Q:  Questions re: Blackouts

My name is Justine and I was diagnosed with bipolar and anxiety disorder 8 years ago and was medicated for depression 2 years prior to that diagnoses. although I must be a pro by now I have a question about "blackouts". all the articles I've read about bipolar blackouts its usually in a fit of rage, but mine are very real and very driffrent. when I have what I call a bipolar "episode" which either happens if I forget to take my meds or if I'm building an immunity to them my blackouts can last hours, days, or like when I was younger and not properly medicated weeks, months, or years. I'm not going to say that I don't get enraged sometimes but most of the time I'm not.

I cant remember half of my life, do to these blackouts. we know that something is wrong when I cant remember what I did that day and only know I did do something because there is evidence that I did. I also get upset easier, and overreact, so the two put together and I figure out that something is wrong and I need to call my doctor. why do I have these types of blackouts? Are these so called "normal" for someone with bipolar disorder? Why do I get them? It's bad enough that I have to live with these horrible diseases that have affected my life so terribly that I cant even work. it would be good to learn at least one thing answered for me so I might understand my disease a little better. Thank you please write back.

Justine
 

Dear Justine -- 
A doc' couldn't be sure just what's going on without a lot more information than we could expect you to be able to provide here, but there are couple of explanations you might want to learn more about, and perhaps eventually (when you know more, so can see for yourself whether these ideas make sense for you or not) ask your doctor about. 

The word "blackout" is very strong. Your story here makes it pretty clear that you really do mean that somehow, you're not "there": you don't have a memory for what was going on, and you discover later that you were doing something (by finding evidence of your action; for many people, this can be something they bought, or something someone says that they said or did). I can't tell if you mean you "see things go black"; it sounds more like you mean there's just a big chunk of time that you don't remember. Here are two common ways that people can miss a chunk of time. 

First, you could be having a type of seizure that doesn't make you fall down and shake (those are called "grand mal" or generalized seizures), but rather one that makes you unaware of what's going on (a common version of this type is called "petit mal" or partial complex seizure). If someone who knows you reports that during one of these times you were doing some odd, sort of automatic behavior like smacking your lips, over and over, that is a clue which can suggest that you might be having this kind of seizure. Learn about partial complex seizures and then, if that seems to fit, ask your doctor about investigating that possible explanation. 

Second, you could be having "fugue states", or what is now called "dissociation". When this is dramatic, people can lose a huge chunk of time, certainly at least many days (months or a year, that would be much more unusual). They find things they bought, like dresses in their closet, but can't remember buying; or they can meet a person who seems to know them, obviously you've met before, yet the person looks like a perfect stranger to you.  Learn about "fugue states" or "dissociation" and see if that fits your experience.  When this kind of experience is repeated over and over, we might say the person has "dissociative disorder", so that's another term to search to learn more. 

As you can see, if I'm interpreting your description of this experience correctly (really "not there"), then we might not be talking about "bipolar disorder" here. Such an experience as this is not commonly recognized as part of bipolar disorder.  Of course, you could have bipolar disorder and one of the conditions I've described above. That might sound like really bad luck, to get two different mental conditions; one would be bad enough. Statistically it might seem very unlikely to be unlucky enough to get two. But these conditions are actually related, somewhat, to one another, so it's not that unusual to have dissociation and bipolar disorder; or bipolar symptoms and partial complex seizures.  I hope your doctor can help you evaluate these possibilities after you've learned more about them. 

Dr. Phelps

Published March, 2006