The Bipolar Brain on Drugs

Every brain is unique. Bipolar brains are unique in a similarly maladaptive way to each other, but even then, they are unique from each other too. Because of this, drugs that affect the brain can affect bipolar brains differently than they affect nonbipolar brains and other bipolar brains.

That’s why it can take years to discover the right cocktail of medications to help and/or stabilize a bipolar brain.

That’s why the drug I was prescribed for heartburn could send me into a raging suicidal depression.

That’s why so many people discover they have bipolar when they are prescribed an antidepressant and end up with an episode that sends them to the psych ward.

That’s why the drug I’m on to (hopefully) attenuate the nerve damage in my leg, which the pain specialist said might make me “a little groggy,” has me holding-the-walls stoned and thinking one thought on repeat for five minutes at a time.

Every new drug is an experiment. Every combination a risk.

Just another perk of being bipolar.

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Rapid Cycling

To earn a rapid cycling badge, a person has to have four or more episodes in a year. Good times! I can’t begin to imagine what that’s like with full-blown mania. Hypomania and depression are enough, thanks! Before I got an accurate diagnosis and serviceable meds, I rarely went two weeks before starting a new episode. Up, down, up, down, up, down. It took years of work to figure out my baseline, i.e., what it feels like to just be me. I still have 4–10 days every few weeks when I’m very up, very down, or first one and then the other. I know some of my triggers: stress, lack of sleep, too much alcohol or caffeine. But some episodes come out of the blue. Rapid cycling means you never know. It means you can be in the middle of an exceptionally bad day before you realize, “Oh, this is depressive irritability” or whatever. And then you’re supposed to have the presence of mind to apply the tools that help you minimize any damage. Which is to say, it gets the jump on you, and because...

What Bipolar Does to the Brain

I’ve been researching what bipolar does to the brain and seriously—fuck. There’s both a lot more research than my 25-year-old B.A. in Psychology could assimilate and not nearly enough. A layperson’s book on the subject is sorely needed. Here’s the gist. * There’s solid evidence that the dysfunction during depressive and manic states causes changes that persist into our baseline states. * There are several neurotransmitters involved: dopamine, norepinephrine, serotonin, GABA (gamma-aminobutyrate), glutamate, and acetylcholine at the least. And hormones that act like neurotransmitters are in the mix, too, like endorphins and oxytocin. * Brain structures yet discovered to be involved/affected include areas of the prefrontal and temporal lobes, the hippocampus, thalamus, and hypothalamus. * Bipolar affects both grey and white matter, meaning both the structural elements of the brain and the connective tissue between them. And by affects, I mean corrodes over time. There’s mor...

Sleep

All of my life, nighttime has been my favorite time. I’m most at peace, most relaxed and myself at night, when the world has gone to bed. When there is no more work, no chores or errands, and the phone can safely be ignored. Loved ones sleep soundly, needing nothing from me, and I am free to write, to read, to watch old movies, to unwind completely, stay up late in the quiet dark, and simply be. But the number one signal/trigger of a bipolar episode is disturbed sleep. My respite has consequences. So now my sleep hygiene (such a Dr. Kellogg kind of term) is perfect. A good eight hours every night (drug induced if need be). No caffeine after three, if at all. No alcohol. No wild nights out. The choice is follow the routine or lose even more days to the disorder. Be good or else.

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