The goblin on my shoulder

I have a mental health issue. I am Bipolar II

Bipolar disorder (formerly called manicdepressive illness or manic depression) is a mental illness that causes unusual shifts in a person’s mood, energy, activity levels and concentration. These shifts can make it difficult to carry out day-to-day tasks. There are three types of bipolar disorder. All three types involve clear mood, energy and activity changes. These moods range from periods of extremely “up”, elated, irritable or energised behaviour (known as manic episodes) to very “down”, sad, indifferent or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes (https://www.nimh.nih.gov/).

The Bipolar I illness is defined by manic episodes that last for at least seven days (nearly every day for most of the day) or by manic symptoms that are so severe that the person needs immediate medical care. Usually, depressive episodes also occur, typically lasting at least two weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) may also occur. Bipolar III disorder, or cyclothymic disorder (also called cyclothymia), is defined by recurring hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes ( https://www.nimh.nih.gov/)

As Bipolar II, the illness demonstrates itself through a pattern of depressive episodes and hypomanic – that is, periods of over-active and highenergy behaviour. The hypomanic episodes are less severe than the manic episodes in Bipolar I ( https://www.nimh.nih.gov/). The condition, if untreated, is a killer: 50% are likely to commit suicide – 25% are likely to succeed and the other 25% are likely to try again.

I was a moody child. As I grew older, the mood swings became sharper and deeper – the “mania” less controllable and the depressive episodes blacker. You must suffer from a bipolar illness to truly understand how many shades of black there are.

Throughout my teenage years and till my early 30s, I muddled my way through – not understanding why, in instances, I am full of energy, unafraid of any challenge, and most of the time, fighting the intensity of despair, negativism, apathy. The severe mood swings impacted those around me. At the time, I was the chief executive of an organisation and little did I realise how my behaviour impacted the people I worked with.

It took a severe outage that led me to seek help. I was placed on lithium and selective serotonin reuptake inhibitors (SSRIs). The medication was a lifesaver – literally. It also allowed me to understand myself better. It also led me to open up with the people I worked with on my illness – not to absolve me of bad behaviour when the mood turned black but to understand me better and when I acted badly, there was no personal intent. Together with my office, we devised a system where they would let people know how good or bad I was on the day. A weather vane, if you will. They would let the people I had to interact with know when I was back to “normal”. One of the things with being Bipolar II is that when I have a mania period, the amount of work I carry out is phenomenal. When I am hyper, I do my creative work and generate quality stuff within a couple of weeks that would take a “normal” person months to achieve. This would compensate for the downside depressive periods – sometimes, the cycles take months. I use this period to do the more mundane and routine work.

I have created my toolbox to handle my Bipolar II: optimise the mania and structure myself with routine stuff when the pendulum swings to the other pole.

I do not subscribe to the school of thought that mental health is a condition. It is an illness and should be treated as such. My journey was lonely – I had to trudge through severe outages with little support. At the time, mental health was stigmatised. People suffered in solitude, afraid to open up. Indeed, accepting that you need help and medication was, and to some degree, still is anathema. Yet we are not afraid to ask for medical support and pills if we suffer from diabetes, high cholesterol or high pressure, to mention a few examples. The same

“Throughout my teenage years and till my early 30s, I muddled my way through – not understanding why, in instances, I am full of energy, unafraid of any challenge, and most of the time, fighting the intensity of despair, negativism, apathy.”

should be true if you have a mental health illness like me.

Since 2002, I have advocated on mental illness and the importance of support structures – from the very young years and our journey through life. We need more champions coming out in public to render the unacceptable acceptable. No doubt, at least in my mind, mental illness is less stigmatised today than in 2002. Whether people emphatise with you – that is a different matter altogether.

I strongly recommend to those of you with a bipolar illness to read the book by Kay Redfield Jamison – Touched with fire: Manic-depressive illness and the artistic temperament, as well as her memoir Nothing was the same. If you suffer from extreme mood swings, as I do, these make excellent reading to help you understand yourself better.