This website, written by someone who has first hand experience with bipolar, will do its level best to give you an answer.
“When I was a kid, I woke up every morning and was scared. A great anxiety, and it was not something you could talk about. If I said something about it I was told: don’t be difficult. Pull yourself together.” ~ Paul
Statistically, the prevalence of mood disorders in general seems to be growing, but it is unclear whether there are actually more people battling these problems or if new awareness and research has led to a higher level of diagnosis.
Whatever the reason, there is no doubt that mental illness has a powerful affect on both the sufferer and his/her family and friends.
Mood Changes for Most of Us
For most of us, our moods have only a minimal affect on our lives.
If we wake up grumpy, it may result in a bad day or a couple of questioning glances and frustrated sighs from family members and coworkers.
But, a few miserable hours really doesn’t change the course of our lives or have a huge affect on our relationships.
Dealing with everyday issues can impact our emotions, leaving us feeling sad, happy, angry, worried, or excited; but, these are transient moods that may affect our “moments” but not our months and years. And, usually, we are aware of our attitudes and will admit that we are irritable or sensitive.
Often we are even able to give an explanation for our mood.
“Everyone knows about being stressed and sad, and then you say that you are depressed. Being sorry is part of life, being depressed is something else entirely”. ~ Paul
For people with bipolar disorder, however, it is a much different story.
Mood Changes when You Have Bipolar Disorder
Imagine having your mood swing wildly from one pole (positively excited or even euphoric) to the opposite (sad and depressed). That’s one effect of bipolar disorder – hence the name.
A particular mood (whether euphoric or depressed) may last for months or years and will “dominate their interaction with the world, and disrupt their normal functioning” often resulting in significant problems with “cognitive, motivational, behavioral, and somatic (body system) functioning” (Comer, Ronald J. Abnormal Psychology, 1992, page 295).
This is not a very funny way to live! Also, it is not very funny for the loved ones of the person who suffers from bipolar disorder.
What Is Bipolar Disorder – Trying to Find Answers
Humans are very complex beings – a combination of physical, spiritual, psychological, and emotional.
Despite extensive research, doctors have been unable to fully understand the interaction between each of these components and how they work together to create individuality.
Mood disorders are especially tricky, since it is difficult to pinpoint a cause, and the effectiveness of treatment varies from one person to the next.
Robert J. Comer, in his book Abnormal Psychology, states, “Because mood disorders are so prevalent in our society, because clinicians treat so many clients with these disorders, and because so much research has been conducted, it seems as though a great deal is known about the subject.
In truth, clinicians do have a lot of information about mood disorders, but they do not fully understand all that they know.”
How Many People Suffer from Bipolar Disorder?
According to the Royal College of Psychiatrists, about one in every one hundred, or 1% of adults worldwide, suffers from some type of bipolar disorder; although some recent surveys are suggesting that this figure could be as high as 2.4%.
Let’s say it is 2% If you know 50 people then you know someone who suffers from some kind of bipolar disorder.
The World Health Organization reports that bipolar disorder is the 5th leading cause of disability worldwide and the 9th leading cause of life years lost due to disability.
In fact, bipolar disorder is responsible for more disability-adjusted-life years than all forms of cancer and other major mental disorders including schizophrenia and Alzheimer’s.
It is important to note that since the requirements for a bipolar disorder diagnosis have changed over the years, it is difficult to get exact statistics on the disease because the criteria followed may vary from country to country.
But, no matter which numbers are used, it is clear that bipolar disorder is a major issue faced by virtually every society in the world, and gaining an understanding of the condition is an important first step to managing and minimizing the symptoms.
The Definition of Bipolar Disorder Has Changed Again and Again
The fact that the definition for Bipolar Disorder has undergone several revisions is proof that it is much more than an explanation in a textbook or a simple illness that responds to a proven round of treatment.
And, since there does not seem to be an obvious cause, treatments are still being researched, leaving many sufferer’s with no option but to experiment with a variety of solutions until they happen upon one that works.
