Bipolar Lite — Cyclothymia

I'd never heard of cyclothymia (sigh-klo-THY-mia) until I read a reference to it online. Turns out cyclothymia is similar to bipolar disorder but with less extreme high and low moods (mania or hypomania and depression) that last two months or longer. Cyclothymic lows do not involve suicidal thoughts, and if you are cyclothymic and in a stable period, you are likely to feel normal.

Because cyclothymia may start in childhood and later lead to bipolar disorder, treatment — in the form of medication and talk therapy — should, ideally, come sooner rather than later and continue throughout life. If you or your friends and family notice your mood swings, periodic excessive activities, unrealistic projects, and bleak bouts of sadness, it may be time to consult a doctor (instead of being offended by the suggestion or slipping into denial).

Cyclothymia symptoms can vary from person to person. Some people may successfully accomplish a lot during a high, while others may have unrealistic expectations. Some may respond to challenges unusually well during a high period while others fall apart.

Drugs prescribed for cyclothymia are sometimes the same ones used to treat bipolar disorder. Along with drugs, psychotherapy can diminish cyclothymic symptoms in both severity and frequency and may help to prevent alcohol abuse, which can lead to mood swings similar to those of cyclothymia. 

It is crucial to be honest with your doctor about how much you drink and any recreational drugs you use.

In addition, keep in your wallet a list of the drugs you take so that whenever a medical professional needs to know, you are ready and won't risk negative drug interactions. Because some drugs used to treat cyclothymia can harm a fetus, cyclothymic women who want to become pregnant should first ask their doctor to adjust their meds. 

Bipolar people are, increasingly, talking and writing about their disorder. But if you tell someone you are cyclothymic, you may be greeted with a blank stare or a frown, because it is a less common disorder, receives less press, and may be misdiagnosed more often than bipolar disorder.

Actor Stephen Fry has been quoted as saying he is bipolar but also as saying he is cyclothymic. Distinguishing between the two is not always a slam dunk, but given that he has attempted suicide, a well educated guess is that he is bipolar.

Cyclothymic moodiness and unpredictability can lead to divorce. On the other hand, if you are cyclothymic, appropriate psychiatric treatment and medication can help you stay on an even keel.

Celebrities with Bipolar Disorder

For those of us who are bipolar, recognizing how successful bipolar people can be may help us build self-confidence. Among well known people who have been identified publicly as bipolar are —

Activists Abbie Hoffman, Jesse Jackson Jr., Patrick Kennedy.

 

Artist Vincent van Gogh

 

Astronaut Colonel Buzz Aldrin, Ph.D.

 

Moguls Andrew Carnegie, Larry Flint, Pierre Peladeau, Martha Stewart, Ted Turner.

 

Performers Dick Cavett, Kurt Cobain, Robert Downey Jr., Eminem, Carrie Fisher, Stephen Fry, Peter Brian Gabriel, Linda Hamilton, Mariette Hartley, Margaux Hemingway, Jimi Hendrix, Steve Martin, Kristy McNichols, Sinéad O'Connor, Ozzy Osbourne, Jane Pauley, Axl Rose, James Taylor, Brian Wilson, Charley Frank Pride, Sting, Jean Claude Van Damme, Robin Williams, Catherine Zeta Jones.

 

Politicians Winston Churchill, Kitty Dukakis (politician's wife), Abraham Lincoln.

 

Health professionals Nassir Ghaemi, Kay Redfield Jamison.

 

Writers Robert Boorstin, Kay Sylvia Plath, Leo Tolstoy, Mark Twain, Virginia Woolf.

In addition, Cameron Herhold, Founder of BackPocket COO in Vancouver, British Columbia, told CBS News in 2010 that, "It took me a while to recognize that symptoms of bipolar disorder are fairly common among entrepreneurs."

The 4.5 to 5.5 million Americans who have been diagnosed as bipolar are probably only about 20 percent of the bipolar population in this country. We have no way of identifying members of the other 80 percent who may be well known for their achievements.

In stark contrast and on the dark side, we bipolar people are drawn to, and successful at, suicide, in larger numbers than the general population. Suicide is the leading cause of premature death for us. While medication cannot cure bipolar disorder, it can prevent suicide in some bipolar people. Ideally, medication will eventually lower the suicide rate of bipolar people, at least to the national average.

Because bipolar disorder has an impact on appetite, judgment, memory, mood, sex sleep, and thinking, building a successful life and career without medication can be more of a challenge than some people can face. 

Even when a bipolar person is successful, the price may be terrible suffering and the success may arrive post mortem. Vincent Van Gogh (1853-1890) was probably bipolar. He apparently committed suicide although the gun that killed him was never found. At the time, he was convinced that he was a failure. Now there are Van Gogh museums in Amsterdam and Paris.

With more medications available today for treating bipolar disorder than ever before, this may be the best time ever to be bipolar. Not that bipolarity is a blessing, but it need not be a curse, either. Appropriate bipolar meds may not only minimize the down side of the disorder but also strengthen our ability to put our gifts to work for us and others.

Bipolar Mania Is Crazy Time

With bipolar disorder (which for years was called manic depression), depression is at one pole, and, for those with bipolar 1, mania is at the other pole. The word mania goes back to the Greek word mainesthai, which roughly translates as crazy. 

