Bipolar Disorder

We want to take the time to talk about and hopefully end some stigma around a very common mental illness that affects around 40 million people worldwide (cited from the World Health Organization). There are some misconceptions around bipolar disorder which leads to misunderstanding of this prominent mental illness, both for those who struggle with it and for those who love people with it. Hopefully this blog post can be helpful for everyone looking to understand bipolar disorder more.

First things first, let's explain what exactly bipolar disorder is.

What is Bipolar Disorder?

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes clear and extreme shifts in a person's mood, energy, activity levels, and concentration. The shifts are known as manic or hypomanic episodes and depressive episodes. During a manic episode, people with bipolar disorder often experience periods of extremely "up", elated, or energized behavior, typically referred to as "high moods". During a depressive episode, one may experience a low or depressed mood and/or loss of interest in most activities, as well as many other symptoms of depression.

When there is a mood shift to mania or hypomania, one may feel very excited and happy (euphoric), full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.

When there is a depressive episode - also known as depression, one may feel sad or hopeless and lose interest or pleasure in most activities.

Symptoms of Bipolar Disorder:

To break it down into simpler terms, let's look at the symptoms of each episode...

A manic episode can look like:

• elevated mood (excessive happiness, hopefulness and excitement)

• increased energy and activity (restlessness)

• grandiosity or inflated self-esteem

• decreased need for sleep

• racing thoughts and speech

• impulsivity and risk-taking behavior

• in severe cases, psychosis - experiencing hallucinations and delusions

A hypomanic episode can look like:

• similar to manic episodes, but less severe

• do not cause significant impairment in daily functioning

The opposite of this is a depressive episode which can be a period of very "down", sad, indifferent, or hopeless periods.

A depressive episode can look like:

• persistent sadness or low mood

• loss of interest in activities

• lack of motivation

• low energy and fatigue

• difficulty concentrating and making decisions

• changes in appetite and sleep patterns

• feelings of hopelessness, worthlessness or guilt

• uncontrollable crying

• irritability

• suicidal thoughts or ideation

There is also a mixed episode which includes both manic and depression symptoms together. One may have the negative feelings and thoughts that come with depression but also feel agitated, restless and high energy.

Episodes of mood swings from depression to mania may occur rarely or multiple times a year. Each episode can last several days to several weeks to several months, it is different for everyone with bipolar disorder. Between episodes, some people may have long periods of emotional stability, a period of normalcy, sometimes referred to as euthymia. Euthymia refers to a period of calm and tranquility, a state of being free from the emotional extremes of bipolar disorder. These stable periods can also vary in duration, ranging from weeks to years.

The symptoms of bipolar disorder can create serious challenges to a person's mental and physical health. People with bipolar disorder often have other mental disorders (such as, but not limited to, anxiety disorders, substance use disorders, post-traumatic stress disorder (PTSD), borderline disorders (BPD), and/or attention-deficit/hyperactivity disorder (ADHD)). When in a manic state, people with bipolar disorder may indulge in activities that cause them physical, social or financial harm, such as suddenly spending extreme amounts of money. Some people may experience symptoms of psychosis, such as hallucinations or delusions which can lead to hospitalization in severe cases. The symptoms of bipolar disorder can interfere with everyday activities, relationships, and work or school responsibilities.

There is much stigma related to the symptoms of bipolar disorder which can create issues for people seeking help and cause a lack of understanding from people who do not have bipolar disorder. We are here to end that stigma and provide an accurate overview of bipolar disorder, as well as, ways to help support those with bipolar disorder and those that have loved ones with bipolar disorder.

Bipolar I Disorder vs Bipolar II Disorder:

There are also two types of bipolar disorder -- bipolar I disorder and bipolar II disorder. Bipolar I disorder is characterized by manic episodes that last at least a week with or without a depressive episode. An episode of depression isn't necessary for a diagnosis. The manic episodes must last at least seven days or be so severe that you require hospitalization. Bipolar II disorder is characterized by hypomania episodes which is a less severe form of mania. It doesn't last as long as manic episodes and it doesn't interfere with daily functioning as much. They also experience depressive episodes. People with bipolar II do not experience a full manic episode which is a characteristic of bipolar I. Hypomania is less impairing than mania, however, bipolar II is often more debilitating than bipolar I due to chronic depression being more common in bipolar II. People with bipolar I and bipolar II may also experience periods of mixed states (episodes of both manic (or hypomanic in the case of bipolar II) and depressive symptoms). The two types of bipolar disorder depend on patterns of manic or hypomanic and depressive episodes.