“When I was 16 years it began to dawn on me that I had to do something, it was unbearable to have it that way. So I went down to the doctor who said I was going to a psychiatrist. Well,I did that. He asked me some questions, and there was a form I had to fill out with him.
So he said: yes, there is no doubt that you are manic-depressive.” ~ Paul
In other words: We know what’s wrong with you – we think – maybe – but we don’t know how to treat you. Nasty, eh? On the bright side this also means that sometimes unexpected things help to alleviate the problem.
“Then they wanted me to take these pills. I tried it for a while, but I didn’t believe it would work. I felt that I came into this strange world, that I was zombie-like, and I was far away. I took them a for a while, and then I stopped. And then I started to experiment. When I was depressed I tried to take some speed to see if I could get a little more energy, and that was really, really bad.” ~ Poul
So, What Is Bipolar Disorder – Exactly?
To answer that question right off, nobody knows – not exactly.
Bipolar disorder used to be known as Manic Depressive Disorder or Manic Depression. In fact, until 1980, this term included all those with depression or mania in any form.
Unfortunately, it was difficult to gather accurate data since studies did not focus solely on those with bipolar symptoms but also involved people suffering from depression only (as opposed to the combination of mania and depression).
As scientists gained new understanding, a revised definition was introduced.
It was stated that a person had to have experienced at least one episode of mania, lasting for a week or longer. Those who fit this description were diagnosed with bipolar disorder.
While this new definition eliminated patients battling depression without mania, it was still somewhat limited.
Consequently, the definition was revised several times, having the ‘one week’ minimum removed and then reinstated, and then introducing a distinction between “Bipolar I” and “Bipolar II”.
Today, these definitions themselves are also growing less and less popular.
If you look up the definition in the Diagnostic & Statistical Manual of Mental Disorders (DSM), you will find a long explanation that can be very helpful, but also very overwhelming. And, depending on which source you check, there can be a few discrepancies in the actual description of this illness.
Like I said earlier, bipolar disorder is a complex illness and understanding the various aspects can be confusing.
So, lets try to lay it out as simple as possible.
Bipolar Disorder is a serious mental illness characterized by mood swings called episodes. In classic form, it typically consists of three stages:
- “high” state of hyperactivity, energy, and excited behavior referred to as “Mania”.
- “low” state of depression.
- “well” state, or intervening periods of normality where individuals feel well and can function normally.
The term “bipolar” comes from the idea that mania and depression are opposite poles, between which a person will vacillate like a pendulum, often experiencing periods of normalcy in the “middle”. This explanation is simplistic, but it gives a clear picture of the basic process.
Unfortunately, most people do not fit a simple textbook definition. If they did, diagnosis and treatment might have been a whole lot easier than it actually is.
On the contrary, the more information scientists and doctors learn, the more complicated the definition of the disorder has become. As a result, several types and sub categories have been identified.
The Royal College of Psychiatrists defines four basic types of bipolar disorder:
- Bipolar I: With this type, people tend to have serious manic episodes, sometimes lasting up to six months. Individuals may also experience depressive episodes although it is not a requirement for a bipolar I diagnosis.
- Bipolar II: Individuals experience episodes of depression as well as milder manic episodes referred to as “hypomania”. To receive a bipolar II diagnosis, a person must have experienced at least one episode of major depression as well as at least one hypomanic episode.
- Rapid Cycling Bipolar Disorder: In about 20% of bipolar cases, individuals will have four or more episodes in a 12 month period, with very short non-symptomatic phases. This is referred to as Rapid Cycling. The term Ultra-rapid Cycling is applied to those patients who cycle through the episodes in one month or less.
- Cyclothymia: This is basically a milder form of bipolar disorder. Individuals experience less severe depressive episodes and milder manic episodes or hypomania.
