What It’s Like Living With Bipolar Disorder

15 years ago, depressive symptoms led to T getting her first diagnosis of mental illness. 5 years after that, after having a hypomanic episode, she was diagnosed with bipolar disorder. We reached out to find out what it’s like to be in her shoes, and what a regular person can do to help. 

* Trigger Warning: The following interview involves a discussion about self-harm and suicide. Please do not read on if you may be sensitive to such topics. 

Q: Hi T, thank you for coming on to share your story. Could you tell us a little bit about yourself and how old you are now?

I’m a 36-year-old Singaporean Chinese woman. I’m single but currently have 2 furkids (I used to have 5 but the others have since passed on). I work full-time in customer service. 

When did you first realise you had bipolar disorder and how did you end up getting diagnosed?

I was initially officially diagnosed with major depressive disorder (MDD), anxiety, and personality disorder in early 2005, weeks before my 21st birthday. It was only after my first hypomanic episode in 2010 that the diagnosis was changed from MDD to bipolar disorder type ii.

By my first visit to the Institute of Mental Health (IMH) in 2005, I had been self-harming by cutting my arms with a razor blade for several years already. However, the cuts were getting deeper and more frequent. I also cried daily for no identifiable reason, and had constant suicidal thoughts and feelings.

Prior to my diagnosis by my psychiatrist at the IMH, I saw a University counsellor who told me that there was nothing wrong and I had no reason to worry, despite his full knowledge of my symptoms. One day, after having inflicted several severe cuts on my wrists, I felt so desperate that I decided to visit the polyclinic to request for a referral to IMH. However, a referral appointment would take weeks or months, and the doctor who attended to me was alarmed at the severity of my symptoms so she wrote a memo for me to be seen at IMH A&E that very same day. It was my psychiatrist at IMH who eventually diagnosed me, first with MDD and subsequently with bipolar ii disorder. 

In hindsight, what were the earliest symptoms you had and how old were you when those happened?

I first hurt myself at age 14 by clawing at my own arm with my nails until I drew blood. After that incident, the next time I hurt myself was when I was 18, by cutting my arms with a razor blade. The self harm became regular then, and slowly became a daily affair.

By the time I sought medical treatment, I was cutting myself several times a day. It took several years of treatment by my psychiatrist at IMH until the frequency of the self-harm decreased. By my 30s I only cut myself on a handful of occasions a year, and in the past 3 years the frequency has diminished to only about once a year, and the cuts are less deep and scarring.

This self-harm was the most visible symptom of having a mood disorder. However, looking back, there were signs that I had already experienced depressive episodes since childhood. The earliest I remember was when I was around 7 or 8 years old. I had extremely poor self-esteem and would have bouts of crying for no reason. And when I was 12, I was obsessed with suicide, although I did not have severe suicidal thoughts or feelings then. It manifested in me drawing fake scars on my wrists and bandaging them as if I had real wounds. My Chinese teacher thought the scars and bandages were real but I don’t recall if she did anything to help. So, in essence I have had depressive tendencies, thoughts, and behaviours since childhood.

How did it feel to be diagnosed with bipolar disorder? How old were you then and how did you think it would affect your life? 

I was just about to turn 21 when I received my first psychiatric diagnosis of MDD, anxiety, and personality disorder. 5 years later, at 26, I had my first hypomanic episode and the diagnosis was changed to bipolar type ii disorder.

I never thought about how it would affect my life because as mentioned earlier, I had actually had depressive tendencies since childhood, so to me it was all normal. I was used to a constant low mood, crying often for no reason, and an obsession with self-harm and death. Frankly, getting diagnosed actually felt freeing and empowering to me, as I finally felt that my constant lifelong struggles were validated, they finally had an explanation and I wasn’t just being self-absorbed and self-pitying.

Were your first presumptions right? Is living with bipolar disorder what you thought it would be? 

