Looking back over seven decades of dealing with what has come to be labelled bipolar 1 disorder(BPD), I would say that I experienced mania and psychosis—a chemical imbalance in the brain. This psychosis was like a detonation. It took place in someone who had exhibited absolutely no symptoms previously, in a person who had led a normal life until that psychotic episode shattered his normalacy. It presented itself as energy of a primordial sort.
One writer likened it to “being in the presence of a rare force of nature, such as a great blizzard or flood: destructive, but in its way astounding too.” Such unbridled energy can resemble that of creativity or inspiration or genius—this, indeed, is what I felt rushing through me. In retrospect it was clearly experienced as an illness. It is not accurate, at least in my case, to describe the experience, as some do, as the apotheosis of health. There was, it could be said, a release of a deep, previously suppressed self. That was part of the good side. My story of BPD tells for the most part the bad side, although I also express some of the positive aspects of BPD. The experience of high energy and creativity are equivalent to a full-blown psychopathology, to a clinical manic episode which, by definition, entailed significant impairment.
Looking back to my first experience of depression in the autumn of 1963, I would have no trouble seeing that experience as unipolar depression or the beginnings of BPDII. BPD individuals are more likely than those with unipolar depression to display psychotic features during a depressive episode (30 percent vs six percent). This was the case for me in the summer and autumn of 1968. Those with bipolar I had more ECTs (18 percent vs six percent) suggesting more severe depressions, and more suicidal episodes (33 percent vs eight percent).
The perils of BPD existed, as I look back some 45 years after my last manic episode, in what I did in the midst of: (a) those two manic episodes to deal with: decreased need for sleep, decreased self-control, irritability and risk-taking behaviours in 1968 and again in 1980, (b) the mixed highs and lows from 1963 to 1967 and 1978 to 1980; (c) schizo-affective or psychotic states in 1968 and 1979-80 episodes; and (d) depression periods with their moroseness, extreme melancholia and suicidal wishes in 1963, 1964, 1968 and 1978. More to come if interest is shown and comments follow.