I’m an expert in bipolar management, yet I still have frequent mood swings and deal with symptoms regularly. Shouldn’t I have “solved” this by now? Shouldn’t I have “recovered”?
Bipolar Disorder, Expertise, & Mood Management
I’ve been writing books about bipolar disorder management since 1998, and my webpage started in 2002. How is it possible that I still deal with so many mood swings? Shouldn’t I be better by now? Why am I still talking about my own mood every day and bipolar in general?
Well, it comes down to this: It’s all about the nature of this illness.
“Julie, why are you so often in a mood swing? If you’re managing your illness, doesn’t this mean you should not be having mood swings so frequently?”
I could tell that the person asked this question with honesty and that there was no judgment. It is probably something many people wonder: Shouldn’t someone like myself, who is an expert in bipolar management, be stable? Why am I not in “recovery” and getting on with my life without bipolar symptoms?
What Is “Recovery” & Does It Apply to Bipolar Disorder?
Before I give my answer, I would like to share my opinions on the term recovery.
Recovery is a word used in the addiction community to describe people who are working within a program while abstaining from addictive substances.
When used this way, it makes sense! There is a behavior (substance use) that has to be stopped or moderated. It can be measured and a person can recover; in other words, go back to how they were before they were using a substance.
This framework simply doesn’t apply to bipolar disorder, in my opinion. Our illness, bipolar disorder, is genetic and is not caused by our choices. Mental health campaigns that talk about recovery and how things get better often leave out illnesses that are more physiological, such as bipolar disorder. As a parallel example, with a physical condition, I don’t think we would use the term recovery when talking about type 1 diabetes. And this is why I don’t use the term in my own work about bipolar. (Please know that this is simply an opinion and I respect that we are individuals and some might disagree with me.)
So, when I get a question like “Why I am not symptom-free, considering all of my focus on management?” I have to remember that, over the past 20 years in the mental health community, there has been an emphasis on recovery and getting better, instead of an emphasis on managing bipolar disorder as a physical illness. Imagine asking someone with diabetes the same question I was asked on Instagram:
“Julie, you write books on type 1 diabetes and health, and yet you still can’t produce the insulin your body needs! I would think that someone who is an expert would be able to control the pancreas a lot better.”
First, I will share my answer to the original question of why I still have so many mood swings, even though I write books and train healthcare professionals on bipolar management.
I have a chronic form of bipolar disorder called ultradian rapid-cycling bipolar. This means I live with daily mood swings. Without my management plan, I would not be here. I never believed I would live a long life, as I was sick for so long. I wasn’t diagnosed until age 31, even though my symptoms started at 16. But … with hard work, I’ve cut my mood swings by around 80%. I used to be sick for long periods of time. For example, I would have a three-year down swing or a four-month manic episode.
Now, I am rarely sick for more than a few hours a day or a few days at a time. I often wake up in a mood swing, and it is always my goal to manage it that day so that I go to bed feeling better than when I woke up. It’s exhausting, but it’s a lot better than being sick for years.
I stay out of the hospital. I can use smaller amounts of medications. And, most important, I have strong relationships and can work part-time. None of this was possible in the past. I also live with a serious psychotic disorder that complicates my bipolar. I use my plan to manage this in the same way I mange mania and depression.
All people with bipolar have the same symptoms, but what differs is the intensity and the duration of those symptoms. Some people have less-intense bipolar and go long periods between mood swings. I am not one of these people! It really is a spectrum. Without my management plan, I continually cycle between psychotic, suicida1 depression, paranoia, mania, irritation, and overall melancholy. I am also plagued by OCD if my work is too stressful.
I have taught myself to manage all of these symptoms, but they are still there, waiting to take over my life. I can feel the symptoms simmering in my brain. The plan I teach in Take Charge of Bipolar Disorder is a lot of work, but it really works! It keeps my symptoms at bay. When they are triggered, as they often are, I am ready to meet them with my management skills. It’s no different than someone with diabetes who uses diet, stress management, and an insulin pump to stay healthy.
Few people with bipolar disorder are asymptomatic. Most of us deal with regular mood swings, some more than others. Bipolar can be managed, but it never goes away. There is no “recovery” from bipolar disorder. Just as there is no “recovery” from insulin-dependent type 1 diabetes. There is management, and there is definitely hope for a better life, but this is an illness of the brain that we have had from birth. It doesn’t simply go away one day.
I am very aware that my brain isn’t an easy brain. It’s a very difficult brain to manage. I can tell you that daily management gives me a very full life. I have far more good days than bad days now. Thank you for your question.
Final Thoughts on Recovery, Management, & Bipolar
Maybe we are scared to hear that bipolar isn’t something that we recover from at this time. One day, there will be genetic help, and we will be able to end this illness. I believe this with all of my heart. For now, the goal is to manage the illness in a way that allows for fewer mood swings, in terms of duration and intensity. This is our success.
If you struggle to manage bipolar, this is normal. It’s why you’re on a website devoted to bipolar disorder management! You aren’t weak if you can’t “recover” from bipolar. The goal is to have a plan that is stronger than the mood swings. This is possible. I am not a negative person. I am an optimist. It’s amazing that we can use a plan to manage our mood swings. Recovery is simply a different topic. For us? I believe it’s all about management and focusing on reducing the intensity of mood swings and making sure they are shorter and shorter each time.
Julie A. Fast is the author of Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder, Get It Done When You’re Depressed, and The Health Cards Treatment System for Bipolar Disorder. She is a columnist and blogger for bp Magazine, and she won the Mental Health America journalism award for the best mental health column in the US. Julie was also the recipient of the Eli Lilly Reintegration Achievement Award for her work in bipolar disorder advocacy. Julie is a bipolar disorder expert for ShareCare, a site created by Dr. Oz and Oprah. Julie is CEU certified and regularly trains health care professionals, including psychiatric residents, social workers, therapists, and general practitioners, on bipolar disorder management skills. She was the original consultant for Claire Danes for the show Homeland and is on the mental health expert registry for People magazine. She works as a coach for parents and partners of people with bipolar disorder. Julie is currently writing a book for children called "Hortensia and the Magical Brain: Poems for Kids with Bipolar, Anxiety, Psychosis, and Depression." You can find more about her work at JulieFast.com and BipolarHappens.com.
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