When Natasha Tracy of Vancouver, British Columbia was 20, she was depressed—and terrified. “I had been depressed before, but this time I was suicidal,” she says. After one false diagnosis of depression, a second psychiatrist diagnosed her with bipolar disorder. "I didn’t know anything about it," says Tracy, now in her 30s and a mental health writer.
"A severe mood disorder, bipolar disorder has two types," says neuropsychologist John Preston, PsyD, Professor Emeritus at Alliant International University in Sacramento, California. "The first includes severe depression with manic, or upbeat, episodes. The second has more depression, a high risk of suicide and [fewer] elevated moods."
According to the National Institute of Mental Health, bipolar disorder affects 5.7 million Americans 18 or older, often developing between ages 20 and 25.
Daily challenges
"Having bipolar disorder feels like living in a tornado," says Tracy. "It is vast and beyond your control, so strong that it can pick up your house and crash it."
Especially difficult is that it seems to arrive out of the blue, says Preston. "After the first episode, the person is often living with fear about when another episode will happen."
People living with bipolar disorder also have to adjust to taking daily mood stabilizers, the standard treatment. "Patients can feel numbed out, and that’s hard to deal with," says Preston. The medications can have other side effects, as well. Tracy experienced an exhausting racing heart, headaches and nausea. Now she is on a medication that is only moderately effective.
Daily mood and energy changes are challenging too, says Tracy: "I do better in the mornings so I work seven days a week to make up for short days." She has little energy so routine tasks—even eating—often go undone.
Eroding relationships
Bipolar disorder can be rough on relationships, too. "One coping strategy is withdrawal," says Tracy. "People can feel it’s difficult to know me because I’m hiding my emotions."
Dating is tricky, too. Sometimes she’s too depressed to go out. And some people reject her when they find out she has bipolar disorder.
Because people with the disorder can say or do bizarre things when they are manic, others can become frightened, says Preston: "You can meet someone, get involved, and then this inexplicable disorder appears. It’s scary."
The bipolar stigma
Not least of the difficulties are false notions about bipolar disorder, says Tracy. "One, that we are unreliable and that moods come and go in a moment. Another, that we are violent. Most people with bipolar disorder are not."
Another misconception is that people can just snap out of it, says Preston. Loved ones may advise people to deal with the condition on their own. "But that leads them to stop treatment, so the advice can be devastating," says Preston.
Healthy steps
The condition has genetic components, but environmental triggers of bipolar play a role. Some can be managed to limit episodes.
- Take your medications. Preston notes that about 20 percent of people will not have any more episodes if they get and stay on the right medication: "But 90 percent of people stop medications after a few months. They may feel better because they have no more side effects. But then they have another bipolar episode."
- Schedule sleep. "Sleep is a priority," says Tracy who gets up and goes to sleep at the same time daily. She also has an unswerving bedtime routine: "It signals my body that it’s bedtime."
- Limit caffeine. "Even a modest amount interferes with deep sleep," says Preston. Cut one cup a day for a week and continue that pattern until you are down to no more than two cups a day before noon.
