Sleepless Nights, Risky Behavior, and Depression: What It's Really Like to Live With Bipolar II Disorder
After years of cycling through periods of crazy-high energy and episodes of hopelessness, Katie Simon finally had a diagnosis.
The summer after my freshman year of high school, I discovered The West Wing. I binge-watched the first five seasons in five days. My television streak cost me about 15 hours each day. But during that time I also learned how to drive, passed my learner’s permit test, applied for a scholarship, and volunteered for several hours at a stretch at a nonprofit. Squeezing all of this into such a short time might sound impossible, but I had a secret: I didn’t sleep.
Over the next few years, I experienced similar periods of sleeplessness and inexplicable energy, my mind racing all the time. I'd be hyper-productive and more confident than usual, and my head would buzz nonstop with ideas.
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But after these supercharged periods ran their course, I would experience the complete opposite: emptiness, exhaustion, and hopelessness. I didn’t take pleasure in any of the day-to-day activities that usually brightened my mood. Even going for long runs (and the endorphin rushes that came with them) couldn’t lift me out of my funk. I tried not to let these dark periods bother me because I could see that rationally, I had no reason to feel so bad.
Depression and bad decision-making
Between high school and college, I took a gap year to backpack around Asia and Europe. My highs and lows continued. At times I went days without sleeping, traveling on overnight buses and talking with new friends. I took impulsive risks: I went on road trips with people I didn’t know, slept on beaches illegally, and continued to travel even after I became sick with the plague—but that’s a whole other story.
Then my mood and behavior would change. I isolated myself and stayed in my room for days, feeling hopeless, exhausted, and disinterested in exploring the fascinating places I was visiting.
After I returned from my trip, I finally reached out to a psychiatrist. She had me try all kinds of antidepressants, but low doses of each resulted in extreme reactions, such as euphoria and psychotic breaks. My psychiatrist explained that my reactions were nearly impossible—unless I had a mood disorder. After asking me a series of questions, she confirmed her theory: I had bipolar II disorder.
What it means to have bipolar II
Approximately 2.5% of Americans have a bipolar-spectrum mood disorder; that’s about six million people. Most people have heard of bipolar I disorder, or just the term bipolar, which involves dramatic shifts in mood, day-to-day functioning, and energy level. Living with bipolar I typically means having at least one manic episode followed by a period of depression.
Since I had never experienced full-blown mania—which causes major behavior changes like reckless spending, risky sex, or foolish investing—I didn’t meet the criteria for bipolar I disorder. But I did meet the criteria for bipolar II. I'd had at least one major depressive episode (loss of interest in all activities; feelings of guilt, sadness, and hopelessness; and/or thoughts of self-harm).
To be diagnosed with bipolar II, I also had to experience a hypomanic episode, which is a period of increased energy, exaggerated confidence, racing thoughts, poor decision making, and/or decreased need for sleep. It was clear to me and my psychiatrist that I had experienced plenty of both.
But let's be clear: neither disorder is better or worse than the other. While bipolar I mania can be dangerous, bipolar II disorder often comes with longer depressive episodes. And people with bipolar II don't always experience one type of episode or the other. Even without treatment, there may have symptom-free periods characterized by a stable mood.
The exact cause of bipolar disorders is unknown, though experts think it could have to do with genetics and biological differences in the brain. Those who have an immediate family member with a bipolar diagnosis are at a higher risk.
A path toward healing
When I broke the news of my diagnosis to friends and family, those who had witnessed my symptoms firsthand immediately got it. But not everybody was so understanding. Older people brushed off my diagnosis, saying things like doctors hand out medications for everything these days, or everybody gets sad sometimes. "Our society needs to stop coddling young people and blaming everything on mental health disorders,” one of my college professors once told me.
In the beginning, my parents struggled to accept my diagnosis; they didn’t want me to suffer, and putting a name to my symptoms probably felt scary to them. Yet the truth is, my diagnosis was one of the best things to ever happen to me. I also know that my treatment likely saved my life. As many as 30% of people with bipolar disorder attempt suicide.
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Opening up about my diagnosis takes a lot of strength, especially because some people don't believe it's real. But science is on my side, and so are a lot of people who love me. My friends know that I’m the expert on my own mental health, and they don’t question what I (or my doctors) say. It took a while, my family has come around too.
Soon after my diagnosis, I began taking medication, which stabilizes my mood and allows me to live a symptom-free, day-to-day life the majority of the time. Since I started taking medication five years ago, I’ve felt a healthy range of emotions: happy, sad, and everything in-between.
Besides taking medication, I’ve also made some important behavioral changes. I prioritize sleep, since erratic sleep can trigger a hypomanic episode. The only hypomanic episodes I’ve experienced were triggered by a combination of many sleepless nights and forgetting to take my medication—a rare occurrence, but it happens!
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I make self-care a priority if I experience a breakup, death of a loved one, or other major life transition, because during these times I’m more prone to sinking into clinical depression. Everybody has a bad day occasionally. But if I’m up or down for more than a couple of days without a particular reason, it’s time to figure out if it’s a bipolar episode.
Once I decided to treat my bipolar II diagnosis the same way I treat physical health issues, my life changed for the better. Speaking honestly about my mental illness strengthened my friendships and support system. Plus, being honest about my own journey is one of the best ways I can contribute to ending mental health stigma.