Bipolar Disorder – “The rollercoaster chronicles”

“Life is like a piano; the white keys represent happiness and the black show sadness. But as you go through life’s journey, remember that the black keys also create music.” ~ Ehssan

Casey, a 28-year-old single mom, has been tossing and turning all night with a million ideas running through her head. She finally decides to wake up and make some breakfast, despite the clock reading that it is only 4am. She feels very energetic today and before long, she’s singing and dancing in the kitchen, music blaring from the stereo, and food spread all over the kitchen counter.

Lisa, her 6-year-old daughter, comes down the stairs looking very groggy. “Mommy what’s going on?” she asks in a low sleepy voice. Casey doesn’t hear her and continues singing “Burn baby burn!”, while holding the wooden spoon like it’s a microphone. Lisa walks up to her mother and tugs on her mother’s sweatshirt. “Holy Cow!” Casey said jumping. “You scared me honey.” She added as she turned down the music. “Mommy what are you doing? It’s still dark outside.” Lisa said pointing to the kitchen window. “Oh!” Casey said looking outside the window. “Well never mind that honey,” she said grabbing two plates from the cupboard. “have a seat, mommy made you a nice yummy breakfast!” she said smiling.

Lisa walks slowly into the dining room, and takes a seat at the table. “Here you go my dear” Casey said as she placed two plates on the table; one filled with pancakes, and the other with scrambled eggs. She then walked back into the kitchen to bring two more plates, one with bacon and sausages, and the other with buttered toast. “Tadaa!” Casey said taking a bow and smiling at Lisa. “Is all this for me mommy?” Lisa asked shocked and excited! “Of course it is honey!” Casey said. “Do you want some more?” she asked Lisa. “Mommy, it’s too much!” Lisa said laughing, as she munched on a bacon wrapped sausage. Casey laughed too and took a notebook out of the draw next to the table, and started jotting down some notes.

“What’re you writing mommy?” Lisa asked as she took a bite of her eggs. “Mommy’s got a really big idea today.” Casey told Lisa. “I’m going to be an inventor and make us lots and lots of money!” she added smiling, as she continued to write in the notebook. “That sounds fun!” Lisa said as she took a bite of her pancake, and then said “I’m full!” as she rubbed her tummy and sat back smiling.

“Alrighty then” Casey said getting up and clearing the plates still filled with food. “Go get ready, we have a lot to do today!” she added as she put the plates in the fridge. “Well, what about school?” Lisa asked confused. “No school today honey, you and I are going shopping!” she said excitedly. “Yay!” Lisa said and ran upstairs to get ready.

They got to the mall fairly early, and some stores were still opening up their window displays. “Okay baby, how about we go to the Disney store” Casey asked smiling. “oh yes mommy, can we really?” Lisa asked excitedly, because her mom had always said it was too expensive. “Of course honey, anything for my baby girl!” Casey said walking Lisa into the store. “So, what do you want honey?” Casey asked as she looked around. “Can I have a Disney princess mommy?” Lisa asked hopefully. “A princess?” Casey asked. “Why just one princess?” she asked. “Let’s buy them all!” she added raising her hands in the air. “Really mommy?” Lisa asked smiling her biggest smile. “Absolutely!” Casey said as she walked to a salesperson at the counter.

“Morning!” Casey said all cheery. “Good morning ma’am.” Responded the sales clerk. “How may I assist you today?” she asked. “I would like all the Disney princess dolls you have for my beautiful princess here.” Casey said as she hugged Lisa to her side. “I’m sorry ma’am, did you say ALL the Disney princesses?” asked the clerk. “I sure did,” said Casey. “and hurry it up, we have lots to do today”. Casey added. “Coming right up!” said the clerk smiling and taking a shopping cart to the back with her.

The clerk returned with a cart full of dolls in large boxes and Lisa screamed ecstatically while jumping up and down. The cashier rang up the dolls and said “That’ll be two hundred and fifty-two dollars ma’am”. Lisa stopped jumping up and down and looked at her mom worried. “Here you go!” Casey said giving the clerk her credit card, and winking at Lisa. Lisa started to dance again with the biggest smile Casey had ever seen. “Thank you, mommy, you’re the best!” Lisa said hugging Casey. “Oh, you’re welcome baby.” Casey said hugging her back. “Here you go ma’am” said the clerk, handing Casey back her credit card. “Thanks!” Casey said putting it away and grabbing the three large bags filled with dolls.

Next stop was the nail and hair salon, where Lisa got to paint her nails coral, and then the clothing store where Casey bought them both a bunch of new outfits. “This is the best day ever!” Lisa said smiling at her mom as they got into the car. “Not yet,” said Casey “we still haven’t had any ice cream.” She added smiling. “Ice cream? Yay!” Lisa exclaimed, filling up with joy. Her mom let her have as many scoops as she wanted, with hundreds of sprinkles on top. Later on as they drove home, they stopped at a paint shop to buy some wall paint for the house.