Bipolar hypomania is a less intense form of mania. Before I was diagnosed and medicated as Bipolar 2, my hypomania periodically took the form of shopping, particularly shopping for costume jewelry. Every time I had a welcome illusion that I was now a new and better (happier) woman, I felt compelled to buy costume jewelry that the new, improved me would wear.

After several years of this, when I lived in Santa Fe, I moved to Santa Barbara. In preparation, I downsized my possessions. One afternoon I found myself sitting in the middle of my queen-sized bed surrounded by the jewelry I had bought in the past decade. Most of it I would never wear again, and I couldn't quite recall who I thought I was becoming when I bought it by mail from the Boston Museum of Fine Arts.

Mania is much more intense than hypomania and may require hospitalization. During manic episodes, poor judgment can lead to terrible decisions and cost people their jobs and friends. In the extreme form, sufferers sometimes hear voices. I have never experienced extreme mania, and I've only once heard an imaginary voice. I was visiting a friend in Cazadero, California, and as I was falling asleep, I heard a deep, strong male voice: "You have a publisher."

This would have been exciting news, even from a disembodied voice, if I had written a new book that my agent had submitted to a publisher for consideration. But all the books I'd written had already been published. 

Alarmed that hearing a that voice meant I was losing my mind, I asked an inarguably sane friend if she ever heard such voices, and she said yes, occasionally. So the disembodied voice speaking to me may or may not have been related to my being bipolar. In any case, it was unforgettable.

Mania is a hormonal high that may create a surge of excitement and energy that banishes sleep. Unfortunately, it may also bring denial that mania has struck. Characteristic symptoms include driving recklessly and compulsive telephone calls. On the other hand, the unusually large number of creative bipolar people suggests that mania and hypomania can nourish creativity.

Manic: A Memoir by Terri Cheney conveys a sense of what experiencing extreme bipolar mania is like. In he gripping story, she Cheney describes how her bipolar brain chemistry inflicted dramatic breakdowns and led to suicide attempts and hospitalization. But despite the obstacles, Cheney graduated from Vassar and became a successful entertainment lawyer in Beverly Hills. Now she is an advocate for bipolar people and bipolar causes.

Without medical intervention, mania can ruin relationships, careers, and reputations. If a client or coworker sees you in a manic phase, screaming at strangers on a street corner, nothing good is likely to come of the encounter. Luckily today, medical and psychological help are available. In a sense, this is the best time ever to be bipolar. But, of course, it is also a dandy time not to be bipolar.

Meds for Bipolar Disorder

Bipolar disorder can't be cured and can be difficult to diagnose. After it is identified, however, it often can be treated successfully.

Taking medicine for bipolar disorder is not like periodically taking an aspirin for a headache or a decongestant for allergy. Bipolar meds are swallowed several times a day on a daily basis, year after year. Once I decided to skip a daily dose of a prescribed bipolar medicine, and soon I became suicidal. After I resumed taking the pill I'd skipped, I had not the slightest ghost of an attraction to suicide. One pill a day made the difference between wanting to live and wanting to die.

Bipolar people who don't respond to medicine may find electroconvulsive therapy or transcranial magnetic stimulation helpful. A bipolar Ivy League professor has written that his career, his marriage, and his life were saved by shock treatment. Today patients are anesthetized while the electric shocks are administered. When they awake, they may have minor memory problems that soon disappear, but the cruel fate of Jack Nicholson in the 1975 classic, "One Flew Over the Cuckoo's Nest," is not an issue today.

One danger of being bipolar but undiagnosed is giving in to an urge to self-medicate with alcohol. Alcoholics Anonymous is a resource, but to get to the point where they can stop drinking, bipolar alcoholics may need to be diagnosed and treated as bipolar first.

A psychiatrist can provide a bipolar diagnosis. For treatment, psychiatric nurses, psychologists, and individual or family support groups may also be involved. Even after bipolarity is diagnosed and treated, at its most extreme, it may lead to periodic hospitalization for bipolar 1 patients.

There is no one-size-fits-all treatment or prescription for bipolar disorder. A psychiatrist and patient may try several solutions before hitting on one that works. As for medicine, Librium was the first to be widely used. But a bipolar friend of mine was allergic to Librium before there were other drugs available. She tried to commit suicide only once, and she was discovered and saved, but daily living required a degree of valor that few of us have to face. Luckily she had a keen joy in life, which may have been related to bipolar hypomania.

Today there are dozens of medications used to treat bipolar disorder. There are also a wide variety of side effects.

Meds include anticonvulsants like Depakote, probably because the part of the brain that houses bipolarity is close to the area where seizures arise. One such drug is quetiapine (Seroquel), the only one approved the U.S. Food and Drug Administration (FDA) for treating bipolar disorder.

Antidepressants are sometimes prescribed for bipolar people, which seems like a no-brainer given that depression is a symptom of bipolarity. But an antidepressant may go too far and trigger a manic episode. Antidepressants may also cool your sex drive. If sex is important you, I'd think a lowered sex drive might be depressing and take you back to where to started. Other side effects might be not only undesirable but also downright dangerous, so a patient should be carefully monitored while on antidepressants.

The anti-anxiety medications Xanax, Valium, and Librium are popular with people who are not bipolar as well as those who are, probably because anxiety is a hallmark of our times. Drowsiness, memory loss, and poorer muscle coordination are the down side.

Being bipolar is not without challenges, but more help is available today than ever before.