How to Understand and Manage Bipolar Disorder: Symptoms

this image shows sadness in bipolar
Sadness in their eyes

How to Understand and Manage Bipolar Disorder: Symptoms

Well Halloween Fans, welcome to ‘How to Understand and Manage Bipolar Disorder: Symptoms.’

I was having a little debate there with myself as to whether to write this evening or leave it a day. I was up all last night and am feeling a bit tired today. Consequently I believe that some physician somewhere is tutting and saying can’t she see that she is in the manic stage. But, no this is not the case. I simply had a lot on and didn’t get much sleep and with the routine in place I was quite busy today. None the less here I am and today I am going to talk about the sadness aspect of bipolar. As I said before and will continue to reiterate this sadness is not a normal up or down. This installment is an extension of my previous bipolar blog ‘How to Understand and Manage Bipolar Disorder: Depression.’ 

How to Understand and Manage Bipolar Disorder: The Three Forms of Sadness

My understanding and experience of the sadness of depression is quite profound. I have experienced the three main forms of sadness; emptiness, numbness and an all-encompassing sorrow, and I have experienced them on several occasions. If you recall from my previous entries one of the continuing emotional problems underlying this mood disorder is extreme empathy. The sadness can come in response to regret or guilt, either by overthinking manic actions or feeling the suffering of others. Equally, the sadness may come in response to grief or through the feeling of failure; not being good enough, not having done enough or rested too much.

As I have already explained, there are sub-cycles in the general cycle of bipolar illness. The survivor must allow their body to rest when it is needed. There is no shame in this, it is a therapeutic remedy. The cycle of resting, feeling guilty and then escalating into sorrow, which in turn triggers further fatigue can only be broken by an acceptance that if rest is needed then it must be taken.

Managing and Understanding Bipolar Disorder: Symptoms of Guilt

Feelings of guilt can be wholly overwhelming, suffocating even. Enduring another person’s past sadness or suffering may be completely unbearable and once again the cycle arises. There are two possible ways that these feelings of guilt can be overcome. The first is to make a mental decision to leave the past firmly in the past. Any action taken during a manic episode, any harmful words or behaviors exchanged have already happened. Wounds do heal over time and rather than reliving the moment it may be better to let it go.

The Buddhist Monk

I read a story from Buddhist thought and it told of a Buddhist monk who was verbally abused by one of his listeners. The next day the listener returned and could not understand why the monk was not angry with him. Allegedly, the monk stated that one never stands in the same river twice. Water and all of its matter are constantly flowing, so the essence is different. In the same way human beings are constantly in a state of flux; learning and growing. Therefore, the monk argued, you are not the same man that was here yesterday, and neither am I.

I think this is applicable in understanding how to release past guilt. Two active solutions are meditation and the ‘Stop’ method. Joining a meditation class trains the student to let go of negative thoughts. The ‘Stop’ method involves visualizing a sign that says ‘Stop’ when thoughts become negative and destructive and forcing yourself to dismiss the thought and engage in another activity.

Managing Bipolar Disorder: Making Amends

The second method of dealing with guilt is one shared with the ‘Alcoholics Anonymous Twelve Steps’ program. This method involves attempting to make amends for any past actions. This is a proactive approach in repairing the damage done. I would caution anyone considering this approach that such efforts may not be welcomed by the other party and in some cases may do more harm than good. It is something only the survivor and perhaps a trusted supported can fully assess. In cases where a head-on approach is unwise perhaps write a letter explaining the guilt and then burn it. Alternatively speaking to a counselor or spiritual adviser may help to lift the burden.

Managing and Understanding Bipolar Disorder: Emptiness

The symptoms of emptiness and numbness are somewhat similar. Numbness is a general feeling of indifference, a lack of ability to enjoy life and a feeling of detachment from everyone and everything. Again, logic may be used to address this; science shows that all matter is connected, and this provides a platform to consider connections from the origin of elements as mutations of hydrogen from the ‘Big Bang’ to genetic links.

There are a number of groups that provide local depression support as well as untold numbers of online groups. These could provide excellent starting points for building connections with those who understand the condition. It is also important to share the diagnosis with those closest and where ever possible enlist support.

Managing Bipolar Disorder with Medication

Emptiness depicts a hollow feeling in the depth of the stomach. Emptiness is painful, lonely and longing in nature. It is this pain that can lead to an urge to relinquish one’s own life. Although, it is not necessarily that the survivor wants to die, more that they want the pain to stop. Opening up to someone, counselor or friend, will help to see the sadness and pain in a different light. There are also medical approaches to alleviating sadness; anti-depressants such as MAOIs, SSRIs or Tricyclics do lift the symptom. Those with bipolar must take these tablets alongside a mood stabilizer to prevent the onset of a manic episode.

SSRIs are probably the most commonly used anti-depressants today. These ensure a higher than usual presence of serotonin in the body. Not every anti-depressant works for every survivor. I waded through nightly tears with Prozac and a complete manic nonsense episode with Sertraline before finding some stability on Lexapro. It really is a case of trial and error to find the right medication. As with any medication there are side effects; insomnia, weight gain and leg tremors are the most common, but when weighed against the effects of depression are often a small sacrifice to make.

Managing Bipolar Disorder With Support

I do realize I have a tendency to sound very upbeat and positive when addressing these symptoms but having lived with them for nearly thirty years I can honestly say it is the best attitude to have. When fighting the sadness of bipolar depression, or indeed clinical depression, your number one weapon is support. Support from friends, support from family or support from groups. This removes the sensation of being disconnected and gives the opportunity to purge those feelings, share those feelings and acquire and alternative insight into those feelings.

Creative Outlets for Coping

My outlet for sadness is to write. Writing was not a career choice, I started writing to turn the negative emotions into something tangible, something visible and something that I could look back on and say I got through that awful time. Whatever I am going through now will also pass. I wrote for many years before I shared my work, largely because the writing was extremely personal and reflective of my illness. Once I started to share, I found that more and more people were able to communicate with me about the illness.

Please do try to find a creative outlet for those feelings, a positive one. Turn them into something real that others can relate to. Thank you for reading ‘How to Understand and Manage Bipolar Disorder: Symptoms.’

Never give up, you have come this far!


Valkyrie Kerry Kelly