Meet Katie.  Katie is 10.  She was diagnosed Bipolar a year and a half ago.  Today she is a listless, seemingly mentally dull kid.  But what you don’t know is the rest of the story.  When Katie was 8 she could hear voices.  They were singing songs, or reciting poems.   It wasn’t in her head.  She wasn’t the one thinking the songs or the poems.  She was hearing them.  But not with her ears, either.  It came from a third place.  Not inside her brain or outside of her head.  These are auditory hallucinations.

She felt like she was being watched or like somewhere “just out of the corner of her ear” someone just made a sound, but she just missed being able to tell what it was.  Just barely.  But someone was there.  It always felt like something bad was about to happen.  She was so tired from always watching out and listening, and because she would think and think all the time and never stop.  She felt sad and her body hurt.  But she couldn’t stop being so busy, busy, busy all the time.  She forgot what she was saying in the middle of it sometimes, and sometimes she would talk and talk about everything to everybody without stopping.  (Pressured speech, expansive mood).  She had to get ready for school but by the time she got dressed, ate, brushed her teeth, and put on her shoes, she just wanted to go back to bed and stay home.  She felt like she was a “nobody” and couldn’t do anything good; that she wasn’t smart.  Then a doctor told her she was “Bipolar”.

Katie is actually Bipolar I.  The most extreme form of Bipolar.  she was nearly psychotic, as evidenced by her delusions of persecution and the mixed states of being both manic and depressed at the same time.

Then she started taking medication and was so suppressed by it that she could only sleep.  For a week!  And so the doctor adjusted the dose down, and added another med, and within another week she was so speeded up that she was sleeping only 2 hours a night.  She was having ideas so fast she couldn’t do them all.  She wanted to paint her room.  She was going to be a model.  She would be president when she grew up because she was sooooo smart.  (Remember the girl who thought she was a “nobody” a week ago?).  These are delusions of grandeur and in the manic phase can lead the Bipolar individual to attempt things humanly impossible, like leaping from a 7th story balcony in an attempt to fly.

Mom became worried that the doctor didn’t know what he was doing, so she stopped all of Katie’s meds.  Katie suffered nausea and vomiting and tremors for three days, and then a headache that lasted 48 hours.  And then it started all over; the voices, messages from god, her named spelled in the clouds, smoke in the room (Don’t you see it mommy? It’s right there!)

Finally the doctor found a combination of meds that is right for her, and yet she is now a subdued child with a dulled or blunted affect (affect is the outward manifestation of a person’s feelings or mood) who speaks in a monotone most of the time and is neither happy nor sad.  All her creativity is dried up, along with her precious personality.

Mom’s life is in chaos as she deals daily with this unbearable pain of seeing her child suffer and be judged by others.  Her beautiful child who, up until 2 years ago was just like all the other kids; her child whom she knows to be bright, smart, capable, funny, creative, loveable and affectionate.  Katie has so much emotion, when it is not suppressed by the meds.  She is much more sensitive than the average child.  She hurts deeper, cares more, loves without reservation.

Mom is very likely to hear comments such as “What in the world does a ten-year old kid have to be depressed about” or “all she needs is a good spanking”, leading her to question her own judgment and in society Katie will face ignorance, and misunderstanding, as well as isolation.

What the Bipolar might like you to know:

A bipolar person may feel full of confidence and ability, ready to take on the world when “up” and conversely feel they can’t even force themselves out of bed and even face the world when they are down.  They feel physically tired.  They are physically weaker during this phase.  And in between thy may have brief, or even very long periods of relative normalcy.  As to their cognitive function, Bipolar individuals definitely have an “attention deficit” during both the up and the down phases.  They often can’t pay attention both because of suppressed mood, and easy distractability.  Neurons don’t fire across the synapse as quickly in the depressed phase, or sometimes mis-fire.  So thinking can be slow and or jumbled.  They can’t process speech as quickly either, so they may need for you to speak a little more slowly and distinctly, with pauses for time to process.  They may seem self-centered because it takes all their inner resources just to function in daily life while being “whip-lashed” constantly around by their own internal “storms”.  As a Christian, I would even go so far as to say that there is a spiritual component to Bipolar, as there is no other darkness as dark as the sucking void they find themselves in when they are at their sickest.  It can render an individual nonfunctional to the extreme of complete dis-ability.  Often they exist for long periods in a sort of “survival mode”, and manage to perform the basic functions life demands, but have little memory of it after.  They often long for the imagined relief of death, but not because they don’t want to live, only because living is so excruciating and they feel they are missing some basic strength required for life which others seem to be equipped with.  And yet they must reach way down inside and tap into a strength few of us are ever called upon to test.  Friends tend to pull away because the bipolar person may seem overly needy when they are very ill,.   People may tend to feel they can’t afford to get close for fear of being sucked into their “black hole” and seeing their friend or loved one that way also makes them aware that if it could happen to their friend, maybe it could happen to themselves.

