Living with Bipolar Disorder: Let’s Talk 2018

“You’ve probably been struggling with bipolar disorder for most of your adult life, but have been able to cope with its ups and downs sufficiently to carry on your daily activities until just recently.”

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What Is Bipolar Disorder?

My life changed forever with that diagnosis from a mental health specialist at London Health Sciences Centre in January 2016.

But, before chronicling how I got to that point and what I have experienced since, a definition of Bipolar Disorder is in order.

Simply put, bipolar disorder, previously referred to as manic depression, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and affects the ability to carry out day-to-day tasks. 

Bipolar individuals vacillate between periods of hypermania characterized by boundless energy, hyper-sexuality, extreme impulsive behaviours like spending sprees, confrontational episodes, delusions of grandeur, and volatile irritability, and extended episodes of depression characterized by persistent feelings of sadness, irritability or anger, loss of interest in previously enjoyed activities, excessive or inappropriate guilt, hopelessness, sleeping too much or not enough, changes in appetite and/or weight, fatigue, problems concentrating, self-loathing or feelings of worthlessness, and thoughts of death or suicide.

During the last three years, I have experienced all of these symptoms, especially those associated with the depression phase of the disorder.

How Did I Get Here?

In the summer of 2015,  for unknown reasons at the time, I sunk into a deep funk during which time I slowly withdrew from all of the summer activities I usually enjoy and from my family and outside social contacts.

When my depression showed no signs of abating as the summer drew to a close, I saw my Family Doctor for advice. Not aware that I was exhibiting signs of bipolar disorder (BPD), he prescribed, with my grudging agreement, the anti-depressant known as Paxil. Not knowing what to expect I began taking the medication that day.

Within a few weeks, my mood improved dramatically and my life appeared to return back to normal.

Little did I know at the time, that I would gradually morph into a period of hypermania by the early weeks of 2016.

My partner, Val Cavalini and my daughter Hilary Young, were the first people to notice what they described as my “buzzed” behaviour and an impulsive buying of items I really did not need. “Foaming at the mouth” was how Val described it.

When my behaviour brought me into conflict with family and friends and resulted in me sleeping as little as two to three hours a night, another trip to my Family Doctor was arranged.

He admitted his lack of expertise and referred me to the Mental Health Program at London Health Sciences Centre for diagnosis and treatment. It was the beginning of my frustrating journey through the Ontario Mental Health system.

After a very quick diagnosis which consisted primarily of a brief oral history and a checklist of symptoms by two doctors of psychiatry, I was told that I was struggling with Bipolar II Disorder — meaning that I had experienced at least one hypermanic episode and one major depressive episode.

I must admit that I was somewhat taken aback by this, as I had assumed my life-long hyper behaviour was the result of undiagnosed Attention Deficit Disorder (ADD). But they were the mental health specialists and what did I know after all?

I was told that the disorder could be treated with any number of anti-psychotic drugs including lithium and several others with names as long as your arm.

After some discussion revolving around my distrust and dislike of medication and the side effects of each option, it was decided that I would begin a course of a relatively new drug called Latuda.

So off I went with a future appointment in three months time, not knowing what to expect.

What happened is that I gained almost 50 pounds ballooning up to around 290 pounds on a 5’10’ frame despite a loss of appetite, and by three months time I had sunk into a deepening depressive episode.

My second appointment at LHSC did not start out well. My assigned specialist had made no attempt to familiarize himself with my name or case history before the appointment and we essentially had to start all over again in the 15 minutes I had been allotted.

His solution to my lack of improvement and dramatic weight gain? Let’s try another anti-psychotic drug, this one called Abilify. So off I went with my new prescription in tow with a third appointment scheduled for three months time.

The three months came and went with no signs of improvement in my well-being. By now, I was completely cutoff from my normal life and was becoming a literal recluse, depending upon my partner and my daughter to buy me groceries and help me cope with the daily demands of survival. Almost a year had passed since my initial diagnosis.

My third appointment again offered no relief and the dosage of the Abilify was increased to see if that would help.

It did not, and on my fourth appointment, I severed ties with the Mental Health Program and returned to my family doctor for guidance and care.

What followed were months of numerous diagnostic tests designed to rule out physical causes such as cancer and any gastrointestinal diseases. As I now joke, every orifice of my body was probed and prodded during this time. All with negative results.

It was the fall of 2017 and I was literally incapacitated and incapable of carrying out daily activities, spending most of my time planted in front of my television set as a distraction from the mental and physical pain I was experiencing. Despite this, Val and Hilary had my back and encouraged me to fight on.

I was now 66 years of age and my thoughts had turned to dying. Friends were calling me wondering what was wrong and I was receiving numerous messages on Facebook inquiring about my well-being. All of these inquiries went unanswered with the exception of one long-time childhood friend, Paul Miszczyk, who stayed in touch throughout my three-year struggle.

Because of my age, my family doctor told me I was now eligible for treatment at LHSC’s Geriatric Mental Health Program. I initially laughed at the term “geriatric” as no one wants to admit getting that old, but agreed to take the plunge with a psychiatric specialist once again. In short, what did I have to lose – except my life at this point?

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Finally, Relief.

It was with some trepidation that my partner Val and I walked through the doors of LHSC Mental Health area once again in November 2017. It would also be an understatement to say that my faith in the mental health establishment was shattered and jaded by cynicism.

That was about to change, however, when I met the man who would change my life – Dr. Akshya Vasudev, Assistant Professor of Geriatric Psychiatry and Medicine of the LHSC Geriatric Mental Health Program.

Our appointment began with something the previous specialist had never bothered to do because he was always in such a rush to get to his Mental Health Checklist and ask me if I had any suicidal thoughts.

Dr. Vasudev simply asked me, “How are you feeling right now?”

When I told him in so many words that I felt like I was slowly dying, he reassured me that I was not. In short, his bedside manner was a marked change from what I had come to expect from the LHSC program.

He reviewed my case history and my prescribed medications up to that point confirming my BPD diagnosis, and taking the time to fully explain the disorder and point out how common it is becoming with people over 60 years of age.

He was the one who told me that I had probably been struggling with BPD most of my adult life. He explained that as a Type A high achiever who had experienced success in my personal and professional life it had been an aide rather than a hindrance as long as the manic episodes outnumbered the depression episodes, which in hindsight they did.

He also apologized for my treatment to date by the program and pointed out that the medications I had been prescribed were inappropriate for someone my age.

He prescribed an anticonvulsant and a mood stabilizer and made a promise that I would be feeling better by Christmastime.

I took this with a grain of salt and walked out of his office with the feeling that this was my last chance to get better.

Lo and behold, I was indeed feeling better by December 25. By the first week in January 2018, my life had returned to normal for the first time since the summer of 2015.

Today I have resumed all of my regular activities and my depression of the last two to three years seems like a bad dream.

But, it wasn’t.

It was very real, and very painful, not only for me but for those closest to me.

To be sure, I would not be here today if it were not for the steadfast support and patience of my partner Val Cavalini and my daughter Hilary Young. I owe my life to them and Dr. Vasudev.

Why Am I Telling You This?

In the spirit of the annual Bell Let’s Talk initiative, I am sharing my story because I think it will make a difference in the lives of those who may be suffering from BPD and other mental health problems.

You are not alone and I urge you to be your own best advocate. Don’t let the system  grind you down and fight to retrieve your life.

Rick Young, January 31, 2018