Mental Health Monday–Bipolar without the Mania

Writer and blogger, Donna Hole, asks:

(Paraphrased) My main character has Bipolar II Disorder. He’s never taken any regular meds, but does self medicate with meth. A period of time in the novel covers about 18 months where he neither uses or has an episode. Is this plausible?

First, a comment on diagnosis. Bipolar Disorder falls under the category of Mood Disorders in the DSM-IV (Diagnostic and Statistic Manual-IV) and refers to “highs” and “lows” of mood states. Someone suffering from Bipolar I Disorder has episodes of depression as well as episodes of mania (characterized by elevated or irritable mood, feelings of euphoria, distractibility, increased pleasure seeking behavior, decreased need for sleep, pressured speech, grandiosity, and flight of ideas/rapid changes of topic–these symptoms are taken to the extreme, by the way). Someone experiencing Bipolar II Disorder has depressive episodes, but not manic episodes. Instead, they have episodes of hypomania (characterized by the same symptoms above, but not as extreme…think of it as having elevated/irritable mood with decreased need for sleep, but still being able to function relatively well).

Methamphetamine use can cause symptoms similar to mania.

Mood disorders fluctuate naturally, so it is plausible that someone would be symptom free for several months. Drug use (if not to the point of abuse/dependence) can also fluctuate.

In one of his drug runs, he is convinced by his family to go to the family doctor (he has an intense distrust and dislike for them for himself). I’ve written the scene with him completely delusional, and the doctor tries to give him a shot of Haloperidol to calm him enough to get him into a treatment facility. He bolts of course, but I’m wondering if the medication would have accomplished it purpose or would have made the situation worse?

The simple answer, is yes, Haldol (haloperidol) is a medication given to someone experiencing psychosis (characterized by hallucinations and/or delusions).

The injectable form is generally given in emergency room settings or on an inpatient unit if someone is exhibiting symptoms/behaviors that could cause harm to the person or people around them. Emergency medication as described in the scenario above doesn’t generally occur in the primary care doctor’s office. If someone melts down, security, the police, or EMS would be called and the person would be taken to the ER if further evaluation is required.

The medication is designed to alleviate hallucinations and delusions and have a calming effect. They generally take effect within a couple days.

Remember, this information is for writing purposes only and is NOT to be construed as medical advice or treatment.

Keep your questions coming!

Be sure to check out Lydia’s and Sarah’s posts!



18 comments on “Mental Health Monday–Bipolar without the Mania

  1. Doris says:

    I hope Donna finishes her novel soon ’cause now I am anxious about reading it 🙂


  2. Ciara Knight says:

    Wow, great characterization, Donna. Can’t wait to read this. Another great post, Laura. Thanks.

  3. Vicki Tremper says:

    Thanks for the info, Laura!

  4. Great information here – and something I can use in my next manuscript, too. Win-Win!

  5. Lydia K says:

    Ooh, great post. I’ve wondered about this situation. I love your MHM’s!

  6. Donna Hole says:

    Excellent! Thanks Laura for helping me keep my character in character. Its a touchy subject for a lot of people and I want to be authentic.

    You’ve been a great help.


  7. Reading posts like this inspire me, and I start imagining situations and characters for future projects… 😀

  8. Talli Roland says:

    Wow – fantastic info! Thanks for the wealth of facts!

  9. My husband is Bi-Polar. He is not extreme. Once, the doctor put him on two meds that made him extreme though. That was very weird and I told him immediately to stop taking the new drug.

  10. Madeleine says:

    Ah I like that idea. One of my main characters has an interesting mental condition, but first he goes missing… :O)

  11. Saumya says:

    Hi, Laura! I found your awesome blog through Lydia’s and love your posts! I’m a medical student and writer so a lot of your information is relateable and valuable. Is there a way to become a follower? I was having trouble finding a link. Looking forward to more of your posts. Best of luck with your writing journey!

  12. Lynn Rush says:

    Nice stuff, here. Great information to create well-rounded characters. THANKS

  13. I love mental health mondays. As a writer and a psych major, they always brighten my day. It’s like “yay! psych lingo!” lol

    ❤ Gina Blechman

  14. Kendall Grey says:


    I’m a little late discovering your blog, but this is *so* cool! Now I know who to go to when I have a mental health-related question about a character. I signed up for updates, so I’ll be back to see what else you cook up on your blog. Yay!

  15. Many in my family suffer from Bipolar and are in and out of the hospital. This is interesting information both for writing and for personal information. Thank you.

  16. Donea Lee says:

    Fascinating! I’m sure this will really help Donna out ~ 🙂 New follower and fellow crusader here, just (finally) making the rounds. Happy Tuesday!

  17. I don’t know much about bipolar or meth. This was an interesting post.

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