They got home and put away all their shopping bags, and Lisa began to unpack her dolls. Casey started to move furniture around to get ready to paint. “Mommy aren’t you tired?” Lisa asked worriedly. “No honey!” Casey said. “I feel like superwoman!” she added striking a pose, then put on an apron and opened the can of orange paint.

Lisa went and took a bath, played with her dolls, then fell asleep. She was beat from such a long day of fun. Her mom stayed up all night painting, singing, and jotting her invention plans onto her notebook. The rest of the week was just as exciting. Casey and Lisa went shopping, visited malls, playgrounds, restaurants and even the amusement park. Lisa had never had an exciting week like this before. She hoped it would never end.

Casey also worked on numerous projects around the house, leaving some half done, and starting on a new idea every single day. She was also working on her inventions in her bedroom, and she made it clear to Lisa that no one else was allowed to go in there.

At the end of the week, at around 6pm, Casey said she was going out to meet a friend for dinner, and that she would be right back. She left Lisa on the couch watching cartoons, and playing with her princess dolls. Lisa fell asleep and woke up around midnight, only to find the television still on, and no one around. “Mommy?” Lisa called out as she got off the couch and went to the kitchen. “Mommy where are you?” Lisa questioned walking upstairs to her mother’s bedroom. “Mommy!” she said opening the door to the bedroom slowly and finding it empty. “Maaa….” Said Lisa crying, once she realized that there was no one home. She walked back downstairs crying, because her mother had never left her home alone before.

Lisa walked up to the fridge and pulled off the paper with aunty Susan’s phone number, Casey’s sister. She picked up the house phone and dialed the digits. The phone rang four times before a voice suddenly picked up. “Hello?” said Susan sounding sleepy. All she could hear was crying on the other side of the line. “Casey is everything okay?” Susan asked worriedly. “No, mommy’s not here aunt Sue.” Lisa said crying. “Lisa?” Susan said sounding more awake. “Where’s mommy?” she asked trying to stay calm. “I dunno aunt Sue, I woke up and she was gone!” Lisa said crying even louder now. “I’m scared.” Lisa added as she looked around the empty house. “It’s going to be okay honey, I’ll be there very soon!” Susan said rushing out of bed. “Okay,” Lisa said, “please hurry auntie!” Lisa added as she slowly stopped crying. “I’m on my way sweety.” Susan said reassuringly as she slipped on her shoes and left the house.

Lisa went back to the couch, covered herself with a blanket and hugged her dolls tight. Susan arrived at the house fifteen minutes later, having sped all the way! She found Lisa crying and cuddling her doll on the couch. She hugged her tight, fed her some warm milk, talked to her, sang her a song, and rocked her to sleep. Susan had been calling her sister Casey’s phone since Lisa had called her, but Casey wasn’t picking up. “Where are you???” Susan texted. After an hour, she stopped being angry and started to worry. She called the police but they said they couldn’t help her, because Casey was an adult and hadn’t been missing for 24 hours. Susan sighed and decided to sleep on the chair in Lisa’s bedroom, just in case she woke up again before her mom got home.

At 6am Susan heard the front door slam and she quickly ran downstairs. There she saw Casey stumbling around like she was drunk. “What the hell Casey!” yelled Susan angrily. “Where were you all night?” she asked sounding very upset. “Suzie!” Casey said stumbling towards her sister smiling. “What are you doing here?” she asked while giving her a hug. “Lisa called me last night crying uncontrollably. How could you leave her home alone? She’s six for crying out loud!” Susan said pushing Casey off of her. “I didn’t leave her alone, she had her dolls.” Casey said laughing while pointing to the couch. Casey reeked of alcohol and that made Susan even more upset. “You need to get cleaned up before Lisa wakes up.” Susan said. “Okay, boss lady. Right after I take a nap.” Casey said as she flopped on the couch and immediately fell asleep. Susan looked at her for a minute, shook her head and covered Casey with a blanket. She then went upstairs and helped Lisa get ready, and took her to school; telling her that mommy was sorry and just needed some time to rest.

In the evening, Susan picked Lisa up from school and when they got home, Casey was still sleeping on the couch. “Mommy!” Lisa called walking over to Casey and touching her face. Casey did not move. “What’s wrong with mommy? Lisa asked looking concerned. “Mommy’s really tired right now sweety,” Susan said, “why don’t we just let her rest okay?” Susan asked. “Okay.” Lisa responded sadly and walked away. Susan felt Casey’s pulse and found that she was still breathing, but she just would not wake up no matter how much Susan shook her. She figured that Casey must have partied really hard and just needed more rest. Susan then decided to take Lisa to her place for a while, until Casey was back to normal. She left a sandwich and a glass of water on the table for Casey, and a note saying that Lisa would be staying with her for a few days.

