Every week, I learn something new about bipolar that punches me in the gut. This week, I learned Benadryl (diphenhydramine) withdrawal can cause psychosis. Worse yet, long-term use can cause prolonged psychotic episodes and even lead to dementia. Like I needed any more help disconnecting from reality.

I’m sure the problem comes in when people abuse the medication or take it for much longer than they should, but it’s still terrifying fact.

Life with mental illness is scary on a good day. When you’re already down in the dumps? It’s like watching a horror film on every screen of a sports bar.

When a new fright reaches me, I try to remember how much I’ve overcome already. Hallucinations scared me until I had them and learned how to survive the chaos they cause. The idea of taking medication filled me with fear because I thought it would change who I was and destroy my creativity. Both were unnecessary fears.

Many of the things we fear turn out to be much less difficult than we expect.

But there is reason for caution. If you take anything from today’s newsletter, let it be this:

Everything you put into your body can affect your bipolar. It doesn’t matter if it’s a pain reliever, allergy medicine, or an antacid. Then there’s alcohol and other recreational substances. Each one can alter your brain chemistry, triggering or worsening bipolar episodes.

So, yeah, the little pink pills help me breathe during allergy season, but I’m going to be a little more wary going forward.

Switching gears, I read this wonderful post this week about living with bipolar depression. The story is gut wrenching, but so spot on I had to share it.

If you missed Wednesday’s announcement, I made a minor change to the Positivity Club. The focus remains on seeing more good in your world, but the slant will lean more closely to bipolar life. This week the Club topic is about making changes. I’ll explain how even the simplest changes can affect your life, how to pick a change to make, and how to get started.

Finally, the featured post this week (below) is about the different types of bipolar disorder. This isn’t the most exciting subject, but it’s necessary for each of us to know exactly what we’re fighting. I tried to make the content as lively as I could.

This week sent me up and down several emotional hills. May was difficult as a whole, but now stopping my allergy meds topped with a massage, and all kinds of feelings are running around in my head. Time to watch Inside Out again.

To keep things on track, I’m spending more time outside, exercise again, and writing more often in my journal. Funny how the journal is always the first thing to go when things get messy.

This can be a great summer (or winter) if we take healthy action now. Stick to your treatment plan, get enough rest, and keep reading Speaking Bipolar. (That helps, right?)

Thank you for being part of the Speaking Bipolar Community and sharing this journey with me. You are the reason I have trigger finger from typing too much. 😂 Have a wonderful week.

Reader, I'm so happy to have you here. Thank you for supporting Speaking Bipolar and reading this newsletter.

Until next time, keep fighting.

Scott Ninneman

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More Than Just "Mood Swings": Getting Real About Different Types of Bipolar

“I have bipolar disorder.”

People often look like I’ve punched them in the stomach or kicked their dog when I say the words. Most try to recover quickly, but I always notice the look of shock or fear they can’t hide.

When someone hears "bipolar," they often picture extreme ups and downs, the man standing on the top of a 10-story building or the woman taking off her clothes in the frozen food section of the grocery story.

For the record, I’ve never taken off my clothes in a grocery store, but I do have an interesting story that took place at midnight during a mid-summer rain storm. I’ll save that for another day.

While the extreme things sometimes happen, they are only a tiny part of the bipolar story. The truth is much more nuanced.

There isn't just one kind of bipolar, and understanding the differences can be a game-changer for getting the right help and feeling understood.

So, let's dive in and look at the main types of bipolar.

1. Bipolar 1: The Big Peaks and Deep Valleys

This is often what people imagine when they think of bipolar. Bipolar 1 means you've experienced at least one manic episode.

What's mania feel like? Imagine your favorite all-powerful superhero. Suddenly, this indestructible being takes over your mind and body. Your energy levels shoot through the roof and you feel like you drank 25 energy drinks.

Your confidence is often at an all-time high and creative ideas are as plentiful as rain falling from the sky. There’s no need to sleep because hundreds of ideas are racing in your mind. You talk a mile a minute, and jump into exciting (or sometimes risky) plans without a second thought.

Mania is a powerful, intense state that lasts for at least a week and can change your world with the impact of a category 10 earthquake.

