And then it happened, he got sick again. I thought, "right, that's how our life's
going to be for the rest of our lives". After that, I'm sort of always on guard,
using my thinking capacity and trying to keep one step ahead of him to stop him from
doing things that would cause irreparable harm. My alarm has worked, but
it's draining my strength. The untold story of living with
someone with bipolar disorder. The content of this video is intended to
be educational, and the general guidance should NOT substitute the advice provided by
a physician or qualified health professional. This video is simply meant to contribute
to the conversation surrounding mental health and caregiving, and challenge
the stigma around bipolar disorder. When someone is diagnosed with bipolar
disorder, it's not uncommon for a close family member to take on an informal caregiver
role. At times, this role can be difficult and may feel like a large burden. However,
research has indicated that this perceived burden can actually be mitigated through something
called psychoeducation. Psychoeducation involves learning about bipolar disorder, its symptoms,
its treatment, and proper management options. Bipolar disorder is a brain condition that causes
extreme fluctuation in a person’s mood, energy, and ability to function. These individuals have
strong emotional states that involve highs and or lows, that can last for days or even weeks. There
are four types of bipolar disorders which include Bipolar I, Bipolar II, Cyclothymic disorder, and
Bipolar Disorder Not Otherwise Specified (NOS). Each type exhibits a different mix of bipolar
symptoms and episodes which have variable effects on a person’s functioning and wellbeing.
In order to best help your loved one, it is important for you to know the four types of
bipolar episodes. These include manic, hypomanic, major depressive, and mixed episodes and they
each have their own different signs and symptoms. Manic episodes
“A lot of times, when she’s manic she’ll just take off period. Take the car and go
and then I worry about her. She’s just racing.” “I’ve had to watch his bank statements
when he’s high - he has mini spend-ups.” “But, when she’s manic, she’s, totally a
different person…she’s very, very selfish, only thinking of herself. Her mind is
racing… she cannot, when she’s manic, you can’t really reason with her.
She cannot see the right thing.” During a manic episode, a person feels
intense euphoria or highs, while often also being irritable. Signs of this type of episode
include fast speech, racing thoughts, less sleep paired with high energy, being easily distracted,
having an inflated sense of one’s own importance, and increased recklessness. Hypomanic episodes “At one time my wife had three jobs.
But that could have been the mania.” “Our marriage is a lot different than
it would have been without the illness; even when she's well, I’m vigilant
for signs of illness all the time.” Hypomanic episodes include some of the seemingly
more positive aspects of mania such as increased productivity and a sense of euphoria without some
of the more outwardly negative aspects such as recklessness and irritability; those negative
aspects that tend to impede an individual’s daily functioning. This milder episode can
mislead people into thinking they can stop their medication. However, that isn’t the
case because hypomania is only temporary and can quickly escalate into full-on mania
or even be followed by a depressive episode. Major depressive episodes "He became remote and different.
Answered in words of one syllable, his voice was completely dead, and his body
language was completely flat. He lay in bed most of the time. I felt as though I was on the
outside of something incomprehensible and unreal." Someone in a major depressive episode experiences
the hallmark symptoms of depression for two weeks or longer and these include feeling down,
losing interest in things they like; things that typically brought them joy. Other symptoms
that can occur include poor sleep or oversleeping, poor appetite or overeating,
difficulties concentrating, feeling worthless, experiencing lower
self-esteem, and suicidal thoughts. When an individual presents with four or more of
those symptoms, they are said to be in a major depressive episode. Mixed episodes “Depending on what mood she’s in, if she’s
in the manic mood or the depressive mood… let’s just say her personality ah is
altered, it's not the same person.” When both mania and depression are
present and cycle throughout the day, the individual is in a mixed episode.
Caregivers must be particularly wary of this type of episode because the
combination of depression with the high energy from the mania puts patients at
a much higher risk of committing suicide. In order to ensure we have a
holistic understanding of the issue, we decided to consult Dr. Roger McIntyre. He
is a Professor of Psychiatry and Pharmacology at the University of Toronto. He's also the Head
of the Mood Disorders Psychopharmacology Unit at the University Health Network in Toronto.
He's published more than 400 articles and manuscripts on mood disorders
including bipolar disorder. How can friends and family help
with managing bipolar disorder? First thing is that when I'm asked by families
and friends how can they be supportive, it begins with education, more education, and more
education because I think we need to have good literacy on the illness and its treatment. And
I think it's difficult to support someone if you don't have sufficient knowledge on what they're
going through and/or sufficient understanding of what the treatments are. So you need to be
equipped and fortified with up-to-date knowledge. Secondly is that I encourage people to go to a
group that is dedicated to families and people affected by bipolar disorders called the DBSA. So
www.dbsalliance.org. The Depression and Bipolar Support Alliance is online. It's based in
the US but it's international and it's an opportunity to meet other families of people who
live with bipolar... What do they find to be more effective to support people with bipolar disorder?
What did they find didn't maybe work as well?? And learn about the timing is right.
Striking when the iron is cold, as they say. How can friends and family
help during a depressive state? I think the key thing is during a depression, one
needs to be aware of the fact that many people with depression as part of bipolar
do experience thoughts of suicide. And I think there needs to be a recognition of
that and of that. And if, in fact, the seriousness of that escalates, I think that they should
really encourage the person who's living with the condition to seek out healthcare services
immediately, whether it's the local physician they see or, in many cases, going to the local
emergency. And sometimes if the person is denying or not wanting to seek out healthcare, there's
serious concerns raised. I think we need to also, in many cases, depend on family and friends
to get that person to a local emergency. As a caregiver, it is essential to encourage
the individual to take their medications to help them manage their episodic symptoms. However, at the same time, it's important for you
not to get overly involved as this can increase the caregiver burden and may not be what's
best for the individual themselves either. Cautionary notice: family and friends are not
the patient's doctor, not the person's doctor. And they are not the person's manager
typically. And we always need to really respect the boundaries and the autonomy of
the person who lives with the condition. But, that being said, we certainly would
welcome mentorship and advocacy, and support. I've treated tens and tens and tens and tens of
thousands of people who have bipolar and most do real well. And so, you know, they're people
you would know, they are well known in Canadian and American societies. They are leaders
in many different ecosystems and spaces. “Accepting the life situation was
difficult. It happened gradually. I got help from a therapist, managed to put
things into perspective, and re-established my belief in myself. I saw that my husband was
growing and that our life became more stabilized. We have undoubtedly both
grown from the experience.”
