What is Bipolar Disorder (BD)?
Bipolar disorder (BD) is a mental illness characterized by extreme mood swings accompanied by changes in energy and activity levels. These changes manifest as highs (manic episodes) and lows (depressive episodes). This disorder can also be referred to as manic depression.
We all experience highs and lows but those associated with bipolar disorder (BD) differ and are marked and extreme. Untreated they can impair a person’s ability to function on a day to day basis.
Mental illnesses rate among the most common illnesses in the US. One in twenty five adults live with a serious mental illness like bipolar disorder (BD), schizophrenia or major depression. (1)
Symptoms
The symptoms of bipolar disorder (BD) are varied and can be mild or severe. People with this disorder can go for long periods without displaying symptoms. Sometimes this can amount to years.
The symptoms can be categorized as manic or depressive. On occasion symptoms from each category can coexist or change quite quickly from highs to lows and back again. These changes in mood are noticeably distinct from a person’s normal behavior.
Manic Symptoms
Mania can leave people feeling extremely happy or elated for long periods of time. Energy levels are elevated and you become more active than usual. Thoughts can be racing out of control, talkativity increases and is random in subject matter.
A sense of confidence is heightened and belief in oneself and one’s abilities can be unrealistic. People often act impulsively, recklessly and take unnecessary risks. Going on a spending spree, gambling savings or having indiscreet sex are not uncommon.
Rude, aggressive and angry behaviour, saying or doing inappropriate things are also symptoms of this disorder.
Sleeping patterns are disrupted and you may feel you don’t need to sleep or don’t get enough sleep. You can become irritable and agitated and not have much patience. Also, your judgement could be impaired and your behavior unpredictable. (2,3)
Depressive Symptoms
The prevailing feelings of depressive mood swings are extreme sadness and hopelessness. You can feel empty and down, have little energy and lower activity levels.
Sleeping can be troublesome, you might get too much or too little. This can leave you feel constantly tired or like you are moving in slow motion.
Concentration levels will be low and you could become very forgetful. Food can also play a factor, you may eat either too much or too little.
It seems like you are unable to enjoy anything and are constantly worried. Feelings of low self worth, death and suicide can also emerge. (4)
Hypomania
This is a milder form of mania and whilst the symptoms remain the same they are less heightened.
A person in a hypomanic episode may function well at work and in social situations. They also can feel good about themselves and be very productive.
However, even though they may not feel anything is wrong the people close to them may notice the change. (5)
Psychotic Episodes
Psychotic symptoms can present as hallucinations or delusions.
People can feel guilty, sinful or worthless or on the contrary self important and exceptionally intelligent or physically fit. They can believe they have some sort of superpowers and are capable of doing anything or being anyone. (6)
Stages
There are no stages as such associated with this disorder. Diagnosis is made dependant on the symptoms experienced. There are however three types of bipolar disorder (BD). These are:
Bipolar l
This classification applies to people that have had at least one manic episode which has lasted for at least seven days. It is possible to experience depressive episodes as well, although this may not apply to everyone. (7)
Bipolar ll
This describes people who have had at least one severe depressive episode accompanied by hypomania. The depressive and hypomanic episodes may alternate. (8)
Cyclothymia
Diagnosis of this type of bipolar disorder (BD) indicate hypomanic and depressive episodes over the course of two years or more.
It can also indicate symptoms aren’t severe enough to meet criteria for diagnosis of bipolar I or bipolar II. (9)
Treatment
The treatments for bipolar disorder (BD) include psychotherapy and/or medication. The types of psychotherapy or talking therapy available are:
Cognitive Behavior Therapy (CBT)
This therapy helps a person recognize and change how their feelings, thoughts and moods affect their behavior. It concentrate on negativity and distortion of the way we perceive ourselves or the world around us.
It uses structured exercises like keeping diaries of mood swings and thoughts. These help identify areas where people don’t adjust properly to situations so they can be corrected. (10)
Interpersonal Therapy
This therapy looks at how relationships with others and life events affect the way a person feels and behaves. It also identifies how their behavior and feelings can affect others. (11)
Family Focused Therapy (FFT)
Bipolar disorder (BD) is associated with impulsive and self-destructive behavior. Suicidal thoughts are common, as well as impulsive sexual behaviors and reckless spending. This can have a huge impact on family members and they they may not know how to cope.
This type of therapy teaches patients and their families about the nature of their disorder. It also looks at how family and relationships can either help or exacerbate their condition.
Dealing with emotions within the family unit can assist both the person with BD and other family members living them. (12,13)
Psychoeducation
As the name suggests this educates people in a way they can develop an understanding of their disorder. It can be carried out on a one to one basis or in group sessions.
It also focuses on medications that are available and the importance of adhering to medical advice. It helps people identify new episodes of the condition and teaches them strategies to cope with them. (14)
Medication
There are medications available which can help reduce the symptoms of bipolar disorder (BD). They include mood stabilizers, antidepressants, antipsychotics, sleeping pills and mild tranquilizers.
The most commonly used are mood stabilizers, the main one of which is lithium. Other drugs include anticonvulsants such as carbamazepine, lamotrigine and valproate. Another option is an antipsychotic drug, asenapine.
All these drugs help regulate the highs and lows associated with this disorder. They each work in different ways so your doctor will discuss which one might be best for you. (15)
FAQ
What is bipolar disorder (BD)? Bipolar disorder (BD) is a mental illness characterized by extreme mood swings and accompanied by changes in energy and activity levels. These changes manifest as extreme highs and lows.
What are the signs of bipolar disorder (BD)? Signs of this disorder present as manic or hypomanic episodes and depression or yo-yoing between the two. The effects of either are extreme and overwhelming and lead you to behave in a way that would not normally do.
How do you develop bipolar disorder (BD)? There does not appear to be a single cause of this disorder. The brain in people with this disorder may function in a different way. Genetics and family history can also play a part. (16)
How are you diagnosed for bipolar disorder (BD)? Diagnosis of this disorder can sometimes be difficult as the symptoms can be similar to those for depression or schizophrenia. A psychiatric professional will want to know about your symptoms, how long they last and how frequent they are. They may ask you to record your episodes going forward. Diagnosis may take some time as the doctor will want to make sure they get it right. (17)
What is the best treatment for bipolar disorder (BD)? Treatments available include several types of therapy and/or medication. Your doctor will discuss the best options for you and treat you accordingly.
What are the long term complications of bipolar disorder (BD)? Due to the nature of bipolar disorder (BD) involving manic and depressive episodes people may avoid social situations. They may find it hard to maintain personal relationships and might find it difficult to hold down a job.
Is bipolar disorder (BD) considered a disability? The Americans with Disabilities Act includes bipolar disorder (BD) as a disability. Dependant on how the disorder affects you, it may qualify for social security benefits. (18,19)
Is there a cure for bipolar disorder (BD)? There is no known cure for this disorder but symptoms can be managed with therapy and/or medication.
Is bipolar disorder life threatening? The condition is not life threatening per se but is associated with suicidal tendencies. (20)
Summary
Bipolar disorder (BD) is a mental illness characterized by extreme mood swings and accompanied by changes in energy plus activity levels. Also referred to as manic depression the main symptoms are extreme highs and lows.
People with this disorder can struggle with everyday life and find it hard to maintain relationships or hold down jobs.
However, there are many treatments available which can help level out the mood swings this disorder causes and help people function.
Bipolar disorder (BD) affects both children and adults. It can also adversely affect family members of suffererers. Fortunately there is therapy that can address issues for both.