Although the mood swings are not as severe, they tend to last longer, often continuing for two or more years, with occasional periods of normal moods. In some cases, cyclothymia can develop into a full disorder.
Bipolar emotional states are usually distinct periods of either mania or depression; however, sometimes episodes include symptoms of both.
This “sub category” is called a Mixed State, and is perhaps one of the most difficult aspects of this disorder to comprehend.
How can someone be happy and depressed at the same time?
Again, there is much about mental illness that we do not understand, but those with mixed bipolar symptoms can enjoy genuine laughter one moment and then burst into tears the next.
Bipolar disorder usually appears between the ages of 15-35 and most often begins with a manic episode. In most untreated cases, episodes can last for several months with intervening stable periods also lasting several months or years (Weismann & Boyd, 1984), except in cases of rapid cycling where normal periods can be short or even absent.
The average person with bipolar disorder experiences about 10 episodes of depression and mania/hypomania or mixed states in their lifetime, although these figures could vary depending on age of onset. For those with rapid cycling bipolar disorder, the numbers would be significantly higher.
Typically, if left untreated, manic states last 2-3 months and depressive states last 4-6 months, with many studies showing that the episodes tend to come closer together as an individual ages.
As you can see, this illness is far more complex than simply alternating between moods, but is actually a condition that affects every aspect of the sufferer’s life.
It can control their thoughts, feelings, perceptions, and actions. It changes the way they feel physically and causes social, financial, and relational problems.
Moods are not determined by life events and seem to have no connection to external happenings, so it is often frustrating to family and friends who want to find an explanation for certain behaviors.
To narrow the definition of bipolar disorder down to a single sentence is like trying to summarize a Shakespeare play using 10 words or less. It is possible, but it certainly wouldn’t be comprehensive.
Perhaps Torrey and Knable, in their book Surviving Manic Depression, outline it the best. They state that bipolar disorder is “a mood disorder that includes at least on episode of mania or at least one period of severe depression plus one period of mild mania (hypomania or bipolar II) or severe mania (bipolar I). The period of severe depression or mania may or may not be accompanied by symptoms of psychosis, such as delusions and hallucinations, in addition to the mood symptoms.”
However, as previously mentioned, with so many subtypes and criteria, it is difficult to create a model that would define the typical bipolar sufferer.
If you think that you, or someone you know, may have bipolar disorder, you can get a clearer picture by looking at the range of symptoms that are often associated with this illness.
What Are The Signs Of Bipolar Disorder?
Bipolar disorder is often difficult to recognize when it first appears. Since episodes are often separated by long periods of normalcy they can be mistakenly viewed as separate problems rather than symptoms of a single illness.
It may take several cycles before a pattern is recognized and treatment is sought.
But, no matter what type of the disorder or duration of the episodes an individual experiences, it is almost always accompanied by impaired functioning at work, school, or in social settings.
Sometimes symptoms may become so severe, often including delusions and hallucinations, that hospitalization is required.
Symptoms of Manic Episodes:
Manic episodes are defined by extremely elevated, expansive, and irritable moods.
Individuals will often be elated, energetic, or hyperactive to the point of exhaustion and frequently engage in impulsive and irresponsible behavior.
The most recent edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) states that in addition to the elevated or irritable mood, at least 3 of the following symptoms must be present for a bipolar disorder diagnosis.
If an individual is irritable only, exhibiting no elation or expansive moods, then four of these symptoms must be present for a diagnosis.
- Inflated self-esteem and grandiosity. Many bipolar individuals will experience feelings of grandiosity, exaggerating their importance, believing themselves to be invincible, or claiming accomplishments that are far greater than reality. For example, someone may claim to be the foremost expert in their field when, in fact, they hold an entry level position.
Individuals will also believe that they are exceptionally talented or gifted, or may even think that they are a celebrity, king, or political leader. In some cases, they may have intense spiritual experiences, report unique spiritual connections, or believe that they are an important religious figure.