I didn’t go into this with any presumptions. As mentioned earlier, I had lived a life of dysregulated mood, and had been displaying symptoms for years, so this was status quo for me, just that now I had a name for it and I had people (my Dr) who cared, understood, and wanted to help. Other than that, I was too busy crying, cutting myself, and trying not to commit suicide to think about how my life would change after diagnosis. 

Can you describe what bipolar episodes are like for you? How often do you have such episodes? 

I have type ii bipolar disorder which involves depressive episodes as well as hypomanic episodes.

My first hypomanic episode was in 2010 and I have only had a few more over the years since then. However, the rest of the time that I was not hypomanic, I was deep in the depths of severe, suicidal depression, since around the time I turned 18.

I think most people understand depression, including the feelings of hopelessness and worthlessness. Perhaps less understood would be hypomania. My mind would race non-stop, 24 hours a day. I would survive on a couple of hours of sleep a day, even without drinking coffee. I was constantly writing things down in my notebook which made sense to me at the time, but later on after the episode I wouldn’t fully understand the notes. They weren’t exactly gibberish, just that there was no point or sense to them. I felt euphoric, on top of the world, the complete opposite of when I was depressed. I constantly had new ideas about the amazing things I could and would do. I had slightly delusional thoughts like thinking I could become a famous successful person.

Thankfully, my few hypomanic episodes over the last 10 years have only lasted a week or two each time. In the past few years I have had periods of 2 or 3 days when very mild and slight hypomanic symptoms would appear, but I would not categorise them as full hypomanic episodes. I am careful not to let myself feel as if I am flying, I am careful to recognise the signs and thankfully so far I have not needed to seek extra help or support during those periods. As for the severe, constant depression, it finally eased in late 2017 and I am very carefully cautious when I say that my depression has been much milder in the 2.5 years since then. 

What was your worst episode like? 

In terms of depression, I was pretty much at rock bottom from 2005 to 2017. I cried and cut myself daily. I was constantly suicidal. It was pretty much one long episode.

In terms of hypomania, the worst episode was my first in 2010. I couldn’t focus at work as my mind was constantly racing and flitting from one new idea to the next. I was planning my sister’s bachelorette party and it was extremely hard to concentrate on what I needed to do to make it happen. However, the energy from the hypomanic episode did help in motivating me to arrange all the logistics and procure all the items needed for the party within just a couple of days, whereas my normally-depressed self would have had no energy whatsoever to leave the house even once a week. Not that hypomania is a good thing, but it can make people very productive. But not necessarily in the right ways or directions.

How is your bipolar condition presently being managed? What medications or treatments are you on and what do they do? 

Currently my condition is managed by taking daily medication and seeing my psychiatrist monthly. The psychotropic medication I take includes: Antidepressant, Mood stabiliser, Antipsychotic. I also have medication to ease anxiety and promote sleep, which I take as needed. 

Do you have any plans to get off those medications someday? Why so? 

I don’t have any plans or intention to stop taking medication anytime in the future.

I have been on psychotropic medications to treat my mental illness for 15 years without any breaks in between. Medication has changed my life. I tried several different antidepressants before I found the one that worked for me, and I remember very clearly that it was “like flipping a switch”—I was in such a dark place before medication but once I found one that worked, it was like a small light was switched on and it helped make it less nightmarish to get through each moment.

I have tried before to reduce dosages of my various medications. At one point, I was taking 120mg of antidepressant daily but I have since reduced to 30mg. However, my attempts at reducing others like the mood stabiliser have not been as successful, as even small dosage reductions made the symptoms return. Some months ago, I also inadvertently ran out of antidepressants for a week, as I had left my bag of medication at the hospital pharmacy and didn’t have time to go pick it up before running out of antidepressant. That one week was pure hell for me, as the severe suicidal depression returned and I was crying daily and almost unable to cope with work. Thus, that “accidental stoppage” of a medication has showed me that I need a certain minimum dosage to continue to function, so I don’t have any plans to try cutting down on medication any time soon.

