I'm finally ready to broach a topic that I've wanted to discuss for awhile now. Our son Cory suffers from Bipolar disorder type 2 coupled with dysthymic disorder. Most people are familiar with the symptoms of bipolar type 1 as that is what is the most common and is often portrayed in the media. In Type 2 the "up" moods never reach full on mania and their depressive moods are usually more severe. In bipolar 1 or 2, the dramatic mood episodes can last days, months and sometimes even years. Dysthymic disorder is characterized by a long-term, low-grade depression for two or more years which is not due to disease or substance abuse. For the past year Cory's "up" moods have been infrequent at best, and his depression has gone from low-grade has to severe and at times life threatening.
We worked with a therapist and our family doctor for six months before things got so bad that a short hospitalization was necessary. It was a difficult decision to come to, but Cory's life was at stake and dramatic intervention was needed to get him on the right medications and help him learn some skills needed for managing his illness. I haven't talked about what we've been going through as a family because it's not easy to describe the disorder, much less the daily level of worry that we've been experiencing. Cory has no opposition to discussing his problems with everybody which is why I'm finally broaching the topic here. My main goal in doing so is to help shine a light on this disorder and maybe help others in a similar situation.
Once we began homeschooling it took two years for me to feel like Cory had mostly gotten back to his pre-bullying "norm", though I knew his self-image and confidence had been permanently damaged to some extent I didn't know how deep it really went. He seemed mostly okay until he was about 17, and then when he seemed irritable and had weird sleeping habits we asked him if everything was okay because depression does run in our family. He said he didn't need to see a therapist and we all just assumed it was that "teenager thing", but to Cory it was just an extension of the way he had always felt inside and didn't know wasn't the way everyone felt. After he completed his high school studies he tried going to classes at a local technical college but had difficulty being motivated and with concentration. He'd done well at the few courses he'd taken there previously so we didn't know what to think when he failed more than he passed and chalked it up to "school burnout". We discussed this very topic just the other day and I reassured him that now we know it was the depression and not his fault and that it's up to him whether he attempts school again when he feels ready.
Medication is the key component in a bipolar treatment program, but he also sees a therapist once a week for talk therapy in order to help motivate him to stick with his treatment and deal with the stressful effects his severely depressed mood has on his work and personal relationships. Attention to a routine of regular sleep, eating habits and exercise can help maintain good mood and this is an area we are still working hard at. Cory suffers from a disinterest in food and is seldom hungry so has to make an effort to eat regularly. Regular sleep is also something that is still eluding him and at its worst he sleeps in one or two hour intervals spread throughout the day or stays up all night agitated and unable to fall asleep.
We finally got a breakthrough on the day we were leaving for Reno. He had an appointment with his psychiatrist and after mentioning his continuing negative thought pattern, nightmares and insomnia she prescribed him a new medication. He took it our first night in Reno and slept for 9 hours! Every night since he has slept 7-9 hours with normal momentary awakenings. In addition, his internal mindset improved almost overnight. The incident where he fell into the water is a good example. He got his camera wet and normally a situation like that would have ruined his good mood for a week, but he was shocked when he laughed about it and took it in stride. He's still talking about how he can't believe the difference in the way he reacted to that situation. On the day we left Reno he woke in a bad mood due to a nightmare, but when we went to breakfast there was a man playing keyboard at the restaurant and by the time we left he was in a good mood again. Sounds like such a simple thing, but to Cory the ability to shake a bad mood hasn't happened in over a year! We're all feeling very hopeful right now that he's finally found the right combination of medications to give him his life back.
As bad as things have been for Cory, he is luckier than most in his situation. He has a supportive, understanding family who has helped him get and maintain treatment. Due to the education and emotional support he's gotten at home he doesn't abuse drugs or alcohol as many other bipolar and depression sufferers do in an effort to cope. He is very articulate which helps his doctors understand as well as treat his symptoms, and he is able to apply rational thought to his behavior sometimes even when his brain is urging otherwise.
I hope my talking about this has helped some people understand this illness a little better. I know it's been hard for us to fully understand how difficult bipolar is to treat. It's a lifelong battle, but we know there's a Cory in there waiting to enjoy life and we're willing to work hard to help him get there.
Want to know more? Psychology Today has a good article on the differences between Bipolar I and Bipolar II here.