Actress Patty Duke, diagnosed with bipolar disorder in 1982, recounts an experience when she believed voices were speaking directly to her through the radio of her car. “The voice told me someone was taking over the White House and that I could be of assistance in the matter. I had to get toWashington! I was on a mission!”
Those with bipolar disorder can exhibit a wide range of symptoms from inflated self-esteem to intense grandiose delusions.
- Decreased need for sleep: Individuals will seem to be “running on adrenaline”, going long periods of time without sleep or feeling rested after only a few hours of sleep.
- Accelerated thoughts and speech: Individuals with bipolar disorder will often comment about having racing thoughts, or having so many ideas in their head that they have a difficult time keeping their thoughts organized.
In an attempt to verbalize all these ideas, the “busyness” usually results in rapid speech referred to as “flight of thoughts.” Individuals will talk excessively, jump from topic to topic with no apparent connection, and will say what they are thinking without restraint or consideration of consequences.
- Distractibility: This is characterized by an inability to concentrate or remain focused on a single task without attention becoming drawn away by irrelevant external stimuli or internal feelings and emotions.
For example, an individual may begin a second task while leaving a first one unfinished, or look extremely busy while accomplishing very little.
Small things can be a large distraction, causing an inability to complete sentences, finish projects at work or school, or take care of children and family.
- Increased activity: During a manic episode, individuals will feel restless and energetic, driving them to work ceaselessly with little sleep.
While there is a high level of distractibility, it is also a period of great productivity when much is accomplished, although the approach to goal achievement is sometimes confusing and disorganized to those around them.
This increased goal-oriented activity is thought to be a result of the euphoric mood combined with accelerated or abundant thoughts and grandiose perceptions.
- Involvement in excessive or high risk activities: In a manic period, those with bipolar disorder will often exhibit a lack of restraint and engage in behavior that has a high potential for unpleasant consequences.
It is not unusual for them to go on lavish spending sprees, spending thousands of dollars, emptying bank accounts, and charging credit cards to the limit.
Hypersexuality is also a symptom, leading to impulsive sexual activity or infidelity.
Excessive spending, sexual risks, and other irresponsible behavior can lead to damaged relationships, job loss, or bankruptcy.
The mania period can last for several weeks or months, but at some point, the pendulum will begin to swing the opposite way.
Those with bipolar I may return to period of normalcy, but for many bipolar individuals, periods of wellness are often followed by a depressive episode.
It is important to understand that the mood swings are not always quick or dramatic. In fact, since the manic periods can be very productive, many patients, as well as their families and friends, believe that all is fine.
But, if mania is left untreated it can become very dangerous, leading to risky or excessive behaviour.
The depressive episodes often follow a similar pattern. Individuals will feel tired, old, or sad, but the beginning stages may not initially be a cause for concern unless you recognize the pattern.
Early symptoms can be subtle and easy to overlook.
William Styron, in his book Darkness Visible, speaks of his struggle with depression: “It was not really alarming at first, since the change was subtle, but I did notice that my surroundings took on a different tone at certain times: the shadows of nightfall seemed more somber, my mornings were less buoyant, walks in the woods became less zestful.”
However, these subtle symptoms can evolve into something very dark and dangerous.
Scientist Lewis Wolpert states, “That’s the thing I want to make clear about depression: it’s got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal – unpleasant but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest ( Wolpert, Malignant Sadness, page 129).
Wolpert describes the depressive aspect of bipolar disorder quite well, but when working toward a diagnosis, the DSM-IV states that at least 5 of the following symptoms must be present for a minimum of two weeks, and one of the symptoms must be either #1 or #2.
It is important to note that all these symptoms must be exhibited everyday, or nearly everyday, to be considered significant.
In other words, insomnia experienced once a week is not a strong indicator of bipolar disorder, but an inability to sleep nearly everyday is cause for concern when accompanied by several additional symptoms.
- Depressed mood most of the day.