Some people like to shame others who are on medication for psychiatric conditions, saying that we should just use “natural” treatment methods such as yoga, exercise, and healthy eating. Some people say it’s bad to keep putting chemicals into our bodies. I don’t share those sentiments. I feel that if a person needs pharmacological therapy to help with the treatment of an illness, then they should be allowed to do so without being shamed.

I have accepted that I may need to be on psychiatric medication for life, but it is this that helps me to stay functional, to keep a full-time job and not to stay in bed crying and cutting myself daily. No one should be allowed to shame me for that, just as no one should be allowed to shame others for depending on spectacles to correct their vision. 

Which 3 items or people help you most when it comes to coping with your bipolar disorder? 

My cats definitely help me to cope with my bipolar disorder. They are calm and comforting, always there for me, and always showing me unconditional love.

My family (parents and 2 siblings) are also a source of support. I have always been close to my siblings, but my relationships with my parents has only improved within the past 5+ years. My family provides emotional support but also sometimes financial support, such as during the period when I was jobless and unable to afford my treatment at IMH.

Finally, having my razor blade and medications nearby at all times helps me to know that it’s always there just in case I need it. Cutting myself helps release tension and brings about calmness and brief relief from the emotional pain, so even though I seldom cut myself any more, it’s still comforting to know I have the tools to do so if I need. This may not be a healthy coping mechanism, but it works for me at this point in my journey. Having my medication on standby also helps me to know that I can take an anxiety pill or sedative in the event that I really need it. 

Which place helps most? 

My bedroom is the centre of my world, one of the only places where I’m really allowed to be myself. I’m extremely introverted and need a lot of time alone to deal with my bipolar disorder and anxiety, as well as to rest and recharge after spending time with others.

Apart from my bedroom, the IMH hospital has also come to be a safe space for me, as I know there are medical professionals around who can help me. I have had many sessions with my psychiatrist and psychotherapist at IMH which have brought me healing and recovery, and many of the other staff (nurses, administrative staff) at the clinic are also very helpful in dealing with patients who are not coping well. And I get my medication from IMH, which as I have mentioned is crucial to my day-to-day functioning. So, being at the clinic helps me to feel safe and validated. 

What advice do you have for those who’ve only just been diagnosed with bipolar disorder? 

Learn as much about the disorder as possible, so that you can recognise the signs and symptoms. 

Understand what treatment is helpful, and stick to a treatment plan even if it doesn’t seem to be working at first. It took me years to find a treatment plan (including medication) that worked. 

Hang in there. Build a support network—family, friends, pets, your healthcare professionals (even my GP helps briefly counsel me when I have acute episodes, and lets me know if he thinks I ought to seek emergency treatment at IMH A&E). 

Have a structure and routine, it helps a lot to have a fixed schedule so that when you are too depressed or hypomanic to think or plan rationally, you still have a sensible routine to follow whilst you wait for the episode to be over. 

And don’t be ashamed to reach out for help. You don’t have to go through this alone. 

What advice do you have for everybody else when interacting with those with bipolar disorder?

Just like with any mental illness, people with bipolar disorder are not freaks or mentally deficient. There is a lot of stigma and many people think that persons with mental illness should be relegated to simple, menial jobs where they don’t need to interact with other human beings, as people fear that all mentally ill people will cause harm to people around them. This is not true. So many people with mental illness are smart, intelligent, kind, empathetic human beings. We just need you to educate yourself, seek the truth about mental illness, and be supportive instead of stigmatising us.People with bipolar disorder can suffer from extreme moods and mood swings. Please understand that these are not under our control, and we don’t mean to harm you or take it out on you. Look for the signs and symptoms of episodes, and provide support (including encouraging the person to seek treatment) where possible. If not, just be there for us. You won’t know how much it means to us for you to do so. 

If you would like to ask T questions about mental illness or show your support of her, you may do so using the comment box below. 

More interviews with people who have been through grief or other physical or mental hardships. available here.

Photographs courtesy and copyright of T. Interviewer: Sy
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