Adjusting the medication of the Bipolar is an ongoing and often difficult process.  But with persistence, it usually pays off.  Glitches most often occur when the Bipolar stops taking their medication because they feel “better” or because of temporary side effects that often go away on their own or can be eliminated with slight tweaking.  And then they have to start the process all over again.  When the Bipolar person begins to stabilize, it can feel somewhat like coming out of a coma or “coming alive again”.  Everyday things can feel unfamiliar, alarming, and even frightening, like being a stranger in a strange land called “normal”.  They are faced with the task of discerning which of their personality traits is “them” and which ones have been “because of the illness”.  So they face a period of figuring out their own identity while at the same time, coming to terms with an illness that is extremely misunderstood and inescapable.

Moods for a bipolar can scarcely be encompassed by the word “mood”.  There is so much more to it.  When you say you are in a bad mood, you are probably irritated or bummed out at something specific that has taken place.  When a bipolar is in a “low mood” it has not been triggered by anything outward, but an internal fluctuation that is beyond their conscious control.  They do not have the empowerment to go out and change some circumstance or even their own attitude, and make things better.  There are all sorts of chemical things happening in their body which cascade over into the physical and psychological.  This in turn affects the mental capabilities at times.

What can you do for your Bipolar loved one?

They need to feel normal and not feel that their particular challenge is something to be ashamed of.  It is called a “mental illness” but as a nurse, I personally feel that is a tragic misnomer.  It is a psycho-physiological illness because it involves the psyche, yet the physical experience of it is very real.  These are sensitive individuals and what they experience affects their body with pain and fatigue, and effects them into their deepest spirit.  Do not assume that medication and more medication are the only answer.  Invite them for a walk.  Give them a hug.  Hold their hand silently while they cry because there are likely no words of understanding you can offer, but what the really need to know is that they are loved just as they are.  Give them the personal respect of admitting that you can in no way begin to know what it is like to be them, dealing with what they are dealing with.  Don’t assume they are just being difficult, malingering, faking pains or overly “emo”.  Don’t look at them as an inconvenience or a bother.  Applaud their courage living life with such a challenge.

The ultimate bottom line, they have all the same needs, expectations, demands, that everyone else does, but fewer resources.  Their energy stores are often small.  Focus is often difficult and takes supreme effort.  Opportunities for solitude, and time to “regroup” in peaceful and safe environment are imperative.  Exercise helps minimize their stress.  Given space and support and time, the Bipolar person is capable of accomplishing and learning anything that others accomplish and learn.  Give them support and unconditional love and acceptance, and you might just give them wings.

As a Christian I would be remiss if I did not also address the spritual aspect of this illness.  As a young nurse, one of my first rotations was on a psych unit.  I can remember being extremely offended by any suggestion that some of what I saw there was a result of things demonic.  But as an RN who has experienced Bipolar (diagnosed at age 32) for herself, I can very honestly tell you that there is an aspect of the illness that does touch the spiritual.  That being the fact that Satan knows our vulnerabilities and will, without exception, seek to exploit them.

Therefore if you or your loved one is a Christian and a sufferer of Bipolar, I would caution you to be extremely vigilant of exposure to anything questionable, including Tarot Cards, Ouija boards, and any games or movies relating to the occult.  Christians should avoid these anyway.  Read the story of the Gaderene Demoniac in Mark 5.

“Madness” is the realm of demons, and so if they meet someone who is vulnerable in their psychophysiological makeup, they see easy prey.  Just like anyone, the Christian Bipolar individual should fill their mind with scripture and meditate and dwell on that.  Psalm 119 is a great place to start.  Wear the armor. Pray without ceasing.  The same admonitions that God gave all Christians, should be taken to heart.

Since I was diagnosed and have been properly treated for my sleep disorders, I no longer am troubled by dramatic mood swings.  But I believe that God allowed me to experience them precisely for the purpose of writing about them now.  There may be some question as to whether what I experienced was a “True Bipolar” and that could be debated, I am sure.  But all things work together for good to them that are the called according to His purposes.  He made me.  He put me here, and it is His perogative to do with me as He sees fit.  Nothing touches me without His permission!

Copyright: STLloyd 2006