What is Bipolar Disorder?
We all experience regular ups and downs in our mood, but Bipolar Disorder (previously known as Manic Depression) presents more intense shifts in mood that can affect your functioning in relationships, at work and in general. Bipolar disorder is certainly treatable, but the difficulty is that most people don’t recognise the symptoms and the condition tends to worsen without treatment. As such it is important to recognise the signs and get help as soon as is possible.
Recognising Bipolar Disorder
The most common presentation of Bipolar disorder is a ‘swinging’ from a significantly low mood to a significantly ‘high’ mood. These mood episodes can last as short as a few hours to as long as days, weeks or months. The disorder results in distortions, not only in mood, but also in energy levels, thinking and behaviour.
Manic highs are normally coupled with sleeplessness, restlessness, racing thoughts, impulsive and sometimes destructive behaviours. On the other hand, the depressive episodes will include very low energy, tearfulness, self-loathing, hopelessness and often suicide attempts.
Bipolar disorder is most likely to show during adolescence or early adulthood. The first episodes of mania or depression are often subtle and can be confusing, which results in people being misdiagnosed and misunderstood. For example, substance abuse and reckless behaviour are often seen during manic episodes. When this happens with a teenager, it is easy to mistake this for defiant behaviour.
There are four main mood episodes:
- Severe Mania
- Moderate depression
- Severe depression
Mania is characterised by:
- Feeling in a particularly good mood and optimistic OR extremely irritable
- Having unrealistic, grandiose beliefs about one’s abilities or power
- Sleeping very little, but feeling extremely energetic
- Talking so rapidly that others can’t keep up
- Racing thoughts and jumping quickly from one idea to the next
- Difficulty in concentrating
- Impaired judgment and impulsiveness
- Acting recklessly without thinking about the consequences
- Delusions and hallucinations (in severe cases)
A hypomanic episode is similar to the above but far less intense.
Bipolar depression is characterised by:
- Hopelessness, sadness and an empty feeling
- Inability to experience pleasure or excitement in things that used to be pleasurable
- Fatigue or loss of energy
- Physical and mental sluggishness
- Appetite or weight changes
- Sleep problems
- Concentration and memory problems
- Feelings of worthlessness or guilt
- Thoughts of death or suicide
Bipolar disorder can present in a variety of different ways. In some cases the episodes of mania and depression are clearly distinct, while in other cases a ‘mixed episode’ is experienced. This means that the depressed episode is coupled with feelings of agitation, irritability, restlessness, insomnia and distractibility and racing thoughts.
- Bipolar I disorder – there is both a manic and depressed presentation and could be mixed episode.
- Bipolar II disorder – when a hypomanic episode and depressed episode are experiences, and could also be mixed episode.
If Bipolar disorder is suspected, it is best to seek help as soon as possible. As stated, Bipolar disorder tends to worsen over time so it is essential to seek treatment and assistance as early as possible. Treatment will include psycho-pharmaceutical intervention with a mood stabiliser and, possibly, an anti-depressant. As each person reacts differently to the medication and there is an array of treatment available for Bipolar disorder, it is important that you consult with a psychiatrist that can assist and guide you with your medication.
Many patients benefit tremendously from psychotherapeutic assistance as well. Psycho-education around the illness and ways in which to manage moods and episodes form an integral part of the therapy. Effective coping strategies are also taught and, often, family therapy is indicated if there has been a negative impact on family or relationship functioning.
Although it is imperative that you seek treatment if you suspect you, or a loved one is dealing with Bipolar disorder, there are also a few things that you can do to help you cope with condition better.
- Get involved with your treatment. There are many medications available to bipolar patients and each person may react differently. Being an active participant in your treatment means educating yourself around the medication that you are taking, noting side effects, improvement and any other factors that could be beneficial information for your doctors. Take your medication as directed and following the treatment programme provided by your therapist.
Many bipolar patients begin to feel remarkably better after starting medication and then feel they can do things alone and don’t need treatment. Staying actively involved in your treatment programme will ensure that you have less chance of relapsing and more chance of managing the condition and improving your quality of life.
2. Take note of your moods and any triggers. It is very beneficial to keep a mood diary where you can monitor any fluctuations in moods over a period of days, weeks and months. You may begin to notice a pattern emerging, and you may even be able to identify particular triggers to manic or depressive episodes. This information is vital in an effective treatment plan and successful management of bipolar disorder.
3. Develop a healthy lifestyle. Make sure that you are eating regular meals that are healthy and low GI. Skipping meals, eating sugary foods and consuming stimulants like caffeine will only affect your moods unnecessarily. It is also important that you get regular sleep and that your sleep routine stays the same over a period of time.
In this sense, avoid going to bed very late and sleeping in some days while trying to awaken early on others. Get regular exercise and fresh air. Make sure you have access to a supportive person who can assist you when you need extra support to cope.
4. Make sure you have an emergency action plan. It is common for bipolar patients to relapse despite their best efforts. A full blown manic episode, or depressive episode can be devastating so it is important that you have an emergency plan in place. Make sure you have a list of your treating doctors and contact details with you, as well as a list of the medication that you are taking. This way, people will be able to assist you if ever needed.
5. Get educated! Educate yourself about bipolar disorder and encourage your close friends and family to do the same. The more you understand about the illness, the more control you have over managing it and the same can be said for your friends and family. It will be beneficial to your relationships if those around you have a clearer idea of what you are struggling with.