There are so many myths and misconceptions surrounding bipolar disorder, most of us have heard of this mental health condition. However, not many have a true understanding.
Firstly, let us stress that bipolar disorder is NOT a rare condition. Indeed, according to the National Institute of Mental Health, Bipolar Disorder affects around 5.7 million Americans. That is to say, around 2.6% of the US population alone and around 60 million people worldwide according to the World Health Organization (WHO)
This post on bipolar disorder aims to dispel some of the fiction and take a close look at this serious, life-affecting condition.
What is Bipolar Disorder?
Bipolar Affective Disorder, used to be called manic-depressive disorder and is characterized by extreme variations in mood and behavior.
The disorder causes very clear shifts in mood, energy, thoughts, behavior and activity levels. The moods basically oscillate between the two extremes on the spectrum of mania and depression.
The manic episodes involve feelings of ‘elation’, delusions and ‘energized’ behaviors whereby the sufferer may well feel out of control. There is also a milder manic phase known as a hypomanic episode.
Interspersed with the manic episodes are depressive phases characterized by feeling sad, down and hopeless.
We all have our ups and downs, but with bipolar disorder, these peaks and troughs are way more severe.
The symptoms of bipolar disorder can seriously affect your job, school performance, your friendships/relationships and disrupt your daily life.
Since bipolar disorder gets a lot worse without treatment, it’s very important to understand the symptoms.
Bipolar depression has many of the features of unipolar depression, however medical studies now recognize that bipolar depression is a slightly different mental health condition.
Typically, the depressive phase of bipolar follows a manic phase and some antidepressant medications can actually worsen the condition.
A person suffering with depression does not experience the manic symptoms characteristic of bipolar disorder.
Different Types of Bipolar Disorder
Bipolar disorder can differ quite dramatically for each sufferer, as a result, the symptoms and unique patterns of the disease can vary dramatically too.
Furthermore, for some people the effects can be mild and they will only experience a few mood episodes over their lifetime, whilst for others the effects can be fairly constant and devastating.
There are 4 main categories of Bipolar Disorder:-
1) Bipolar i disorder: The first type of bipolar means that you usually will have experienced periods of severe mood swings on the spectrum of mania to depression. In order to be diagnosed with bipolar i disorder you must have experienced at least one manic episode that has lasted longer than a week.
2) Bipolar ii disorder: In the second type of bipolar disorder, there will be periods of mood elevation as well. However, these episodes are known as hypomania and are milder than full blown manic phases. These episodes are interspersed with symptoms of severe depression.
3) Cyclothymic Disorder: If the symptoms do not fit bipolar i or bipolar ii types than a diagnosis of cyclothymic disorder may be given. This type of bipolar disorder is typified by briefer periods of hypomania and depression over the course of 2 years.
4) Rapid Cycling is a term given when the occurrence of manic, hypomanic or depressive episodes happens at least four times over the course of a year. Often the changes in mood from high to very low can occur within a week or even a day. Furthermore, the pattern of rapid-cycling bipolar disorder increases the risk for severe depression and suicide.
Bipolar Disorder Treatment
If you suspect that you (or somebody you know) may have any symptom of bipolar disorder it is essential to consult a mental health professional as soon as possible.
Bipolar disorder will, unfortunately, get worse if it is not treated and can seriously affect your career, health and relationships.
In addition to this, bipolar disorder is often misdiagnosed as major depressive disorder. Indeed in one medical study, 40 % of patients suffering with mood disorders had bipolar disorder and were misdiagnosed for between 7.5 and 9.8 years and treated with antidepressants.
Obviously, this is not good because antidepressants can actually trigger rapid cycling in bipolar disorder.
The Basics of Bipolar Treatment
1. The main aim in the treatment of bipolar disorder is to try and recognise and reduce the number of manic and depressive episodes.
2. It is essential to find a psychiatrist who both specialises in, and understands bipolar disorder. Bipolar disorder is a complex disease and, as mentioned above, diagnosis can be very complicated and treatment is often challenging. For safety reasons, medication should be carefully monitored. A psychiatrist who is experienced in bipolar treatment can guide a sufferer around some of the twists and turns.
3. There is more to treatment than medication. Medications alone are sometimes not enough to fully combat the symptoms of bipolar disorder. The most productive treatment plan for bipolar involves a mixture of medication, therapy, lifestyle changes, and social support.
4. Bipolar requires long-term treatment. Since bipolar is a chronic, relapsing illness, it is very important to continue treatment even when you’re feeling better. Most people with this disorder need medication to prevent new episodes and stay symptom-free.
Talking Therapies for Bipolar Disorder
Although getting the medications right is an important part of treatment for bipolar disorder, talk therapy can also help immensely.
Therapy can help with all aspects of life. Several psychotherapies have been shown to be useful for bipolar disorder.
Behavioral Therapy: As the name suggests, this type of therapy focuses on changing behaviors. Bipolar disorder sufferers can learn to check their behavior and particularly develops some anti-stress techniques.
Cognitive-behavioral therapy cbt involves looking at the way we think (cognitive) and feel with an end result of changing behaviors. Cognitive behavioral therapy can be useful in trying to identify the thought patterns and feelings that are associated with mood swings.
Family-focused therapy: This therapy can be useful in addressing some of the relationship difficulties that the symptoms of bipolar disorder can cause. This therapy can also help family member learn how to deal with a loved one with bipolar disorder and not exacerbate the symptoms.
Bipolar Disorder Causes and Triggers
Bipolar disorder is a serious mental health disorder that does not have a single cause.
Some medical studies have shown that certain individuals are genetically predisposed to bipolar disorder. Although not everyone with an inherited vulnerability develops the illness, indicating that genes are not the only element.
