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the highs and lows of living with bipolar disorder

when the manic episode gave way to symptoms of depression, huang says he would lay in bed for days, not speaking to anyone

by robin roberts

oct 24 2022

6 minute read

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what is it like to live with bipolar disorder?

the behavioural component of bipolar is defined by radical decisions — like moving houses. these behaviours can become quite dangerous if uncontrolled. getty

content warning: this story contains references to suicidal ideation and violence against individuals living with psychiatric diagnoses.

if you are in need of support for yourself, a friend or a family member, the canadian suicide prevention service helpline offers help and can be reached at 1-833-456-4566 toll free or connect via text at 45645, from 4 p.m. to midnight et.

lee huang was diagnosed with bipolar i about 14 years ago, when he was 19, but he suspects he had been living with it before then.

during his manic episodes, huang would get into altercations with strangers. on one occasion, he impulsively bought a $23,000 car in cash. two days later, he spent another $20,000 on modifications. when the mania gave way to a depressive state, huang says he would lay in bed for days, not speaking to anyone. at his lowest, he considered suicide.

“then i thought of how my parents would [react to] losing a son to suicide, and that was what stopped me,” he says. “my parents don’t necessarily understand the illness, but they are very supportive. i’m in a good place in my life now where i have it under control. i haven’t had a major episode in about seven years.”

according to the cleveland clinic , there are two types, bipolar i and bipolar ii. bipolar i is defined by episodes of both mania and depression, although depression isn’t necessary for a diagnosis. depressive episodes usually last two weeks, while manic episodes last a week or more, sometimes becoming so severe people require hospitalization. bipolar ii includes both depressive and hypomanic (milder and shorter euphoric) episodes, but not full mania as in bipolar i. bipolar ii is often more debilitating because the depressive states can be chronic.

dr. keith dobson, faculty professor emeritus in clinical psychology at the university of calgary, says official diagnosis follows the american psychiatric association’s (apa) diagnostic and statistical manual, which analyzes three components of functioning: mood, cognition and behaviour. mood is characterized by excitation in the extreme.

“people laugh inappropriately, become excited for reasons unclear, feel euphoric and, to some extent, lose contact with reality,” says dobson.

cognition describes racing thoughts and, often, sleeplessness. “sometimes people engage in risky behaviour like gambling, making investments, sexual behaviour that they wouldn’t normally because of ideas of grandeur,” says dobson.

the behavioural component of bipolar is defined by radical decisions — like moving houses. dobson explains that these behaviours can become quite dangerous if uncontrolled.

huang says the condition can be especially difficult for those of asian heritage because the stigma around mental illness often prevents them from addressing it. he says there is, however, a support group called hong fook that offers mental health services for the asian community. he himself got involved with the group and now acts as an advocate for others, giving talks and sharing his story.

from manic depression to bipolar disorder

around aristotle’s time, when the greek philosopher was among the first to acknowledge melancholy as a psychological condition, people with mental illness were routinely executed. religious zealots believed those with “mania” or “melancholia” — the terms of the day — were possessed by demons. the only way to vanquish them was to vanquish the humans who harboured them, or subject them to often life-threatening treatments to free them of the demons, such as trephining or exorcisms.

“people with bipolar disorder were seen as dangerous and unpredictable,” says dobson. “and, of course, there were no effective treatments at the time.”

eventually, researchers studied the condition objectively, but they divided “mania” and “depression” into two separate disorders. it wasn’t until the mid-1800s when the french psychiatrist jean-pierre falret described the illness as “circular insanity,” characterized by deep depression followed by manic excitement, and made what is considered the first diagnosis of bipolar disorder.

it wasn’t until 1952, however, when it was officially recognized by the apa. in 1980, the terminology changed from “manic depression” to bipolar disorder.

diagnosing bipolar disorder

dobson says it’s difficult to quantify the exact number of canadians with bipolar disorder because most research, last conducted in 2012, focuses on self-reporting. if subjects are asked if they have ever felt manic or agitated, and they say yes, they are automatically deduced to have bipolar, he says.

“[but] current estimates are less than one per cent of people have lifetime bipolar i. for bipolar ii, it’s about half that.”

falret believed bipolar disorder had a genetic component, which most mental health professionals today agree with. some estimates put the chances of inheriting the condition from a parent at 10 per cent; others suggest more than two-thirds of people with bipolar have at least one close biological relative with the condition.

“studies with twins, however, suggest that the hereditary component of bipolar disorder is not that great,” says dobson. “especially bipolar ii. the rate of concordance for twins is no greater than obesity and lots of other conditions. so, it suggests there’s room for [environmental causes].” other research suggests trauma and stress can play a role.

moving through a bipolar diagnosis

dobson says lithium carbonate, which has been the first line of treatment for over 70 years, remains the recommended therapy to reduce the frequency and severity of symptoms, although there are other mood stabilizing drugs available. he says people are also often treated with antidepressants when they are in the depressed phase. a combination of medication, psychotherapy and cognitive behavioural therapy is most effective.

the challenge, however, is convincing some patients to take their meds. dobson says many people with bipolar ii say they enjoy the exhilarating sensations, that they feel better, are more productive, and have a positive sense of self. the downside is that they eventually crash — which could happen within days, weeks or months.

dobson says bipolar disorder is considered a lifetime condition in most people. besides medication and other types of therapies, he says it is helpful to keep routines as predictable as possible, which helps minimize some of the agitation and excitement.

other experts recommend not using alcohol, drugs or tobacco, since they can interfere with medications. it may help to keep a diary or mood chart that tracks thoughts, feelings and behaviours to identify triggers. getting enough sleep and exercise, as well as reducing stress, can be beneficial, while yoga and meditation can also have a calming effect.

finding support

huang was prescribed lithium when he was first diagnosed, but when that had no effect, his doctor switched him to the mood stabilizer epival, which has brought his symptoms under control. he encourages others to ensure they’re on the right medication for them.

“first, get your mood stabilized. after that, there are things like exercise, hobbies, keeping yourself busy,” he says. “i find that when i’m busy i don’t have depressive episodes for a very long time, and manic episodes are very minute.

“also, have patience. give yourself time to heal. there were times for me it felt like this is the end, but with time i know it will get better.”

huang also recommends finding support, through friends and family or advocacy groups, such as those offered through the mood disorders association of ontario, where he also volunteers, the mood disorders society of canada and hong fook.

“[hong fook] is where i first started speaking about my experience. i figure, i already have bipolar, i might as well play the cards i’ve been dealt. and if i can help just one person, then living with bipolar is worth it.”

update: 2022-10-27: this article was updated to add a reference to the mood disorders association of ontario, where huang also volunteers.

robin roberts is a vancouver-based writer.

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robin roberts

the highs and lows of living with bipolar disorder

when the manic episode gave way to symptoms of depression, huang says he would lay in bed for days, not speaking to anyone

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from manic depression to bipolar disorder

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the highs and lows of living with bipolar disorder

when the manic episode gave way to symptoms of depression, huang says he would lay in bed for days, not speaking to anyone

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