Your Most Pressing Questions About Bipolar 1 Disorder, Answered By People Who Know

What does it feel like to have bipolar 1 but not know it?

Charlotte: It feels like alternating between the highest highs and the lowest lows with no control. For me, the lows came first. I was sleeping for 20 hours a day and feeling extremely numb. I stopped playing my guitar, stopped singing—I had no creativity whatsoever. I quit my job and isolated myself from my friends. My social anxiety was through the roof. If I did go out with people, I’d have to drink so much to feel normal, even around my best friends.

But then my mood would flip all the way around. When I first started experiencing symptoms of mania, I didn’t realize what was going on. I thought, Oh, I’m finally being normal. I’m not depressed anymore. It was thrilling at first. Writing songs was easier than ever; they just flowed out of me whenever I picked up the guitar. I’d play for hours every day. But it was an extreme, destructive euphoria that also included stealing from stores, driving recklessly and getting into car crashes, smoking and drinking a lot—I couldn’t stop myself from doing these things. A lot of furniture was broken in our house. I’d have terrible fights with my parents, punch walls, and scream until I lost my voice.

How can I help someone struggling with their mental health—especially if I don’t know what the issue is?

Kim: The three years before Charlotte’s diagnosis were confusing for all of us. She was being extremely reckless, continuously engaging in risky behaviors, and doing things that were out of character for her. Bipolar 1 doesn’t run in my family or my husband’s and we were not familiar with the illness. How could our daughter have this condition? Initially we were in denial, but understood that the first step in being able to help someone is overcoming that innate refusal to admit that something is wrong.

We had to do something. Without notice, I drove to pick her up. When we got in the car, I told her, ‘I’m going to take you to the hospital.’ Charlotte looked at me and said, ‘I think that’s a good idea.’ It was very calm. We drove to the hospital and went to the emergency room. Charlotte was admitted to the hospital. We both knew that we couldn’t do this anymore.

What are the first steps after diagnosis?

Charlotte: For anyone facing bipolar 1, it’s important to surround yourself with a strong support system. We all need people to be there for us. Another thing that helped me was establishing a schedule for myself. If you’re doing nothing during the day, it’s easy to spiral in either direction—up or down. And you need a good night’s sleep. Making a commitment to sleeping a normal amount each night has helped a lot.

Kim: When your loved one is taking these first steps, it’s important to remain patient and supportive, and try not to trigger them. Love them. Listen to them. But at the same time, seek professional help. Once we got the help we needed, things improved.

Charlotte: To get the help I needed, I had to figure out a treatment regimen that worked for me. I found a healthcare provider I trusted, and together we discussed treatment options to figure out what could help me manage my symptoms.

What is the process of finding the right medication for yourself?

Kim: Charlotte and I both knew that finding the right medication for her condition was a journey best taken with the guidance of Dr. Price, Charlotte’s psychiatrist. She began treatment with medication, but it was hard to find one that worked for her. One medicine helped to reduce her bipolar 1 symptoms; but, unfortunately, it came with side effects she couldn’t tolerate. We discussed our concerns with Dr. Price and together, we engaged in open and informed discussions about other potential treatment options. One of the treatment options he told us about was LYBALVI® (olanzapine and samidorphan).

A note about LYBALVI: LYBALVI is an oral prescription medication used in adults to treat manic or mixed episodes that happen with bipolar 1 disorder, either alone for short-term (acute) or maintenance treatment or in combination with valproate or lithium. LYBALVI is also used in adults to treat schizophrenia. It is not known if LYBALVI is safe or effective in children. It’s important to note that LYBALVI may cause serious side effects, including increased risk of death in elderly people with dementia-related psychosis. LYBALVI increases the risk of death in elderly people who have lost touch with reality (psychosis) due to confusion and memory loss (dementia). LYBALVI is not approved for the treatment of people with dementia-related psychosis. Please read additional Important Safety Information below.

Charlotte: Since starting LYBALVI, I’ve noticed improvement in my bipolar 1 symptoms and I have been able to manage the side effects. Working collaboratively with Dr. Price helped me get to this point of finding a plan that works for me. However, this is just my experience, so it’s important to talk with your healthcare provider about what may work for you.

It’s important for me to stay consistent in managing my condition. I take my medication as prescribed, meet regularly with my doctor, and stay on top of the other things that keep me healthy, such as exercise, healthy eating, staying active with my music, and striving to stay hopeful and positive. I make an effort to remember why focusing on my health is important.

After hearing Charlotte and Kim’s story, we had an opportunity to speak to Charlotte’s mental health care provider, Richard Louis Price, MD, about the things he wants everyone to know about bipolar 1 after his years of diagnosing and treating the condition.

What are the signs that people should look for when questioning if their symptoms may be related to bipolar 1?

Dr. Price: There are certain signs of mania that are observed primarily in bipolar 1 and not in other mood disorders, such as remaining highly energized on little sleep without the influence of stimulants, or intense hypersexuality that seems out of character. In my experience, bipolar 1 is best observed over a longer period of time where you can document the up-and-down mood swings; these fluctuations are the primary characteristic of the condition.

Do these mood swings present themselves the same way in everyone with the disorder?

Dr. Price: No two people present with bipolar 1 in the same way—it’s a spectrum. For example, the mania component of bipolar 1 could lead to delusions and hallucinations, which could require hospitalization. Or, someone with bipolar 1 might remain highly functional while still existing in this unhealthy state. The mood episodes (“ups” or “downs”) that people with bipolar 1 experience can be chronic (persistent or constantly reoccurring) or episodic (occurring occasionally and at irregular intervals).

Getting the right diagnosis and helping patients find treatment that works for them is important because the results of getting it wrong can be damaging.

What is the role of the caregiver in the treatment process?

Dr. Price: I believe that many people in our society lead already stressful lives. Having a loved one who is living with bipolar 1 can add to that stress, unintentionally placing a burden on the person living with the condition, which could make things more difficult. To me, the role of caregivers in the treatment process is to create an environment where everyone understands that having bipolar 1 is not a personal failing. My hope is for families to understand that being more accepting, tolerant, loving, and understanding will help everyone involved.

If I‘m diagnosed with bipolar 1, won‘t medication change my personality?

Dr. Price: With medication, people may feel as though they’ve lost their ‘high’ (manic state), but what we need to remind everyone is that mania isn’t a healthy state, and that what they’re feeling now is a much more manageable state. One of the most exciting parts of my job is helping people figure out their treatment routine and helping them work towards their treatment goals, whatever those may be.

If you or a loved one is living with bipolar 1, talk to a healthcare professional. To learn more about LYBALVI, visit lybalvi.com.

Please read the Important Safety Information about LYBALVI below. See Prescribing Information and Medication Guide.

This is perspective from Charlotte, Kim, and Dr. Price and does not represent the opinions of all patients, caregivers, or healthcare professionals. The information included is not a substitute for professional medical advice. Always talk to your healthcare provider. Intended for US audiences only.