Most folks with bipolar 1 also go through depressive episodes. These are the deep, dark periods where everything feels slow, sad, and worthless. Think overwhelming sadness, no energy, losing interest in everything, and trouble concentrating.

It's a stark contrast to the manic highs.

Bipolar 1 is the type I walk with every day, but let’s look at a few more.

2. Bipolar 2: Hypomania's Here and Depression's Hanging Around

Now, Bipolar 2 is a bit different. Here, you'll experience those tough depressive episodes, but instead of full-blown mania, you'll have hypomanic episodes.

Hypomania is a milder, less intense version of mania. A less powerful superhero takes over. You might still feel really good, energetic, and productive, and need less sleep. It's often described as feeling "on top of the world" or "supercharged." The key difference is hypomania usually doesn’t spin so out of control that it blows up your world.

Hypomania usually lasts at least four days, but rarely leads to a hospital stay.

People with Bipolar 2 often spend more time in depressive states than in hypomania. This tendency means many receive a diagnosis of clinical depression rather than bipolar disorder. The misdiagnosis means the patient suffers longer on their road to stability.

3. Cyclothymic Disorder (Cyclothymia): The Ongoing Rollercoaster

Cyclothymia is like a milder, but more constant, version of bipolar. Instead of full-blown episodes, you experience ongoing ups and downs—periods of hypomanic symptoms and periods of mild depressive symptoms.

The mood shifts with cyclothymia are less intense than Bipolar 1 or 2. Often it takes a year or more of riding this roller coaster before a diagnosis appears.

While the highs and lows with cyclothymic disorder might be less dramatic, living with these constant, fluctuating moods can still wreak havoc on your personal and work life.

4. The "Other" Bipolar Stuff: When It Doesn't Fit Neatly

Sometimes, your experiences don't quite fit perfectly into those main categories. This is where categories like "Other Specified" or "Unspecified Bipolar and Related Disorders" come in.

This might include things like:

• Rapid Cycling: This isn't a type, but a specifier for Bipolar I or II. It means you've had four or more mood episodes (manic, hypomanic, or depressive) within a single year. I rapid cycle, and it’s just as awful as it sounds.
• Mood changes that are clearly linked to substance use or other medical conditions.

I would be remiss if I didn’t mention Borderline Personality Disorder here. Borderline is not a form of bipolar, but both have similar symptoms. Borderline can also occur with bipolar, making for an even more interesting ride.

So, Why Does All This Matter?

Knowing the specific type of bipolar disorder you're fighting is about more than labels. Knowledge really is power, especially in terms of mental illness. When you know which type you have, you can focus on:

• Getting the Right Tools: An accurate diagnosis means your doctor can create a treatment plan that actually works for you. Different types often respond best to specific medications and therapies.
• Understanding Yourself: When you know your type, you can start to understand your unique patterns, triggers, and early warning signs. This is huge for building your own mental health toolkit.
• Ditching the Stigma: The more we talk openly and accurately about the varied faces of bipolar, the more we can break down old stereotypes and build a community of understanding and support.

If you're reading this and thinking, "Hmm, this part sounds a bit like me," please reach out to a mental health professional. Bipolar disorder is not one of those things you should self-diagnose, so seek the right help to get a clear diagnosis.

Yes, seeking help takes bravery, but there can be so much good on the other side. I wouldn’t be here today without a doctor-led treatment plan. I want you to stick around, so reach out for the guidance you need.

Journal Prompt: After reading this post, what do you want to discuss with your care team and support network? How did this information make you feel?

Until next time, keep fighting.

I publish two newsletters each week. The Sunday All Things Bipolar Newsletter (this newsletter) features the newest content about bipolar life. The Speaking Bipolar Positivity Club Newsletter shares inspirational stories to help you maintain a positive mindset.

Additional Reading:

• ​A Man Named James: a Lesson in Overcoming Life’s Trials​
• ​Bipolar Disorder: Setbacks and Support Systems​
• ​Misophonia and Bipolar Disorder: How To Cope When Noise Makes You Angry​
• ​Some People Will Be Unable To Understand Your Mental Illness​
• ​There Are Always Reasons to be Grateful​​
• ​Archive Newsletters​