Environmental factors also play a role including childhood trauma and stressful events.
Indeed, brain imaging studies show there are physical changes in the brains of people with bipolar. It is possible that bipolar may be related to the malfunction of neurotransmitters in the brain.
External Factors or ‘Triggers’
1. Medication – Some medications, particularly classic antidepressant supplements and drugs, can cause mania. Additional drugs that can trigger mania or hypomania, include caffeine, appetite suppressants, cold medicines, thyroid medication and corticosteroids.
2. Substance abuse – Many bipolar sufferers will use alcohol and drugs to try and self-medicate. These substances can trigger an episode and exacerbate the condition however. Drugs such as amphetamines, ecstasy, and cocaine, can produce mania, whereas alcohol and tranquilizers can trigger depression.
3. Stress – Stressful life events can also trigger an episode for bipolar sufferers. Finding methods of relaxation and coping with stress can be very beneficial in stabilising the condition.
4. Seasonal changes – Episodes frequently follow a seasonal pattern. Mania is more common during the summer, and major depression more common during the winter, spring and autumn.
5. Sleep deprivation – Lack of sleep, even as little as skipping a few hours, can trigger an episode of mania. It is, therefore, vital to establish regular, healthy sleep patterns.
Bipolar Disorder and Me: A Personal Tale
Speaking from experience, one of the greatest challenges when it comes to dealing with psychiatric disorders is a lack of awareness.
More often than not, people who have the condition are unaware of their mental health status, as are those around them.
This means that often sufferers do NOT get the help they need to lead a fully functional life.
This was exactly the case with my bipolar disorder before I got diagnosed and started therapy. I am sharing my story in the hopes that it will help you, or somebody that you care about, cope with this condition.
When Did I Start To Notice That Something Was Wrong?
Psychiatric conditions, particularly bipolar disorder are notoriously difficult to diagnose. The fact that the condition has periodic and very different manifestations makes it even harder to identify the problem.
This was very true in my case. I grew up happy and seemingly healthy with my fair share of good times, bad times and just-another-day times.
However, when I was in my early twenties, I started to have some pretty erratic mood swings.
One minute I was happy and having fun with my friends and the next I was crawled up in bed super stressed about nothing in particular.
At the time, I didn’t pay that much attention to the changes in mood as I assumed it was school-related stress.
I spent a great deal of time in bed feeling hopeless and very low. During these times I also lost all enthusiasm and drive for activities that I once found exciting including tennis, reading and socializing with friends.
Interspersed with these depressed periods I would suddenly become very hyperactive. Indeed many of my friends often used to joke that I had attention-deficit hyperactivity disorder.
I would feel elated, my thoughts would race and I would have endless ideas about all sorts of things. I couldn’t speak fast enough to express these feelings and had boundless energy.
These two extreme mood swings and many other symptoms I encountered are what drove me to seek professional help.
How Bipolar Disorder Affected My Relationships?
One of my least favorite things about bipolar mood disorder is the fact that if unchecked, it can ruin your life and relationships.
Before my diagnosis and therapy, I got into a lot of silly fights with people I cared about.
There were times when I was highly irritable and would find insignificant issues to argue about with everyone from friends and families to supervisors and even strangers.
The funny thing is that I was so passionate about whatever it is I chose to fight about. I offended a lot of people and lost a lot of friends during this time.
The extreme mood swings with the episodes of depression also contributed a lot to straining of the bonds I had formed with different people.
One of the reasons for this is the fact that my episodes made me come off as snobbish and anti-social when in fact I was in my own world of pain and suffering.
The depression also made me extra critical of my friends which led me to push people away. During a depressive phase, my own negative thoughts about myself and low self-esteem made it very difficult for me to reach out when I was in need.
Even more confusing to my friends and loved ones was the periodic manic phases whereby I could become quite grandiose and not let anybody get a word in. Often I would get really irritable too.
How Bipolar Disorder Affected my Life
My bipolar disorder also affected other aspects of my life including my education.
This is because I felt completely unmotivated and chronically fatigued.
This made getting through college an unnecessarily difficult task.
Finally, it affected my physical health. The fatigue and major depression resulted in loss of enthusiasm for physical activity. I also turned to stress eating and gained more than a couple of pounds.
The bottom line is that bipolar mood disorder seriously affected my life especially in terms of relationships and would have continued to cost me more if I had not sought help.
Diagnosis of Bipolar disorder
The first step was acknowledging the fact that I have a mood disorder and getting help.
This led to a diagnosis of bipolar disorder. Fortunately, my bipolar symptom started in early adulthood so the prognosis is slightly better than early-onset bipolar disorder.
What Helps Me Get By?
A mood-stabilizer medication (Lithium) was prescribed to keep the condition in check.
I also learnt as much as possible about my condition in behavioral therapy.
I try and keep my life as stress free as possible and avoid things that can trigger my manic episodes.
Recognising the early warning signs that I might be going into a manic phase or a major depression means that I can seek help before I enter a full-blown episode.
One of the most helpful strategies for me is the family-focused therapy.
This has helped me mend relationships that I broke and to develop new and healthy ones. The result is a steady support system that helps me cope with my condition.
In conclusion, if you or someone you know has bipolar, it is important to get help.
If there is something to learn from my story, it is that bipolar and other psychiatric disorders, can and will, ruin your relationships.
Early detection and treatment is therefore essential.
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- Geddes JR, Miklowitz DJ. (2013) Treatment of bipolar disorder. Lancet. 2013 May 11;381(9878):1672-82. (Retrieved November 7th 2016) https://www.ncbi.nlm.nih.gov/pubmed/23663953