Before any formal diagnosis was made, Jennifer Marshall endured two unexpected bouts of psychiatric hospitalizations in December 2005. She found herself fighting turbulent episodes of mania, losing control of her moods as she fluctuated between feeling extremely energetic and experiencing symptoms of depression. During a manic episode, she would feel invincible and very productive even as she struggled to stay focused on tasks. She found it difficult to participate in conversations as her mind jumped from one idea to another. She barely slept. In 2006, after consulting doctors, she finally got a diagnosis: bipolar disorder, type I.
Marshall, 39, a former corporate recruiter from Ashburn, Virginia, was at a loss. She feared for her future, wondering what lay ahead. “Thankfully, after working with my doctor and trying several different types of medicine, we finally found the one that worked for me and I began to climb out of the darkness of depression,” the blue-eyed, mental health activist and co-founder of This Is My Brave, told Re:Set. Her non-profit organization works towards removing the stigma and labels attached to mental disorders through storytelling, poetry, writing and music from successful people with mental illnesses.
Bipolar disorder is a mental illness characterized by drastic changes in moods that may include feeling euphoric and experiencing intense periods of depression. It’s important to note that these aren’t regular mood swings and can greatly affect a person’s energy levels, interfere with their regular routine and negatively impact their interpersonal relationships. The intensity of the symptoms may vary for different individuals. According to Dr. Eva Huening, a psychiatrist with extensive experience in treating mental disorders like anxiety, depression and bipolar disorder at the German Neuroscience Center, Dubai, patients going through a manic episode may sleep very little and still feel unusually active without realizing that their health is suffering. They may also be prone to making reckless decisions, experience delusions and miss out on work and other responsibilities. “The patient is impaired by their judgement and has no insight into their own behaviour [during a manic episode],” she told Re:Set, adding that patients who experience mania feel like nothing is wrong without them and are usually only diagnosed when they experience depression.
“I had difficulty in relationships and keeping jobs.”
David Wise, a 36-year-old blogger, from St.Louis, Missouri was diagnosed with bipolar I in his mid-twenties after he tried to end his life several times. “I struggled for many years, trying different medications, therapies, and even electroconvulsive therapy [which uses electric currents to alleviate symptoms],” he told Re:Set. “I had difficulty in relationships and keeping jobs. Eventually with the help of the right medication, therapy, and focusing on getting well with the support of family and community mental health centers, I was able to maintain a level of wellness and stability.”
Wise has been in recovery for seven years. He is married and has two children, Pablo and Diego who were born in March 2017 and July 2018 respectively. “I think, having dealt with a serious mental illness for many years has given me patience as a parent,” Wise told Re:Set. After experimenting with several options, he has established a routine that works for him.
“I currently take one psychiatric medication and have been on it for four years. It works really well for me,” he explained. “I have found that self-care, good sleep hygiene, eating well and exercise have helped me.” Wise also finds writing therapeutic and often turns to religion in times of uncertainty.
It is estimated that around 60 million people across the world have bipolar disorder as per the World Health Organization. There are two prominent types of bipolar disorder, namely, bipolar I and bipolar II, according to Huening. Other types that don’t fall under the two categories are rare. Certain individuals with bipolar I tend to have phases that last for at least a week and may require to be hospitalized for treatment. “It can last for one year in very severe cases,” Huening said.
For Marshall, life’s been topsy-turvy post diagnosis. While she was able to resume work after getting medical help and gave birth to her first baby, Owen in 2008, she had a relapse after he was born. “Unfortunately, because I was determined to stay off psychiatric medication during my pregnancy and postpartum, I suffered a postpartum psychosis episode and had to be hospitalized for a week,” she said. “I wasn’t able to see my baby or breastfeed any longer.”
Since it was her first baby, Marshall felt pressured to do her best. “I felt as though I was invincible and hardly needed to eat or sleep. The less I slept, the more energy I seemed to have,” she wrote in a blog post. “I never napped when the baby napped because I’d always find something to do around the house that was, of course, more important than catching up on sleep,” she added. Things escalated quickly, and her husband was the first one to notice something was terribly wrong. He dialled 911 and called for help. She stayed in the hospital for a week, recovering and getting her health back on track.
Whenever an episode hits, things get too fast, too chaotic, too out of control for Marshall. “The major symptoms with my type of bipolar disorder are racing thoughts, high energy, decreased need for sleep, and fast speech that is incoherent,” she told Re:Set. “I describe bipolar disorder as a spectrum that I live within. My goal is to keep my mood stable and in the middle, at a five on a scale of 1-10.”
“Being a parent who also has bipolar disorder is the same as being a parent with any other condition.”
As a parent, Marshall believes in being transparent about her journey. When she went through a manic episode, her husband and their relatives took care of the kids to give her time and space to recuperate. “Being a parent who also has bipolar disorder is the same as being a parent with any other condition,” Marshall said. “I manage it as best I can and I talk openly with my kids about it so that they understand that it’s not anything to be ashamed or embarrassed about. There are good medicines that can help people who live with bipolar and other mental illnesses.”
Bipolar disorder doesn’t discriminate. In April last year, American singer Mariah Carey opened up to People about her struggles with the mental health condition. While she received her first diagnosis of bipolar II in 2001, she decided to seek help only sometime back after a particularly rough period. As per Huening, bipolar II has less severe phases which are known as hypomanic episodes. The symptoms are similar to bipolar I and include mood changes, restlessness, not sleeping enough, being impulsive and extremely energetic among others. Depression can also be a telltale sign. “In type II, the mania is not that extreme,” Huening said. “We can reach the patient with our advice, our explanations,” she added, explaining that it’s easier for family members to help the patient calm down and take care of themselves. A person with bipolar I, on the other hand, remains unconvinced by what they’re told by close friends and family. A person’s personality type also has an impact on the severity of their symptoms.
“Until recently, I lived in denial and isolation and in constant fear someone would expose me,” Carey told the publication. “It was too heavy a burden to carry and I simply couldn’t do that anymore. I sought and received treatment, I put positive people around me and I got back to doing what I love — writing songs and making music.”
Bipolar disorder, like other mental illnesses, continues to suffer from widespread stigma. “The common opinion is that you cannot function anymore when you have this diagnosis. And that is not true,” Huening said. “It should not be so stigmatized because there’s the possibility of help.” She thinks that with the right knowledge and information from mental health professionals, patients with bipolar disorder can get a lot of perspective and learn how to manage their health well. Huening believes that family members should turn to doctors for guidance and educate themselves about treatment options such as medication and talk therapy so that they know how to help their loved one during an episode.
For Marshall, being kinder to herself, practicing yoga, eating healthy food and paying attention to her triggers has really helped. “I protect my sleep by going to bed at the same time each night and getting a solid 7-8 hours every night. I also manage my stress level to keep that at a comfortable level so that I don’t get overstressed and lose sleep,” she told Re:Set.
Wise acknowledges that it’s a difficult journey. “I sometimes worry people will judge my ability to parent well or effectively simply because I have bipolar disorder; however, I let my kids’ smiles, laughter and health tell the story,” he said. “I would encourage anyone living with a mental illness or bipolar disorder to not give up. Keep hope. Most of all, remember you are unique and created special. The world cannot replace you.”