Now that we have explained what bipolar disorder is, the symptoms, and the difference between bipolar I and bipolar II, we can go over ways to "treat" bipolar disorder. Unfortunately, there is no cure, but there are ways to manage and treat it.

Management and Treatment of Bipolar Disorder:

Managing and treating bipolar disorder is the best way to help those with bipolar disorder. Such treatments that have been effective include:

• Psychotherapy (talk therapy).

• Medications (mood stabilizers, anti-depressants, antipsychotics).

• Self-management strategies, like educating oneself on bipolar disorder and identifying the early symptoms of an episode or possible triggers of episodes.

• Helpful lifestyle habits, such as exercise, yoga and meditation. These can support, but not replace, treatment.

• Other therapies, such as electroconvulsive therapy (ECT) in cases that are poorly responsive to medication or where rapid control of symptoms is necessary to prevent harm.

There are a range of effective treatment options and while bipolar disorder is not necessarily curable, it is possible to cope with the symptoms and live a meaningful and productive life with bipolar disorder.

It is important to recognize what can trigger a manic (or hypomanic) episode and a depressive episode.

Causes of Bipolar Disorder:

It is not exactly known what causes bipolar disorder, but some of the factors that may be involved are as follows:

• Genetics - bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may cause bipolar disorder.

• Biological differences - people with bipolar disorder appear to have physical changes in their brains. The brain structure and function of people with bipolar disorder may differ from those of people who do not have it.

• Periods of high stress, such as the death of a loved one or a traumatic event.

• Drug or alcohol misuse

How Can I Help Myself?

If you are someone that has been diagnosed with bipolar disorder, there are certain things you can do to help yourself. These things include, but are not limited to:

• Get treatment

• Keep medical and therapy appointments

• Take medication and treatment as directed

• Structure activities - keep a routine for eating, sleeping, and exercising

• Try exercise like jogging, swimming, or bicycling, which can help with depression and anxiety, promote better sleep, and support heart and brain health

• Avoid using drugs or alcohol

• Keep a life chart or mood journal to help recognize your mood swings

• Find out what your triggers are for a manic (or hypomanic) and depressive episode

• Ask for help when trying to get treatment or stick with your treatment

• Be patient with yourself

See more on how our founder who struggles with bipolar disorder II manages it.

How Can I Help Someone with Bipolar Disorder?

It may be difficult to know what to do when you have a friend, family member, or loved one struggling with bipolar disorder. There are ways to support them.

• Offer emotional support, understanding, patience, and encouragement

• Listen and be open to their experiences

• Ask about and try to understand their triggers and be alert to any major mood changes

• Include your loved one in fun activities

• Remind the person that getting better is possible with the right treatment

• Offer practical help (especially important in depressive episodes) (I.e. offer to do their dishes, make them dinner, drive them places, take them out, etc)

• Ask them what they need

• Take care of yourself, too

As a friendly reminder, during extreme depressive episodes, a bipolar person may resort to drastic measures to feel better. This may include self-harm, suicidal thoughts, or suicidal ideation. It is important to understand this when a bipolar person is in a depressive episode and to be there for them accordingly.

If you would like more information on bipolar disorder, please see the following links listed in references. You can also read a blog post from our founder here on what it is like living with bipolar disorder and how she manages her illness.

Disclaimer: This post was written by our founder, Maddie, who does not have a background in psychology. She wrote this using reliable resources from the web.

References:

1. https://www.who.int/news-room/fact-sheets/detail/bipolar-disorder#:~:text=An%20estimated%2040%20million%20people,and%20experience%20discrimination%20and%20stigma.

2. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

3. https://www.nimh.nih.gov/health/topics/bipolar-disorder

4. https://my.clevelandclinic.org/health/diseases/9294-bipolar-disorder

5. https://www.nhs.uk/mental-health/conditions/bipolar-disorder/

6. https://www.verywellhealth.com/euthymic-mood-in-bipolar-disorder-5208599