The Paralells Between Bipolar and Alcoholism

I didn't want to get into too many details yesterday for the reasons I stated, but in order to blog today, I have to get in a little deeper.  The problem I was trying not to discuss is Alcoholism.  A very close loved one of mine is an alcoholic.  Of late, we have had cause to examine our ailments together. While probably not a groundbreaking discovery, it is remarkable at how similar the symptoms of Alcoholism and Bipolar can be.

We've mainly compared the effects of mania and alcoholism.  First there is the intoxication of it, of course.  The primary difference is that the alcoholic's judgment skills are affected before the intoxicated feeling, ours are affected after the mania sets in.  Their disease sets in and wreaks havoc on their minds, tempting them with all sorts of reasons as to why it's ok, why they should have a drink.

There is the notion of choice.  Conventional wisdom says alcoholics can choose whether or not to have a drink.  People who are Bipolar have no choice whether or not they are going to have an episode.  On it's face it seems to be true, but given that Alcoholism is an actual disease, this isn't exactly fair.  Given the rationalization process I described above, how much of that truly involves a choice?  I know it sounds like I'm the one who is rationalizing now, but I'm not.  I realize that there are millions of people who have successfully achieved sobriety and are successfully able to make that choice.  The point is they have to make that choice every single day.  They are never free of that rationalization process, they have only become skilled at working their way through it.  It takes tremendous effort and practice, and relapse is only a heartbeat away. 

There's no actual beating it, it's forever a fight.  Just like Bipolar, you can be in remission.  You cannot be cured.  In comparing it to a Bipolar episode, it's true that we cannot prevent an episode from setting in on us if we are not medicated or if our medication fails us.  For those of us who are in treatment, being compliant with our treatment regimen is a must to delay or prevent aggravation of our illness.  Additionally, we should all be aware of our warning signs and have informed our loved ones of those signs.  There should be a relapse plan and everyone should know what they need to do should an episode come on.  These are the choices we are able to make.

Intoxication.  Now, I've been drunk before.  I've been manic.  I've been drunk AND manic.  I think I know more than a little about impaired judgment.  This is where it's hard for me not to rationalize my own behavior, hard not to say that Bipolar is far worse than Alcoholism.  Simple truth is that I'm that even though I've been drunk, I'm not an Alcoholic. I can relate, but I don't necessarily understand.   I think about the commonalities: infidelity, gambling, uncontrollable spending, shoplifting, anger management issues, and so on and so forth.  Which behaviors are exclusive to Alcoholism and which are Bipolar?  Uhhhhh...

More...the intoxication of mania is not something that 'wears off' the way high does, or a bender ends.  We are completely at the mercy of the illness, and medications aren't a quick fix.  Our option?  Hospitalization until our illness is sufficiently under control.  Counterpoint is that many Alcoholics also face hospitalization for detox and rehab.  In both cases, the need for hospitalization depends on the severity of the situation.

I can toss this ball back and forth until I go mad.  It seems there are far more similarities than there are differences.  Though Alcoholism has long been called a disease, this recent experience has made me see it truly in this fashion.  By comparing it to my own, I know it now as it truly is.  As much as a non-alcoholic can, I guess.

What does all this do to reconcile my current situation?  Absolutely nothing.  This person's Alcoholism is a trigger for my mania.  My mania and the recollection of my manic episodes are a trigger for this person's alcoholic behavior.  We can talk it to death, we can relate to each other as much as we can, but the problems divide us more than they bring us together.  Maybe it won't always be this way, but the memories may always linger.  Will we always be on edge?  Will there always be a fear of an episode or a break in sobriety?   Stupid Illnesses.

Circular Triggers

I apologize in advance for the ambiguity of this post.  It involves a third party, and I'd like to protect his/her anonymity.  I hope you understand.

I had a situation happen the other day that has left me feeling discouraged, dejected and deflated. I'm heartsick. Without going into details, it is one of the major triggers that has brought about manic episodes in the past. Obviously, I'm concerned. Especially considering I'm taking the Zoloft, and because it was just increased. Crushing depression always immediately follows my manias. So far, my medication seems to be working, as I only feel what I imagine is a healthy response to a bad situation. I function normally, but have this sad feeling. My thoughts are not consumed by what happened, though it is very present in my mind.

Now what do I do? I wouldn't have known what to do before...I would have just had this chemical response with no choice but to surrender to it. Now that it seems I do have a choice, I am at a loss as to how to approach the situation. I've been doing some talking with a supportive person, but to what end? It doesn't allay my fears, it doesn't provide me comfort, it isn't reassuring. Do I just keep talking? Is that the only way to resolve it? I am a proactive person. I cannot rest until I think I am doing something about a problem (although in a manic state my judgment was consistently poor, I still thought I was doing something). Removing myself from this particular problem is not an option.

The circumstances of this problem are a HUGE trigger for me. The irony of the situation is that something I did, albeit innocently, triggered it. Quite the predicament. It's also not something I can prevent from happening again, so far out of my control is the nature of this problem.

