I thought I would break down what I experience for a couple of decades, suffering from Bipolar I. I’m giving this magazine the credit for this here… bphobe.com
1. With anxious distress
During the most recent or current mood episode (depressive, hypomanic or manic), at least two of the following symptoms are present: feeling keyed up or tense, feeling unusually restless, difficulty concentrating because of worry, fearful something bad will happen, or feeling on the edge of self-control. Anxious symptoms improve as the underlying mood episode resolves.
I always worry about my family and fear that something bad will happen. My irrational brain seems to believe someone will break into my house and hurt the people I love. I do have anxiety working at night. I don’t like being left alone at any point. I do suffer from Anxiety all the time. I worry about completing my series. I worry about people hating me for taking so damn long. I worry that my book will fail miserably. If I could stop the anxiety, I’d be a happy camper.
2. With mixed features
Denotes the presence of depressive symptoms during a manic or hypomanic episode, or hypo/manic symptoms during a depressive episode. This replaces the separate category for “mixed state” episodes, which required meeting full criteria for both poles at the same time.
A mix of being manic and depressed at the same time. Before Depakote, I experienced these on a regular basis. I wanted to claw my skin off because I couldn’t stop being angry and depressed at the same time. Anger counts as mania. It doesn’t mean “you’re happy” all the time. This is the worst place for me. I hate these when they come. You never know how long it will last or who would be in your path of destruction.
3. With rapid cycling
Technically, this simply means four or more mood episodes of any kind within a 12-month period—although people whose moods fluctuate quickly, sometimes within the course of a single day, often use “rapid cycling” to describe those mood gyrations. (The correct term for many ups and downs in a day is “ultradian cycling.”)
I am a “rapid cycler.” I can and had several mood changes in one day. It is the worst feeling in the world. One minute I’ll be happy and the next I’ll be angry and sad. You can’t do anything when you’re up one minute and down the next. You don’t want to go outside because you know you’ll have a meltdown. I couldn’t tell you how I was fine at home, but the moment I stepped outside, I became a tyrant. Shopping became a nightmare for me. I remember yelling at my husband numerous times for no reason at all. And this made him frustrated with me at times. You cannot force someone with Bipolar out of the house when their moods are scattered all over the place. Not unless you want to be embarrassed in public. If they say they don’t feel well, please be compassionate and understanding.
4. With catatonic features
Used when certain extremes of physical activity and speech occur during a mood episode, including lack of response to stimuli, not moving or speaking, repeating words or movements of another person, or frantic movement with no purpose.
I used to get stuck in my own mind. I would sit out on the porch, just staring off in a distance. Kids and the husband would wave their hands in front of me, but I would be trapped in my own brain. Just looking at the leaves or trees. Sometimes the sky. I never acknowledged them or responded. We thought they were seizures, but it’s a part of Bipolar.
5. With psychotic features
Noted when paranoia, delusions, or hallucinations—auditory (hearing voices), visual (seeing things) or sensory (feeling something that isn’t there)—occur at any point during a mood episode. Religious delusions are common, such as believing you’ve been given a special mission or special message from God.
Loud speakers! They’re everywhere! I didn’t understand that these were auditory hallucinations. I really was doing a job for God! He picked me! Not really. Now that I’ve had more time to think about this, I remember my first auditory hallucination happening at age 4. I thought my dad called me into another room, but he wasn’t there. He was at work at the time. This is another funny story. Sad, but funny. I wanted to quit a warehouse job for a famous online retailer. All the sudden a voice appeared. “You need to stay here. The man of your dreams is coming.” All on a loudspeaker. Except the warehouse didn’t own any loudspeakers. I asked others if they heard that voice. Nope! I was the only one who heard it. It must come from God. So, I stayed at that job. Good thing I did because that’s where I met my second husband. I am God’s warrior. I don’t need to go to church because I’m exempted. He doesn’t like the way his followers are behaving anyway. That wasn’t what he meant to say in the bible! That’s what my irrational brain thought. And the paranoia. I’m still convinced aliens come and kidnap me at night. And there are angels and demons. I also see auras. Wait… That’s all delusions from an irrational brain. Meaning, my brain is full of faults and short circuits from time to time. Not since I’ve been on Depakote. I hate it when it’s right by my ear. That shit creeps me out.
6. With melancholy features
Describes a depressive episode characterized by an almost complete lack of ability to feel pleasure even when something good happens. Typically, there is also insomnia and significant slowing of speech and activity.
Have you ever had sex and it was good, but you can’t voice an opinion about it being good? I suffer from this. Like with important events that should matter, I feel nothing. My kids win awards, and I feel no excitement or happiness. I am happy, but you can’t see it. It’s just a blank expression. When people are extremely happy, I’m like… Whatever. It is what it is. I couldn’t get excited from when my children were born. It was always blank. Insomnia was quite common with me. I would go three days in a row without sleep. And if that happens, I noticed Bipolar would become worse without it.
7. With atypical features
Applies to a depressive episode in which the person sleeps and eats more than usual, often gaining weight. Other traits: Feeling sluggish and “leaden,” and being abnormally affected by rejection. If there is low mood, spirits may lift in reaction to a positive experience.
I don’t like being rejected. I don’t handle negative criticisms well; especially, when it comes to my books. That’s why they’re off the shelf for now. We need to get me well before that happens. It doesn’t make you motivated to write another book when you’re depressed. So, I used to spend my days eating “bad” food and watching YouTube videos from other people suffering from mental disorders. Ironic, isn’t it? I didn’t want to go anywhere or be with anyone. Off to my bat cave, I went!
8. With seasonal pattern
This is also used for depressions that recur during certain seasons—typically in fall or winter—that can’t be attributed to events like school starting or seasonal unemployment. More rarely, people experience a pattern of summertime depressions.
I hate the winter! I can’t stand it! It’s all gray and nasty! I don’t like the snow or ice. It’s too depressing. There is rarely any sun during the months of November to March. I love watching the leaves and flowers bloom in the spring. I am not a huge fan of driving in the snow. I often like to hide in my room. Hibernate until spring. Some people are the opposite of me, but I love looking at the roses. I love watching new life come out of hiding. There’s nothing sweeter than seeing ducks with their ducklings. Birds with their chicks. Pollen is a bitch, but I love feeling the waves and sandy beaches. I am not meant for skiing. I am a summer baby. My depressive episodes hit more in the winter than the spring or summer.
#9) With peripartum onset
Indicates mood episodes that begin during pregnancy or in in the months after giving birth. This replaces “postpartum onset,” the term used in previous DSM editions, to reflect the fact that many women have mood symptoms that pre-date delivery.
I didn’t have a good time after my third son was born. I suffered from severe postpartum depression. I was extremely happy when I was pregnant with him. After he was born, it was like a part of me died. I couldn’t get out of bed. I didn’t want to do anything. When our daughter was born, I knew what to look out for. With my older two sons, I was always jumping from one mood swing to another. I hated myself when I was pregnant with them. I would be happy and the next, sob for no reason. If there was a time for my husband to walk out on me, it would have been when I was pregnant with our two oldest sons. Thankfully, he stayed. He shouldn’t have, but he did.
As for Depakote, I’m still waiting on my lab results. They left a message, but I didn’t answer it on Friday. So, my anxiety level is way up this weekend until I get a hold of them. My biggest fear is that my body can’t handle the medication. This is the first medication that works, and I don’t want to change medications. They make sure your liver and kidneys can handle it. If not, it’s back to the drawing board. I’m going to keep my mind focused on my books. I need to keep it busy or the anxiety will win.