Bipolar is a mood disorder, often referred to as manic-depression. While most have heard of the illness, very few know much about it. It is underdiagnosed, as approximately 5% of the population has bipolar disorder, but few seek treatment or get the appropriate treatment.
Being bipolar does not merely mean being a moody person. While a person may experience fluctuations in mood, that is not a defining characteristic. There are two distinct types of episodes in bipolar disorder; depression and mania, or hypomania.
Symptoms of depression in bipolar patients:
- Persistent sad, hopeless, or empty mood.
- Cannot look forward to anything in their life.
- Appetite changes, to the extent of gaining or losing weight.
- Sleep pattern disturbed, sleeping too much or too little.
- General anxiety and irritability.
- Decreased energy and overall listlessness.
- Loss of interest in former activities can include sex.
- Inability to concentrate, remember, or make decisions.
- Feelings of inferiority, guilt, or worthlessness.
- Thoughts of death, and/or suicide.
Symptoms of mania/hypomania in bipolar patients:
- 1. Decreased sleep, which the patient doesn’t seem to miss it.
- 2. Increased activity and energy; may not be able to sit still long.
- 3. Extremely good mood, perhaps euphoric.
- 4. Extreme irritability, often flaring unexpectedly.
- 5. Racing thoughts and speech feel everyone else is going too slow.
- 6. Can’t concentrate or focus, conversations are disjointed and abruptly change.
- 7. Impulsive ” can be seen in shopping sprees or sexual promiscuity.
- Over-inflation of ego believing self to have more power or ability than in actuality.
- Drug or substance abuse, often impulsively.
- Behavior that is out of character for the person.
- Overreaction or even provocative behavior. Can be aggressive or hostile.
- Doesn’t think there is anything wrong.Mania in detail.
Frequently a person with bipolar doesn’t experience full-blown manic symptoms. Instead the symptoms seem milder, and the person may even have more creativity, or productivity than usual. A person who is hypomanic is reluctant to treat their illness, as hypomania is a pleasurable mood state. However, it will not last and without treatment the hypomania will most likely develop into a full mania, or crash into depression.
On the other end of the mania spectrum is when the mania is so severe that the patient may become psychotic. Psychotic means experiencing hallucinations, either visual or auditory. Some depressed patients experience psychosis as well. Because of the psychotic symptoms, patients not yet diagnosed as bipolar may be misdiagnosed at this point with schizophrenia.
Those who experience true manic symptoms are defined as bipolar I. People who primarily deal with depression and hypomanic episodes are considered bipolar II. If a person experiences four or more episodes in one year, the illness is considered rapid-cycling.
The beginning of the illness is considered the most dangerous in terms of suicide risk. The mortality rate for bipolar disorder is higher than that of most cancers. If a person is suicidal, professional help must be sought immediately. Don’t wait for an appointment, get help now.
Take all threats or warning signs seriously. Also, if the person’s mood changes to a more upbeat feeling, don’t let the guard down. Frequently bipolar patients commit suicide as they emerge from depression and head into mania.
They have enough energy to act upon their suicidal intentions then, and also are quite impulsive, leading to dangerous behaviors. Some patients even experience symptoms of depression and mania at the same time, which makes them especially vulnerable to suicide attempts.
Now the good news: Bipolar disorder is highly treatable. It is not curable. It is an illness that doesn’t just disappear. Treatment options concern taking care of problem occurring now, and preventing episodes in the future. All too often a patient recovers from an episode and feels great, then discontinues medication.
Before long, the patient is struggling with mania or depression again, and often worse than before. Even more serious, the treatment which worked before may not work the next time, so staying on medication is imperative to long term well-being.
Bipolar patients benefit from therapy. Some will focus on living with their illness, learning to anticipate mood swings, learning healthy ways to maintain stability such as regular sleep schedules, or how to deal with jobs and family. Other therapy may concentrate on addressing faulty thinking patterns or behaviors, or deal with associated problems such as addictions.
However, the mainstay of treatment remains medication. Unfortunately, many people with bipolar disorder balk at the idea. They fear losing their personality, their intellect, their creativity, or their will. They imagine themselves sitting alone in a corner, staring and drooling. Nothing could be further from the truth.
The goal of medication is stability. All moods won’t be levelized, and a patient should not feel flat. The main medication will be a mood stabilizer. There are many options today, from lithium to anticonvulsants such as Depakote or Tegretol, to new drugs such as Topamax and Lamictal.
Often other drugs may be added, such as antipsychotics (not for psychotic patients only) or antidepressants. Antidepressant therapy must be handled carefully, so as not to destabilize the patient or send him into a mania. Many bipolar patients require thyroid treatment, as well.
It takes time to find the right combination of medications at the right dosage. They will probably need adjusting from time to time. Careful follow-up is important, to monitor any changes and address them, and to watch for side-effects that may be serious. Bipolar disorder is a lifelong illness, but it doesn’t have to be devastating.