More threads by David Baxter PhD

David Baxter PhD

Late Founder
Living With Bipolar Disorder: Ask the Expert Patient
Monday, October 29, 2007

The bad news is you have bipolar. The really bad news is you have to live with it. With this issue of Ask the Expert Patient, we have a series of questions from individuals working to deal successfully with the particular challenges that their illness poses, ranging from concentration to obsession to bad hair days to bullying to being late to isolation to waiting for the other shoe to drop to codependency to delusions.

Concentration -Normalnow writes:
I'm feeling down tonight. I've studied really hard for a series 6 test and flunked it twice. I don't want to blame this illness. It sure would be easy too but I find myself using that as a cop out. It's just sometimes I can focus soooo much better than other times.

What's the BEST solution to better focus and study habits? I seem to be sleeping well, eating right. I can't say that my mind is real clear of other issues. I have a business to run, a son that is divorcing and relationship issues.

Hi, Normalnow. Concentration tends to be the first casualty of a mood episode. Even in so-called well states, a good many of us struggle with residual cognitive impairments. Add to that the stress that we are particularly sensitive to - such as what you are dealing with right now - and our focus on the things we need to be paying attention to goes right out the window.

I deal with frequent working memory and concentration problems. Fortunately, I am self-employed and work from home, so I can take time off or reassign projects. Some very complex things I can do on autopilot. Conversely, relatively simple things - but are new and require learning - can throw me for a loop when my mind is processing at only half-speed.

Some psychiatrists prescribe Alzheimer's meds and ADD meds off-label for those with problems concentrating. You might want to ask your psychiatrist about this option.

Otherwise, it sounds like you are being conscientious regarding sleep, etc. You can also pick up some good focusing tricks by practicing meditation. I'm a very bad meditator, but the practice did teach me a lot about focus and concentration.

Obsession - Shirltig writes:
I just read the article on obsession and was disappointed. There was not one answer as to how to stop the obsessions. The article was me in the flesh and it is very discouraging to have such thoughts on a regular basis.

Hi, Shirltig. I don't know which article you're referring to or the nature of your obsessions. The experts attribute obsession to a serotonin deficiency. Hence SSRIs for treatment. Cognitive behavioral therapy and mindfulness techniques also help.

Really bad hair day - Oem asks:
Is it normal for BPs to constantly change hair color when hypomanic?

Hi, Oem. Unfortunately, almost any behavior is normal when one is hypomanic.

Personal attacks - Berry writes:
Yesterday, I had someone bring up my past on a non-bipolar list. I have never hidden what I have done, and I am well respected despite the things I have done before I sought treatment. The post was intended just to hurt, nothing more and nothing less. They even called my ex-wife a liar. How do folks deal with people that refuse to accept that one did what they did due to their illness? That refuse to accept that one is doing the right thing by going through treatment? I would not mind if they could not accept it, but to keep bringing it up?

I hear you loud and clear, Berry. There are vicious people in this world who love preying on the perceived weakness of others. You are never going to please these people, no matter what you do.You are fully entitled to be angry. But once you work through your anger, you need to work on cutting these people out of your life. They're not worth it. Find new friends.

Lost in time - Elizabeth writes:
I have been diagnosed as bipolar for 10 yrs. So much comes with it! My life has been a literal rollercoaster during this time. I've lost a lot. Now, because I cannot get anywhere on time, I stand to lose even more. Is there a relationship between Bipolar and not being able to be anywhere on time? Bipolar seems to affect everything. I am fighting to maintain a "normal" life but it seems to dominate. Could there be a relationship here too?

Hi, Elizabeth. I'm not sure if there is a relationship, but I do experience various time distortions in certain states. If I am put on hold, the wait will seem forever. Conversely, if I am on a writing hot streak, someone else's three hours is my ten minutes. The important thing is you have identified the problem. Now you might want to work with a talking therapist to tease out whatever fears or other emotions are underlying the problem. The tone of your question suggests this is a high-priority issue for you, one well worth canceling your cable and investing the savings in getting therapy.