The next morning Susan tried calling Casey but there was no answer. Susan asked her husband Roy to pick up the kids after school, including Lisa, so that she could go check on Casey after work. When Susan arrived at Casey’s, she noticed that the sandwich and water had not been touched. “Casey!” Susan called shaking her sister’s shoulders. Casey opened her eyes and looked at Susan, then turned around and continued to sleep. “Casey what’s wrong?” Susan asked. “I wanna help you but I don’t know how.” She added getting teary eyed. “Please talk to me sis.” She said shaking her again. “I just wanna sleep” Casey whispered sadly. “But you’ve been sleeping for days!” Susan said. “At least have some water Casey. Please?” Susan pleaded. “I wanna die Sue” Casey said in a low sad voice. “Please just kill me.” Casey said crying and covering her head with a pillow.

Susan stepped back in shock, and called Roy and told him what Casey had just said. He told her to call 911 and that he was on his way. An ambulance arrived about six minutes later, the EMTs took Casey’s vitals, and then put her on a gurney. They told Susan the hospital they were taking Casey to and left. Roy showed up just as the ambulance was pulling away, and Susan ran into his arms crying, wondering if her sister would be okay, and what she was going to tell Lisa.­­­­­­­­­­­­­­______________________________________________________________________________

Bipolar disorder is a brain disorder that causes extreme mood swings that go from emotional highs (mania or hypomania – high energy, extreme happiness), to emotional lows (depression – sadness, emptiness, hopelessness).

Symptoms:

Manic or Hypomanic Symptoms:

Mania is more severe than hypomania, and causes significant problems at work, school, and even in relationships. Mania can also trigger psychosis (a break from reality), leading to hospitalization. An episode includes 3 or more of the following symptoms:

  • Person has lots of energy
  • Person feels “wired” or “jumpy”
  • Person is more active than usual
  • Decreased need for sleep
  • Person talks really fast jumping from one topic to another
  • Feeling invincible, or overly confident in one’s abilities and powers
  • Having racing thoughts
  • Risky behavior (buying sprees, reckless sex, etc.)
  • Person might be agitated or irritable
  • Impaired judgement

Depressive Symptoms:

An episode can cause significant distress in life (work, school, relationships), and includes 5 or more of the following symptoms:

  • Feeling sad, empty or hopeless
  • Feeling fatigued and having very little energy
  • Loss of interest in most activities, and/or withdrawing from friends and family
  • Trouble sleeping (sleep too little or too much)
  • Loss of appetite or increase in appetite
  • Slow speech
  • Feeling worthless or having inappropriate guilt
  • Trouble concentrating or making decisions
  • Thoughts about suicide or death.

Treatment:

Bipolar disorder is a lifelong condition. Treatment is focused on managing the symptoms, and is best guided by a Psychiatrist. An effective treatment plan usually includes a combination of medication and talk therapy.

  • Medications 
    • These include mood stabilizers, antidepressants, antipsychotics and sleep aids. Only take medications that have been prescribed for you, and speak to a psychiatrist or pharmacist if you have any concerning side effects.
  • Psychotherapy 
  • Consistent routines 
  • Electroconvulsive Therapy (ECT)
    • ECT – running electrical currents through the brain to trigger a brief seizure – can be an option for Bipolar treatment for severe cases, those who don’t get better with medications, or those who cannot take medications due to a health condition e.g. pregnancy. It is also used for those who are at very high risk for suicide.
  • Avoid drugs and alcohol.
    • People who are depressed or manic may turn to drugs and alcohol to help them “perk-up” or “slow down”. However, these substances may disrupt emotional balance and interact with medications, thus hindering recovery.

Resources:

U.S.A

**National Suicide Prevention Lifeline – 1-800-273-8255

National Alliance on Mental Illness – http://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder/Support

PsychCentral – https://psychcentral.com/lib/resources-for-bipolar-disorder/

Depression and Bipolar Support Alliance – http://www.dbsalliance.org/site/PageServer?pagename=home

KENYA

Users and Survivors of Psychiatry in Kenya (USPKenya)- http://www.mhinnovation.net/organisations/users-and-survivors-psychiatry-kenya-uspkenya

International Bipolar Foundation – http://ibpf.org/

Amani Counseling Center: http://www.amanicentre.org/counselling.php

 

References:

American Psychological Association – http://www.apa.org/monitor/feb08/consistent.aspx

Mayo Clinic – http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/home/ovc-20307967

National Institute of Mental Health – https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

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