- A loss of interest in activities, particularly ones that the individual would typically enjoy or find pleasurable.
- Insomnia or hypersomnia – an inability to sleep or excessive sleeping.
- Significant weight loss (not caused by intentional dieting) or weight gain, or a concerning increase or decrease in appetite.
- Psychomotor retardation or agitation. According to the Mirriam-Webster dictionary, psychomotor is “motor action proceeding from mental activity.” In other words, how your mind affects your physical actions. Psychomotor retardation is characterized by slowed thoughts accompanied by slow movements and speech, and impaired skill levels. Those showing psychomotor agitation may exhibit symptoms such as twitching, pacing, or fidgeting.
- Fatigue or loss of energy.
- Feelings of worthlessness and unjustified guilt. Poet Emily Dickenson, thought to have suffered from bipolar disorder, described this aspect of depression when she wrote, “I’m nobody. Who are you? Are you nobody, too? Then there’s a pair of us – don’t tell!”
- Indecisiveness or an inability to think or concentrate.
- Recurrent or frequent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.
As previously mentioned, most bipolar disorders begin with a manic episode.
So, if these depressive symptoms appear in someone who has already experienced a period that may be considered mania, it may be a good idea to seek professional council.
Also, people who have bipolar disorder are at a much higher risk of suffering substance abuse, and the number of suicides is 60 times higher among those with bipolar disorder than that of the general population.
As you can see, the symptoms of bipolar disorder cover a wide spectrum and can have a great impact on an individual’s life, as well as the lives of their family and friends. Famed poet, Edgar Allen Poe wrote:
“I am excessively slothful and wonderfully industrious – by fits. There are epochs when any kind of mental exercise is torture, and when nothing yields me pleasure but the solitary communion with the “mountains and the woods” – the “altars” of Byron. I have thus rambled and dreamed away whole months, and awake, at last, to a sort of mania for composition. Then I scribble all day, and read all night, so long as the disease endures.”
How is Bipolar Disorder Diagnosed?
Since the symptoms of bipolar disorder vary for each person, it is very difficult to diagnose.
In fact, it is one of the most frequently misdiagnosed illnesses and it is estimated that only about half of those suffering from bipolar disorder are diagnosed correctly.
Research has shown that the younger an individual is when the symptoms first appear, the less typical or classic they are, causing the disease to often be mistaken for stress or teenage rebellion in adolescents.
For many people between the ages of 15-21, the struggle to find proper treatment continues until they reach adulthood.
If you suspect that you, or someone you know, may have bipolar disorder, the first step is to visit your doctor to begin the diagnostic procedure.
Since the illness cannot be diagnosed with a blood test, x-ray, or brain scan, most doctors will begin by gathering information about your medical, family, and mental health history.
- Medical history and physical examination. This will usually include lab tests and blood work to evaluate the individual’s overall health and to eliminate the possibility of any medical condition that could have the same symptoms as bipolar disorder, such as thyroid issues or brain tumors.
- Psychiatric history and examination. A psychiatric exam is necessary to rule out the possibility of other mental disorders or issues that may lead to similar symptoms such as anxiety or behavioral disorders, substance abuse, hallucinations or delusions, or compulsive disorders. Several symptoms of bipolar disorder also occur in other mental illnesses, so a screening process is necessary to determine an accurate diagnosis. This exam will also help mental health professionals document previous mood swings and identify the existence of depressive or manic episodes.
- Family history. Several studies have shown that many mental disorders have genetic connections or appear to run in families. Although these conclusions are still controversial, most doctors will want to understand family histories and the existence of mental illness before making a final diagnosis.
- Evaluation of symptoms. Doctors will look at current symptoms being experienced to determine if they fit any mental illness, particularly the depressive or manic episodes indicative of bipolar disorder.
If no physical cause for symptoms is identified, if no other mental illness seems present, and if current symptoms fit the criteria, then an individual may be diagnosed with bipolar disorder.