Isolation - Frank writes:
Recently my roommate moved in with her boyfriend. We are best friends and I am trying to adjust to living here alone. I am also in recovery and attend meetings NA, but I haven't really gotten to know people there on a personal basis just say hello at the meeting ...

I guess what I am trying to say is with all the health concerns and the changes in my living arrangements I have recently gone into a depression of sorts. While I do not mind living alone I can isolate myself really well.

Hi, Frank. You deserve credit for recognizing the problem. Isolation can be worse than the illness. The two tend to feed off each other. I know, I've been there, myself. One rule of thumb I use: Anytime I tell myself I want to stay inside is when I need to get myself out the door.

Is recovery for real? - Monica writes:
As I glance through the statuses of people who want to post on this site, I'm curious about the "recovered" label. It's not that I haven't thought of myself as off of the rollercoaster for good. I have certainly lived in that fantasy world. It's just that I can and have gone years between episodes only to be hit with a mania that knocks my string of good days back to square one. For me, it's more of a Sisyphean disorder. I will never recover fully. I do, however, enjoy my life. I'd love to hear from those who feel an episode will never happen again. I'd also like to connect with those who are managing this illness and what's working for you.

Hi, Monica. I very much relate to Sisyphus, the guy condemned to push a rock uphill for eternity. I, too, have a Greek myth metaphor, that of the Sword of Damocles. I am enjoying a good life these days, but I know with this illness I have a sword hanging over my head. I'm always one bad day away from everything crashing down. No matter how good I feel, I never let myself forget that.

Codependency - Hunkychunky writes:
I was wondering how common it is to have codependency issues. ie over caring, over responsible, people pleasing, controlling behaviour, with a bi polar diagnosis.

Hi, Hunkychunky. Codependency lies outside my realm. I can make this one general observation: Because of our illness, we can overdo it as well as be over-needy. You seem very aware of this, and vigilance may be your best friend, here. This is also a great question to bring up in a support group.

Sleep - Rum writes:
Does anyone have any suggestions on how to get to sleep when in hypomanic state. I take Lunesta 3 mg. Some nights it works. And as you can tell, other nights I'm still wide awake after midnight. Then I'm not ready to get up in the morning and I have children to get ready for school. I've tried everything I know to do. Cutting back on caffeine, no naps during day, sitting and un-winding at end of day. But I seem to get more and more frustrated and aggravated as time goes by. And I know that is only making problem worse. Any info is greatly appreciated.

Hi, Rum. Obviously, some nights you sleep just fine. What is going on in your head on the nights when you don't sleep? We bipolars tend to have racing thoughts, even when not manic. Put a little stress in your day - a bad discussion with your boss, financial worries, domestic concerns - and combine it with racing thoughts kicking up a worry-storm and I guarantee you will have a hard time sleeping. No pat answers for this, but awareness of the problem - if this does apply to you - is the first step toward a resolution.

Delusions - Vsaryre writes:
After my surgery I had a serious delusions . It scared me bad. I saw writing on the wall and people in my home that wasnt there. Is this part of the illness? I am worried it will happen again.

Hi, Vsarrye. I experienced almost the exact same thing when I was hospitalized with a physical complaint a number of years ago. I figured out two things were at work: 1) I couldn't sleep, which cranked up the mania and the possibility of seeing things. 2) I couldn't keep my meds or foods down. Chances are your sleep schedule was disrupted, and with surgery my guess is you weren't on your meds. Many individuals with bipolar do experience psychosis, which may include delusions. I'm also guessing that ordinarily you don't experience delusions. But they may occur if you miss sleep or meds doses.

Please keep in mind that I am not a physician. I cannot diagnose or give medical advice. This section is for sharing information and offering support as a nonphysician "Expert Patient."
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