What Is a Bipolar Depressive Episode?
There could not be a better time for me to write an article about a bipolar depressive episode. I have been depressed for the past few weeks. During the depressive episode, I think about my symptoms, what my mind tells me and what I do to cope. I want to be able to share honestly, so I can help you in the best way possible.
Depression and Bipolar Disorder
I think depression is such an important topic of discussion for those of us with this debilitating illness. The National Alliance on Mental Illness (NAMI) reports that of the more than 5.7 million Americans who have bipolar disorder, 83% of all cases are severe. This comes as no surprise to me.
How Is It Unique?
I know when I am depressed, I experience true suffering. Only those of us who have bipolar disorder can relate to this type of misery. So, I set out to answer the question: how can those of us with bipolar disorder manage the depression aspect of our illness in the best way possible to reduce suffering? I sincerely hope sharing my experience, strength and hope helps you.
It took me a long time to fully understand and accept what goes on when I am depressed. I am a Marine veteran and for years I struggled tremendously with the idea that I can somehow overcome my depression with sheer willpower. I put up a fight before I finally had to surrender and accept that bipolar is stronger than me. I am powerless over my own brain chemistry.
Bipolar depression is a specific type of depression that belongs to those of us who are diagnosed with bipolar disorder. Everyone on the planet experiences periods of situational depression during their lives for different reasons. For example, someone might experience depression after the death of a loved one, a divorce, or the loss of a job. Bipolar depression is different.
What Causes Bipolar Depression?
Bipolar depression is caused by the depletion of certain so-called “feel good" chemicals in the brain – namely dopamine, serotonin and oxytocin. The bipolar brain is unable to effectively regulate these chemicals. These chemicals are responsible for a number of important functions, such as feelings of contentment, concentration and memory.
Because of the dysregulation of these chemicals, people who have bipolar disorder experience periods of extreme highs (known as mania) when there is a surge of these chemicals, and extreme lows (known as depression) when these chemicals are lacking. Depression can last for days, weeks, or months.
What Are the Symptoms of Bipolar Depression?
The bottom line is that bipolar depression sucks. There is no other way to put it. Most of us agree that mania or hypomania (a lesser manifestation of mania) feels fantastic. I have always said that if I could stay in a hypomanic state all the time, I would be a New York Times best-selling millionaire by now. Unfortunately, hypomania is fleeting and depression always returns.
This is my take on bipolar depression symptoms:
- Low energy – just holding up your own head feels like a task
- Heaviness – like you are wading through wet concrete with every movement
- Loss of interest – everything feels totally uninteresting, like “meh"
- Hopelessness – the future seems dark and bleak
- Sleep disruption – it could be wanting to sleep forever or total insomnia
- Uncontrollable crying – the tears keep coming for no reason
- Isolation – the strong desire to cut off all human contact
- Physical pains – for me, it is migraines and body aches
- Loss of concentration – completing even the simplest task feels impossible
- Agitation – easily annoyed or angered for no real reason
- Suicidal thoughts – thoughts of wanting to kill yourself
- Suicide attempt – in this case, you should reach out and get help immediately
Learn more about the warning signs of a bipolar depressive episode.
Bipolar depression runs deep. This is not just “feeling blue". It is a very overwhelming, soul-crushing experience that consumes your being and makes you want to give up and quit life altogether.
Treatment for Bipolar Depression
Understanding why you have bipolar depression is helpful. It is also helpful to know that bipolar disorder is treatable. I fought effective treatment for years because I refused to accept that I had the illness. My way of managing my excruciating symptoms was with alcohol and street drugs. It should come as no surprise that doing things that way got me into a heap of trouble and, of course, only made things worse.
Medication and Psychotherapy
Today, I treat bipolar disorder with a clinical approach that includes medication and therapy. Mood stabilizers, antidepressants, antipsychotics and other mental health medications are prescribed by psychiatrists for this illness. Also, I am a staunch advocate for psychotherapy. It helps to have a therapist to talk to on a regular basis.
Alternative Therapy Options
I also believe therapy comes in other forms as well. For instance, walking, animal therapy (I love my rescues kitties…. they save me from myself on a daily basis), prayer, meditation, laughter, time with good friends and other feel goods are important aspects of bipolar treatment for me. I encourage you to find what works for you. It could be knitting, golf, volunteering, 12-step recovery, woodworking, or chess.
6 Ways to Cope With Bipolar Depression From Someone Who Gets It
Of course, it is always best to do everything in your power to prevent a bipolar depressive episode. This happens by being an active participant in treatment. However, there will be times when there is nothing you can do about it – depression will show up and take you down. Here are some coping skills that helped me during my most recent episode.