This is a time when I really feel Bipolar ruins my life. I feel angry and...I don't know if there is a word for what else I am feeling. Helpless? Hostage? Impotent? All are true, but they don't quite capture the hostility that is intertwined with them. I guess hostile is the right word, now that I think of it. I should clarify that these feelings I describe are not toward this issue, but the illness itself. Even if I am stable, it is still affecting me in a negative way. It still has the power to impact my life and do harm to me and the people around me. It limits how much I can say, how much I can share, how much I can reveal about it's effects on me. It hurts the people I love. As much as they might love me back, and feel for what I go through, they have their own feelings about it.  At times must protect themselves from me. Bipolar still alienates me, even if it is in remission. These are the battles Bipolar always wins. I do not have an effective defense.

So in short, someone else's trigger triggered my manias a few times. Recalling those manias recently ignited the trigger that had triggered my past manias. Now I'm worried about it triggering the mania again, all the while worrying about that initial trigger that sparked my manic episodes and the harm that it is doing to the person involved. It's this circle that I'm afraid can't be broken. I'm afraid I will break in some way instead.

There has to be a way through this, out of this. I refuse to let this battle be lost.

The Thrill and The Fear of Mania

Recently, I saw my psychiatrist for my monthly medication management visit. She increased my Zoloft by 50mg due to some lingering issues I have. Of course, I'm always wary of the potential for a manic episode due to such a change. So far, I haven't noticed too much of a change, but something caught my attention the other day.

My last post, although having nothing to do with Bipolar Disorder, detailed an endeavor that I had attempted several times over the last year and a half. This time, I approached it with a singular determination I have not had with my prior attempts. It was not like I steeled myself to do it, or had made a firm plan to do it. I just decided in the middle of the day I was going to give it a shot, and then was determined that he was not going to outlast me. While someone might not find this odd, for me it can be disconcerting. I just did it. There was no thinking about it, nor planning, not even a decision involved.

A phenomenon that used to puzzle me was that sometimes I was able to just pull this amazing self discipline out of nowhere. For example, if I had put on some weight, I'd make half hearted attempts to take it off, but was just too lazy to stick with anything. Then somewhere, out of the clear blue sky, I had it. There was no thought put into it. It's like I was on auto pilot. I'd be at the grocery store and just buy the right things to go on a diet. I'd get up the next morning and go to the gym. Suddenly I was off...and in the space of 2-3 months, I'd have lost 15-20 lbs., or however much I wanted to lose. One time, I got really heavy. It happened and I lost 50 lbs. within 3 months.

When I get hypomanic, it sets in differently. I want to make things beautiful and am likely to start a home improvement project. All the while, I will feel resentful that I'm the one doing it, that I can't rely on anyone else to get anything done. I'll be grumpy and spiteful, downright angry that no one would even bother to help. Funny thing is if anyone tried to help, I'd be even more pissed off. As if they didn't think I was fully capable of doing it on my own, or that they were trying to horn in and destroy my vision.

Once I learned I was Bipolar and began looking back and examining my behavior in the past, I realized this was the first sign of the onset of mania for me. I don't start with pressured speech. In fact, I don't have that much at all. I have flight of ideas, but that's mostly at night. I have competing thoughts all the time, manic or not, so that's not much of an indicator. For me, full blown mania involves the sense of a constant thrill, a heady, intoxicated feeling. My skin tingles. I smile a lot. I become the quintessential party girl. Anything to pump up that intoxication, make it go higher and higher. I feel grandiose, and for once I feel like I truly love myself. I also feel like everyone else should too. When I'm not manic, I feel very embarrassed about it, because I know I was so over the top it must have seemed weird or tiresome to everyone else. I must seem very conceited.

I don't feel any of those things now, but it does take some time from the onset of discipline to the elation. My worry then becomes "Will I say anything about it?" Will I secretly hope no one notices? Will I hope that they not have the courage to take my happiness away? I admit, these things have already entered my mind. That's how seductive mania is. Then there is the desire to think "Please, just let me feel it a little while before anyone notices. I won't let myself go too far before I say anything." It's like being a junkie. Just let me have one little hit and then I'll go straight, I promise. I even feel ashamed for having these ideas and feelings. It's that much like being an addict.

On the other hand, I'm terrified. What if it turns into a psychotic episode? That scared the shit out of me. It is something I never, ever, ever want to suffer again. It hit out of nowhere and crashed down on me like a tidal wave. To keep manic feelings to myself and then sink into the madness of delusions and hallucinations? Not only is that terrifying, it becomes very dangerous. I'm completely out of control and God knows what could happen. What if I hurt someone this time? Not a risk I'd like to take.

Then the junkie raises her head again. But it's not like that...you're not traumatized by surgery this time. You're not on all those pain meds, antibiotics, anesthesia coursing through your veins. I have already asked my husband to keep a vigilant eye on me, but the sneaky addict thinks she can conceal it, or at best convince him that everything is fine, or guilt him into doing nothing. See, classic junkie behavior. It's sickening and shameful to me.

For now, I'm just keeping an eye on it, and praying for strength. I may be worried for nothing, but I'm watching out for myself.

As a footnote, (and totally irrelevant to this post), I logged a lot of miles on that potty train with my youngest. We had some success this weekend. Unfortunately for me, my oldest son decided to put him on the potty just one time, and reaped the benefits of all my hard work. Sigh. That's irony in action. I'm disappointed I didn't get to have that moment all to myself, but I'm so proud of my oldest. It was such a mature thing to do. I'm also proud of my youngest, it was the harder of the two things to do in potty training. Not that you wanted to know that part. It's just a major breakthrough (as anyone who has ridden the potty train knows).