Living with bipolar disorder
What is bipolar disorder?
Bipolar disorder is a mood disorder which can be described as manic, hypomanic or depressive. A person living with bipolar disorder will have severe mood swings which can last several weeks, months or a long period of time. The Royal College of Psychiatrists states that feelings include severe depression, feelings of extreme happiness or a combination of depression with restlessness.
How common is it?
According to the Royal College of Psychiatrists 1 in every 100 adults has bipolar disorder at some point in their life. The American Psychiatry Association claims that the average age for a first manic episode is 18 years old, but it can start anytime from early childhood to later adulthood. It rarely starts after the age of 40. Both males and females are affected equally (RCPsy).
The symptoms of bipolar disorder
Like depression, bipolar disorders also influences predominantly mood, but in a different way. Bipolar disorder causes fluctuations in mood, energy and the ability to function (APA).
This can includes dramatic mood swings. Individuals with bipolar disorder may have episodes of depression that may alternate with what it known as a manic episode. For a period of time a person may experience a “manic episode” unusually high or elevated, feeling on top of the world, highly energetic or irritable. Also, change in sleep commonly demonstrated by decreased need for sleep, or complete lack of sleep. The individual will often demonstrate hyperactivity and feeling of an intense state of high energy. Reckless or risky behaviour may also predominate. Thinking is often speeded up so that individuals with mania experience their thoughts moving extremely rapidly. Changes in eating are usually marked by a significant decrease in appetite. A “depressive episode” is where a person is perhaps feeling sad and hopeless. Some people have both depressed and manic episodes, some people have only manic episodes, and some have more manic than depressed episodes or more depressed than manic episodes. There are often periods of normal moods in between these episodes.
The American Psychiatric Association states that a manic episode is when a person is very high spirited or irritable in an extreme way most of the day for most days, has more energy than usual for at least one week. The person may experience the following;
Exaggerated self-esteem or grandiosity
Less need for sleep
Talking more than usual, talking loudly and quickly
Doing many activities at once, scheduling more events in a day than can be accomplished
Increased risky behavior (e.g., reckless driving, spending sprees)
Uncontrollable racing thoughts or quickly changing ideas or topics
Changes in behaviour can affect work life, social activities and become evident to friends and family people.
A hypomanic episode is similar to a manic episode but the symptoms are less severe and may only last four consecutive days.
Major Depressive Episode
A major depressive episode is a period of two weeks in which a person has at least five of a feeling of sadness, helpfulness as well as some of the following (APA);
Loss of interest in activities
Feeling worthless or guilty
Feeling restless or agitated
Changes in appetite
Loss of energy, fatigue
Difficulty concentrating, remembering making decisions
Frequent thoughts of death or suicide
Bipolar I Disorder
Bipolar I disorder is diagnosed when a person has had at least one manic episode which has lasted longer than one week (RCPsy). Most people have periods of manic and periods of depression. Untreated a manic episode will last typically from 3-6 months. Depressive episodes can last up to 12 months without treatment (RCPsy).
Bipolar II Disorder
Bipolar II disorder involves a person having at least one major depressive episode and at least one hypomanic episode (APA). People return to usual function between episodes.
Cyclothymic disorder is a milder form of bipolar disorder involving many mood swings, with hypomania and depressive symptoms that occur often and fairly constantly (APA). This can develop in to full bipolar disorder.
People with bipolar disorders frequently have other mental health disorders including attention-deficit/hyperactivity disorder (ADHD), an anxiety disorder or substance use disorder. The risk of suicide is significantly higher among people with bipolar disorder than among the general population (APA). People with bipolar II often have other co-occurring mental illnesses such as an anxiety disorder or substance use disorder.
The causes of bipolar disorder
Most scientists who study the cause of bipolar disorder believe that biological vulnerabilities are the most important risk factor. 80-90 % of people with bipolar disorder have a relative with either depression or bipolar disorder and therefore there is a link with bipolar disorders running in families (APA). External factors such sleep deprivation, extreme stress, drugs and alcohol can trigger episodes of mania in some cases. Mood swings can be brought on by physical illness. RCPsy states that there could be a physical problem with the brain systems which controls our moods, hence why bipolar disorder can be controlled with medication.
How can bipolar disorder be treated?
People with bipolar disorder can be treated and go on to lead a very full and productive life. There are a variety of very effective treatments for bipolar disorder, including medication alone or a combination of talking therapy and medication. Medications such as mood stabilizers are the most commonly prescribed and for bipolar disorder II antidepressants also. For cyclothymic disorders, treatment may start and stop over time and be predominantly focused on talking therapy. In psychotherapy, the individual works alongside a mental health professional to decide a treatment plan, better understand the illness and help to rebuild relationships. Helping the person cope with the stress of the illness, especially as it affects relationships and ability to work, is often very important. In some cases, when medication and psychotherapy have not helped, a treatment known as electroconvulsive therapy (ECT) may be used (APA). Each person is different however and each treatment is individualized.
Friends and family support
Bipolar disorder can disrupt a person’s life and relationships with others, particularly with family members. As a result the disorder can have a stressful impact on the family. It is therefore beneficial for family or close friends to seek professional support including resources, support forums and advice. This can then help families learn strategies to enable them to prepare, cope and be an active part in the treatment plan (APA).
Ways to stay well
Learn about bipolar disorder and understand your medication. Talk about any concerns or advice needed with your nurse, psychiatrist, mental health worker
Maintain healthy relationships with friends and family
Perform relaxation techniques such as yoga and meditation
Do something you enjoy such a hobby or sport. This could include;
Art therapy. Art is a great form of therapy for helping individuals express themselves, social networking and a way of obtaining a sense of achievement in the art produced.
Look after your physical health, eat a balanced diet and exercise regularly. Both your GP and psychiatrist can help you with this. Attend regular health checks, monitor your weight, blood pressure and try to stop smoking entirely.
Avoid caffeine in coffee, tea and sugary soft drinks. Particularly important if you are taking lithium medication.
Avoid sugary fluids and drink regularly. Maintain a balance of body fluids and salts
‘WPA Public Education Initiative’
Dr. Avdesh Sharma, International Lead, WPA; Consultant Psychiatrist, India
Dr. Sujatha Sharma, Consultant Psychologist, India
Stefanie Radford, Senior Project Manager, United Kingdom
Rajeev Verma, Administrator, India
Pragya Mehra, Media Specialist, India
Jatin Kumar, Media Editor, India
Supported by Unrestricted Educational Grant by SUN Pharma
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