Riding the Waves of a Bipolar High
Is Genius Curtailed by Medication that Diminishes the Highs?
I was recently reminded from a podcast I made several years back that some bipolar folks never experience depression. For a subset of people diagnosed with bipolar 1, their symptoms do not include depression. It seems odd to me to encompass this unipolar mania on the bipolar spectrum, as “bi” means “two.” Regardless, depression is not a prerequisite to a bipolar diagnosis.
My husband and I met up with one of his college friends for lunch this weekend. By my estimation, Jacob is a genius. He has several successful business ventures, bounces around from various spots on the globe, sleeps very little, has a never ending stash of ideas and philosophies, and a healthy dose of paranoia. You see where this is going. I only see this guy every few years when he breezes into town, but I feel a kinship. I love bantering with him. We exchange quick dialogue and challenge each other’s thinking. I’ve had numerous entrepreneurial ideas that never go anywhere, so I feel inspired when talking the ins- and outs- of his ventures. His anecdotes are enthralling. But this was the first time I considered that he is probably bipolar 1.
When we first sat down, I asked how he was doing, to which he replied “not great.” He had just gotten back from a trip where he was trying to find himself. When I asked if he had succeeded, he shook his head. He told us that due to the dissolution of a 3-way relationship, which was helping to ground him, he is chaos surfing. We talked about whether his detachment is problematic to his life. Does he actually need to be grounded? My husband suggested he get a dog. I suggested that his rapidly changing pursuits and moves, and fast thinking, is just who he is. I didn’t ask if he was bipolar, not wanting to offend (though I regularly speculate to friends that they may be on the bipolar spectrum). I encouraged him to stay the course and lean into his chaos. Was my encouragement of him remaining in his current state doing him a disservice? Am I enabling ignorance of a possible medical condition?
I expect many bipolar folks would agree that hypomania or mania are the states most likely to allow our genius to come through. I think Jacob has tapped into his, and maybe if he were medicated, he would just be a run-of-the-mill fellow. Many research articles explore the connection between bipolar and creativity. I didn’t omit discussing bipolar with him just to avoid offense. I avoided it because I would feel bummed to see him any other way.
The results of my neuropsychological testing in 2019 came back as bipolar 1. The psychiatrist I started seeing after the test considers me cyclothymic (codes as undiagnosed bipolar for insurance). When I went through the testing, I had been on an anti-depressant to treat my anxiety for several years. I suspect that answering “no” to questions about experiencing depression probably contributed to the bipolar 1 result. Having now spent hours upon hours researching various circumstances associated with bipolar, I think it’s safe to say I am not bipolar 1. I’ve never hallucinated nor had delusions, and am leading a functional life in spite of periods of high energy, flowing ideas, and (past) sexual escapades. Interactions online with other bipolar folks inform me that my highs and lows are indeed mild.
As soon as I was diagnosed, I quit the anti-depressants and started anti-convulsants. The dosage of oxcarbazepine was too high, and the hypomania was killed off, but depression became the norm. I eventually came down to a low enough dose that the depression eased up; but drive and creativity were still pretty rare. After I quit my job late last year, I decided the time was right to go unmedicated. After a week, I felt unhinged. Less than a month later, I started a low dose of lamotrigine, which I have continued. I now have less depression and a few instances of mild hypomania. But was going back on medication the right move? My interaction with Jacob has left me wondering if I am failing to find my genius by quelling my highs.
When I am firmly in a low energy place, I convince myself there is no genius to be had. But as often, when neither depression nor hypomania has come around for awhile, I perceive my condition to be so mild that I should forego medication. I did not go unmedicated for even a month. Maybe my state would have stabilized after a few months. After all, I went for decades without medication. But as a mother and wife, I have a bit more riding on my stability. For now, I’ll just have to hope that if I have genius in me, it can find a way out — in spite of the meds.
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