According to the DSM-IV, those who experience a manic episode are expected to eventually experience a depressive period and, therefore, receive a diagnosis of bipolar disorder.
This may later be specified as bipolar I, bipolar II, or cyclomania as the patient moves through more cycles and additional information is gained.
Those who experience rapidly alternating episodes (between manic and depressive) are diagnosed as bipolar disorder, mixed or rapid cycling.
What Causes Bipolar Disorder Mood Disorder?
Despite extensive research, scientists and medical professionals are still uncertain about what causes bipolar disorder.
New studies have shown support for several possible causes, but much of the theories that exist today are based on the success of treatment and family history records.
For example, positive results have been achieved when norepinephrine levels are adjusted, thereby leading many to believe that chemical imbalances may play a role in the onset of the illness.
Basically, two areas have been focused on: genetics, and hormonal or brain chemical activity.
Some studies have also included environmental factors such as stress, and medical issues like infectious agents, with some interesting information being discovered.
The idea that bipolar disorder is caused by chemical imbalances has been supported by the Catecholamine Theory.
Basically, the brain’s chemical functions are governed by little messengers called neurotransmitters. Neurotransmitters are chemical substances that transmit information from one nerve cell to the next and affect everything from mood and appetite to attention, sleep, and learning processes.
Many scientists believe that depression is caused from a deficiency in the neurotransmitter epinephrine, also known as adrenaline.
In fact, several studies have shown that not only does low epinephrine supply lead to depression, but an excessive supply will cause mania. One particular study found that manic patients had a significantly higher level of epinephrine and norepinephrine than those of depressed or control subjects.
When bipolar patients were given Resperpine, a drug known to reduce epinephrine and norepinephrine supply, many showed a lessening of manic symptoms (Telner, Lapierre, Horn, Browne, 1986).
Research has also shown that a low level of serotonin, another neurotransmitter, is also linked to both mania and depression.
Oddly enough, both “poles” of the disorder seem to be impacted by a lack of serotonin, which is a mysterious finding considering the opposite symptoms that are manifested.
Studies focusing on chemical imbalances in the body have shown strong support for a link between the levels of certain neurotransmitters and bipolar disorder.
Although further investigation is still necessary, there seems to be promising evidence to indicate a biological cause to the illness since many patients, when give medications designed to help correct imbalances, have experienced significant improvement in symptoms.
Many researchers also believe that there is a genetic connection that may predispose an individual to bipolar disorder.
One field of study suggests that an individual does not necessarily inherit the disorder, but that the genes involved are somehow ‘altered’ at conception.
Some scientists say that these genetic changes can result in the production of faulty proteins within the brain cells, thereby leading to bipolar disorder.
The idea is that it is not passed down from generation to generation, but that it does have a genetic basis. In other words, no one in your family may have ever had a mental illness, but if something goes wrong genetically at conception, you could be at risk for developing the disease.
While this group of professionals believes that there is a genetic, but no familial connection, there is another area of study that shows strong support for the idea that bipolar disorder does, in fact, run in families.
They argue that even if the disease is caused by genetic factors, an individual can actually inherit the predisposition to biological abnormalities that lead to bipolar disorder.
And, in looking at evidence, it is difficult to deny the fact that mental illness often seems to carry through the generations, showing that there may be some support for a familial link.
In fact, statistics show that close relatives of people with bipolar disorder have a 4-20% likelihood of developing the disease, as compared to a less than 1% chance among those in the general population (Fieve et al., 1984; Dunner et al., 1980).
However, many other studies have produced conflicting or inconclusive information regarding a link between bipolar disorder and inherited factors.
So, while we know that there is definitely a genetic connection, we are uncertain whether genes are actually a cause, or if an individual’s genetic make-up predisposes them to something else that may be the cause. In other words, are genes to blame or are they simply risk factors rather than causes?
