictability of which phase I will be in at any given my moment. I’ll often experience “mixed episodes”, where the phases blend into each other. The depression is not true depression because the high energy is mixed in as well. That’s why when depression sends me to bed, I can’t fall asleep. I feel fatigued and have no interest in activities, yet I can’t sleep because my mind is still racing. With mania, the high energy makes me excited, but soon after it’s spinning in my head and I’m uncontrollably mad.
Working with my New Psychiatrist
I’ve been on Lamictal for a while (which is a mood stabilizer that targets depression). My new psychiatrist added Trileptal now, which focuses more on the mania. Thank G-d, I’m not experiencing any significant side effects.
I’ve been feeling better since I started. I hope. Today, for example, I resigned myself to taking Klonopin (a medication which temporarily helps calm the brain and nerves) just to survive the day because the mixed episodes were back. Am I doing better? Can I do better? I don’t know.
What I do know is that when I tell my psychiatrist that I felt depressed on Tuesday and irritable on Monday, she understands. She tells me it’s normal – that she often hears from her clients that depression follows irritability. It’s the low after the high. When she asks me if my mind is racing, I am so relieved that she knows and understands. This kind of validation means so much to me.
My moods, my “bad” actions – it’s not all me. There is a biological reason behind my challenges. I’m still responsible for them, but I’m not bad for it. And when medications will finally help keep me calm and in my proper self, I will feel vindicated, knowing that it never was my fault. And maybe I will also be able to begin trusting myself to be capable of baking up a storm, and not losing myself halfway through the job. Maybe I will feel brave enough to follow my dreams, without fearing that I won’t follow through on them because of my mind’s tricks.
I pray and wait for that day.
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