1. Be Kind to Yourself
I do not know about you, but when I am depressed, my bipolar brain wants to kick the shit out of me. It tells me I am worthless and good for nothing. It says I will never accomplish anything with my life because of my illness. It reminds me of all the times I have failed and insists that the road ahead is sure to be marked with even greater failures and disappointments. I have to talk back and remind myself that I am dearly loved, that I have done great things with my life and that I still have greatness within me. I know there are brighter days ahead.
I allow myself the dignity of being temporarily ill, knowing that my depression will pass, just as it always has. I speak kind and loving works to myself and, quite frankly, I get gangster on my depression - I tell it where to go. I encourage you to do to the same when you are coping with bipolar depression. Be kind to yourself.
2. Take Your Medication on Schedule
If you are anything like me, I get seriously annoyed when I hear this advice. It is the worst from coming from my mom: “Have you taken your meds, honey?" Of course, she is coming from the most loving and caring place. But, boy, does it get on my nerves! However, taking your meds on schedule when you are depressed is very wise advice when you are coping with bipolar depression. Medication helps us get better.
Those of us with bipolar disorder are notorious for stopping meds, skipping meds and self-medicating. It is imperative that we take our medication as prescribed, on schedule. This can be difficult to do when we are depressed. Our motivation is low and just about everything can feel like it requires more effort than we have to give. Plus, we have a tendency to sleep a lot when we are depressed which means we might miss doses.
I cannot stress it enough that even if you do not want to, even if you think the medicine is not working, even if you do not feel like getting out of bed, take your medication on schedule.
3. Indulge Yourself in Simple Comforts
When I am depressed, I feel bad. Like, really bad. Sometimes, I feel so bad that suicide starts sounding like a good idea. So, some time ago, I learned that when I am depressed, I need to indulge in simple comforts that give me a boost and make me feel a little bit better – whatever those might be.
For me, it means laying in bed snuggled up with my kitties and my baby blanket binge-watching my favorite show (“Real Housewives of Beverly Hills", anyone?). It’s having that pint of cookies and cream ice cream. It’s going over to my moms and having four cups of tea in my pajamas even though I can barely hold my head up.
Find out what works for you and give yourself permission to do the things that make you feel better. Remember, when you are in the grips of bipolar depression, you are sick. You are ill. You are unwell. I truly believe giving yourself some chicken soup for the soul helps move the depression along quicker, so you can get to the other side and start feeling better.
4. Feel the Love
When I am depressed, my mind attacks me with the most vicious lies. It tells me I am a burden to those around me. It insists that my loved ones would be better off without me. It says the people in my life are sick of me because of my illness and how it affects them. I used to believe this, but today I know different. The truth is, I am dearly loved! When I am depressed, I am overwhelmed with support, encouragement and kind words from my friends and family.
During this recent bipolar depressive episode, I allowed myself to feel the love. I actually experienced a deep sense of gratitude during the past few weeks, which is new for me. Usually, I buy into the nonsense my mind feeds me, which is that people are just pretending to care about me. I am willing to bet good money that you are dearly loved as well.
5. Accept Help From Others
When bipolar depression rears its ugly head, I isolate myself and “go dark", as one friend puts it. I get off social media, I stop calling and texting, and I basically sink into myself and become enveloped in the illness. During this most recent depression, I did something different.
I accepted the support and encouragement of my friends, family and colleagues. In the past, I have suffered in silence and shut people out. That just makes things worse. I have a chronic and progressive illness called bipolar disorder. I do my best to manage it, but sometimes it manages me. I have to be honest with the people in my life and sometimes that means reaching out for help.
6. Just Do One Thing
The world does not stop spinning just because we have depression. We still have daily responsibilities. Bills still have to be paid. People in our lives still have to be taken care of, and this includes ourselves. When I am depressed, I want to completely blow everything and everyone off and just lay in bed with the curtains drawn and do nothing.
I will say I do believe there is a time for that. During my most recent bipolar depressive episode, I gave myself permission to lay in bed and just rest for three days. After that, I knew life had to go on and I had to take care of business. So, I reverted to a strategy I use that helps me. Just do one thing. One thing. No matter how bad the depression is, I know I can just do one thing.
Whether it is taking out the trash or doing the dishes or going through the mail. I start by doing just one thing. After that, I just do one thing. And then, one thing. Soon, momentum builds. Then, I have done many things. Before long, I am engaging in life and pulling it together.
Some Final Thoughts on Bipolar Depression
With experience, I have learned that a bipolar depressive episode does not come to stay, it comes to pass. It reminds me of what my mom always tells me: “This too shall pass, all things do." There is no doubt about it, depression sucks. But it does not last.
Next time, you have a bipolar depressive episode (or if you are having one now), try the coping skills I shared. Remember to be kind to yourself. Take your meds on schedule. Indulge yourself in simple comforts. Feel the love. Accept help from others and just do one thing.
Keep fighting the good fight. Bipolar may not be a super awesome companion to live with, but it is here to stay. It is important to make the best of it and learn to live with it the best way you know how. I am doing the same. We got this!