Many people also argue that just because a disease runs in a family doesn’t necessarily mean it has a genetic basis. For example, members of the same family are often exposed to similar non-genetic factors such as diet, toxins, infections, and lifestyle habits including smoking, drug use, or stress management skills.
Lets say that you smoke, and your father smoked, and your grandfather also smoked, and you all have battled lung cancer at some point in your lives. Is it fair to say that lung cancer runs in the family, or is it the smoking habit that actually runs in the family?
You may have a genetic predisposition to lung cancer (since some smoke for years and never develop the disease) but are your genes actually to blame? If you didn’t smoke, your genetic ‘risk factor’ would not be an issue because you would not be causing the damage necessary for cancer cells to thrive and grow.
The argument is similar with many mood disorders.
A genetic predisposition does not guarantee that you will develop the disease. In fact, many can go their entire lives with no episodes at all while others, because of their lifestyles, will experience symptoms.
While this is still controversial, both sides of the genetic debate seem to have strong evidence to support their theories, proving once again, how complex bipolar disorder can be.
There has also been some suggestion that stress, difficult relationships, or a traumatic childhood experience can lead to bipoar disorder, but the evidence for this idea is thin at best.
In fact, any minimal evidence seemed to show that only a small percentage of people relapsed due to stressful factors, and even then, the stress had to be very severe.
There is a difference, however, between causes and “triggers”. While stress, lack of sleep, steroid medications for conditions such as asthma or arthritis, or drug use may ‘trigger’ episodes in people who have already experienced bipolar symptoms, they themselves are not a ’cause’.
Episodes are not always triggered by something specific, in fact they may have no explainable reason at all, but sometimes depression or mania may be brought on by a particular event.
Recently, a new promising field of study has been developing.
Since scientists already know that thyroid abnormalities can mimic bipolar disorder, this prompted them to begin investigating a link between mental illness and infectious agents.
The immune system is very complex, and research has shown that it interacts with the brain and affects behavior.
Although this area requires much more extensive research, it does offer some hope to those suffering with bipolar disorder.
If a connection can be made between mental illness and infectious agents or immune factors, then it is possible that the condition can be treated with medications that will boost immunity or fight infection.
Treatment For Bipolar Disorder:
Treatment can vary from person to person, and doctors will often experiment with options to discover what works most effectively for each individual.
Ultimately, the goal of any treatment program is to address two main aspects of bipolar disorder: relieving existing symptoms, and preventing recurrences.
This is accomplished with medications, psychosocial therapies, and in some cases, specialized treatments such as ECT or alternative medicines.
Basically, bipolar meds fall into two main categories: mood stabilizers and those used to treat specific symptoms (adjunct medications).
The goal of mood stabilizers is to help minimize mood swings and to prevent new manic or depressive episodes from occurring. Perhaps the most well-known and effective mood stabilizers is the drug lithium. This drug has been used for over 50 years and has been one of the most successful bipolar treatments, often helping to correct both the manic and depressive phases of the illness.
In one study, only 36% of 212 bipolar patients experienced relapses while taking lithium as compared to the 79% relapse rate among a group of 68 patients who were administered placebos (Davis, 1976).
These findings show that lithium not only relieves symptoms, but may actually prevent them from developing, leading some doctors to believe that treatment should continue on a long-term basis, even after the current episode has passed.
Adjunct medications are used to treat specific symptoms such as sleep disruption, depression, anxiety, or psychosis.
Drugs thought to be effective in treating manic episodes are usually from a group of medications known as neuroleptics, also referred to as antipsychotics. These drugs work quickly but often have side effects.
Antidepressants will frequently be prescribed to treat depressive episodes.
These work by adjusting the levels of neurotransmitters such as dopamine, seratonin, and epinephrine.
The use of antidepressants among bipolar patients must be monitored carefully because they can actually throw neurotransmitter levels in the opposite direction, causing a switch into mania or rapid cycling bipolar disorder.
Like neuroleptics, these drugs should only be used on a short term basis to correct immediate symptoms, then mood stabilizers will be prescribed for long-term maintenance.
Electroconvulsive Therapy (ECT):
Electroconvulsive therapy has been a very controversial treatment over the years, and most criticism comes from the depiction of this procedure in the popular media.
Many doctors believe that it is safe and very effective in treating both the manic and depressive phases of the disorder, and it is occasionally used to prevent recurrences even after episodes have subsided.
This procedure involves administering a brief electrical stimulus to the surface of the brain causing a convulsion similar to an epileptic seizure lasting 15 seconds to 2 minutes.
This treatment has been used since 1938, and studies have shown that it does not cause brain damage.
In fact, it is not nearly as dangerous as people think, and for many it is regarded as a miracle treatment because it works so effectively when other medications and interventions have failed.
This is also known as `talk therapy` and is done under the care of a qualified therapist.
Although medications can alleviate the symptoms, those suffering with bipolar disorder often deal with social and psychological issues that must be addressed.
It has been found that by expressing feelings and gaining an understanding of the underlying, psychological processes that may be taking place within the patient, individuals are better equipped to adapt and cope.
For the bipolar individual, awareness is a big problem. Usually, they do not realize that they are ill and will often explain away their symptoms.
“Clinically, awareness of one’s illness is of crucial importance: people with manic depression who believe there is nothing wrong will not seek psychiatric care or accept it if it is offered. Awareness of illness is therefore one of the most significant determinants of long-term prognosis” (Torrey & Knable, Surviving Manic Depression, 2002).
Many bipolar patients know very little about the illness so they need to be taught how to treat it, how to manage it, and how to recognize or prevent the onset of future episodes.
Furthermore, a large percentage will stop taking their meds once they start to feel better, so the importance of drug compliance needs to be taught and enforced.
Symptoms can be reduced fairly quickly but treatment must continue in order to ensure long-term success.
Cognitive Behavior Therapy:
Psychotherapy is based on the idea that an individual’s unconscious thoughts and beliefs are the most important factor in their behavior and actions.
Cognitive therapy, on the other hand, believes that it is a person’s conscious thoughts that determines self-perception, world perception, and outward behaviors.
Therefore, if thought patterns can be changed, then perceptions can also be changed, leading to a different set of behaviors and actions.
Family members are one of the most important aspects of a bipolar individual’s support network so it is vital that they are educated about the illness.
“Bipolar patients who return to critical and overinvolved families are more likely to relapse within nine months than bipolar patients who live in a more supportive and less intrusive family atmosphere” (Miklowitz et al.,1988).
Social Rhythm Therapy:
This a fairly new field of therapy, but results have been promising.
Basically, it works to stabilize sleep/wake cycles and to eliminate sleep disturbances that are often associated with bipolar disorder.
So, what is bipolar disorder?
It is a complex mental illness that affects each individual differently.
Since symptoms vary, diagnosis can be difficult and effective treatment can be hard to find. But, by understanding the basic criteria, you can learn to recognize the problem, which is the first step to recovery.
If you are concerned that you, or someone you know, may have this disorder, seek medical or psychiatric attention immediately.
It is important to note that symptoms will usually continue to accelerate without treatment, and even with treatment, you may still experience some episodes, resulting in a possible change or increase of your current medication.
This is why it is necessary to recognize mood changes and contact your doctor if you notice any signs of either depressive or manic onset.
The good news is that bipolar disorder is manageable, and with proper treatment, most people can live a happy, productive life.
“I took all sorts of stimulants, and it was as if my mania ran completely off the rails. It made me feel OK, but the slump afterwards was extremely violent.
Then I was lucky to have a good friend who spend a lot of time with me. We went for walks, went fishing, did a lot of common things together. That somehow brought me back to life.
Today, I can live with my bipolar disorder, and it has given me a greater self-knowledge. I have worked extensively with meditation and it helps me a lot.” ~ Paul
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