Receiving a bipolar disorder diagnosis or having someone close to you diagnosed with it will lead to many questions. Hence, educating yourself and learning more about bipolar can uncover the mystery of mental illness. Additionally, this knowledge is empowering. If you’re a patient, you can find your voice, feel validated, decide on appropriate treatment options and advocate for yourself. On the other hand, if you’re connected to someone with bipolar acquiring correct information makes you a better ally and supporter. You can confront your bias and unlearn society’s stigma and prejudice against mental illnesses like bipolar.
Bipolar Disorder Is Defined As
Bipolar disorder is a psychiatric disorder that causes mood, energy, and behavioral fluctuations. These shifts in mental and emotional states are known as episodes. Additionally, these episodes can last for days, weeks, or longer. The episodes associated with bipolar are mania/hypomania and depression. In advanced types of bipolar, you may experience a psychotic episode known as psychosis. Or you may have a mixed episode, a blend of mania and depression.
Bipolar Disorder Symptoms Are Unique To Episodes
Bipolar symptoms are unique to manic and depressive episodes. The behavior and cognitive abilities you experience in a manic episode will differ from a depressive episode.
- Less sleep
- Excessively energetic despite getting less sleep
- Rapid speech
- Racing thoughts, flight of ideas
- Easily distracted
- Increased interest in goal-oriented projects or activities
- Engaging in risky behavior with an increased potential for harm (reckless driving, shopping sprees, hypersexuality)
- Aggressiveness, irritability
- Debilitating sadness or despair
- Lost interest in hobbies or activities you once enjoyed
- Feelings of guilt or worthlessness
- Sluggish, fatigue, loss of energy
- Increased need for sleep, sleeping more often
- Insomnia, unable to stay asleep or fall asleep
- Appetite changes (eat more or eat less)
- Slowed speech
- Delayed reaction time, decreased movement and speed
- Suicidal ideation, thoughts of death or dying
- Inability to focus
- Memory lapses
While mania/hypomania and depression are well-known episodes attributed to bipolar. There are instances in which you can experience psychosis or a mixed episode. These are primarily associated with Bipolar I. The addition of a psychotic break with bipolar will include mania and depression symptoms combined with hallucinations and the inability to differentiate between reality and fantasy. You will usually require hospitalization to adequately treat these symptoms. On the other hand, mixed episodes contain both mania and depression symptoms that occur in tandem.
Bipolar Disorder Consists Of Two Separate Classifications
Psychiatrists classify Bipolar Disorder into two categories based on variances in the intensity of manic episodes. Manic episodes refer to periods of elation and feeling unstoppable, as though you rule the world. You become self-involved, holding yourself in the highest regard believing you’re superior and the best at all things.
This detachment makes it easy for you to become unaware of how your actions can create negative consequences. This increases your desire to make risky, reckless decisions about finances, business ventures, projects, major life decisions, and sexual relationships. And in extreme cases, it may lead to hospitalization. Mania occurs primarily in Bipolar Disorder I and is considered the most intense.
On the other hand, Bipolar Disorder II has a less extreme version of mania known as hypomania. Both have the same symptoms; however, hypomania doesn’t necessarily prevent you from engaging in daily life. But they are still challenging and contribute to negative consequences in the form of unhealthy coping mechanisms (suicidal ideation, self-harm, disordered eating habits, drug and alcohol abuse). In addition, interpersonal relationships and job performance still suffer, causing severe consequences.
Diagnosing Bipolar Involves Analyzing Symptoms
Psychiatrists diagnose bipolar by analyzing symptoms and looking for a cyclical pattern and presentation history. For example, for a Bipolar Disorder I diagnosis, you must have experienced a manic episode that lasted a minimum of one week with four of the symptoms of mania present. Additionally, you must have at least one depressive episode with five symptoms present for two weeks.
In contrast, a diagnosis of Bipolar Disorder II is assigned when you have a hypomanic episode for a minimum of four days with four mania symptoms present. You also must have experienced a depressive episode with five symptoms present for two weeks.
Additionally, to receive a diagnosis of Bipolar Disorder I with psychosis, a manic episode with four symptoms present and concurring psychotic symptoms. Additionally, experiencing a depressive episode in which five of the symptoms are present alongside psychotic symptoms. Therefore, you must simultaneously experience manic and depressive symptoms when diagnosing mixed episodes.
Bipolar Is A Treatable Condition With A Combination Of Approaches
While currently, there is no cure for bipolar it is a treatable condition involving a combination of methods. A well-known method of treatment is to prescribe mood stabilizers. As the name implies, these medications aim to stabilize moods by preventing extreme lows and highs. For cases involving psychosis, an antipsychotic may also be subscribed during acute episodes.
When medication is first prescribed, you’ll undergo a titration period to find the appropriate dose for you. Unfortunately, you can expect things to get worse before they get better. Breakthrough symptoms are common as your body adjusts to the medication. Working with a knowledgeable and trustworthy psychiatrist who analyzes and monitors your dosage and symptoms is imperative for receiving excellent treatment. Being transparent and discussing your thoughts, feelings, and side effects can assist your doctor in determining an appropriate treatment plan for you.
Additionally, psychotherapy is a perfect complement to medication management. As your mood stabilizes, you can learn more about how your condition impacts you. For example, you can learn how to modify your behavior, improve interpersonal relationships, utilize social skills, adjust negative thought patterns, and make various lifestyle changes to help create structure and balance.
Lifestyle Changes Are Important Tools For Symptom Management
Integrating lifestyle changes in your treatment plan provide a holistic approach to bipolar management. These elements focus on self-education, prioritization of routines and schedules, and developing healthy coping mechanisms.
Self-Education Improves Knowledge And Self-Acceptance
Self-education not only improves your knowledge but aids in improving self-esteem by helping you accept your diagnosis. So often, it’s easy to have a mixture of feelings upon diagnosis, including anger, shame, and loneliness. However, the more you learn about bipolar and its’ effect on your mental health aids you in managing your condition.
For example, identifying behavioral and cognitive changes that indicate upcoming episodes can help decrease their severity and manage symptoms effectively. Additionally, therapy and support groups help provide necessary skills to help with pattern identification, and you feel validated and less alone. Realizing this is helpful on this journey.
As it pertains to supporting a family member or close friend that’s newly diagnosed, self-education can lead you to confront your implicit bias toward the disease. Furthermore, you can unpack the lies that societal stigma, ignorance, and prejudice bipolar patients encounter. There are numerous classes for those living with family members or friends that have bipolar. As a result, you can work through your frustrations and difficulties with maintaining a happy relationship with your family member or friend.
This makes you a better ally and support system because you can regularly empathize with what your loved one has to face. It also means you are in the best position to aid them in managing their care. Meaning you can identify symptoms that indicate an upcoming episode or send gentle reminders to take medication. Your health and support are invaluable to helping them find stability in their life.
Routines And Schedules Create Stability And Improve Moods
Prioritizing the creation of routines and sticking to a regular schedule helps create stability and structure. This is an important management tool since bipolar episodes can be triggered by a chaotic lifestyle with no set rhythm.
Creating a sleep routine with specific sleep and wake cycles can ensure that you’re getting adequate rest. Ideally, seven to eight hours of sleep is recommended for healthy adults. Additionally, routines ensure you take your medication on time and do not forget or skip doses. For example, setting an alarm that goes off or associating a specific behavior with taking your medication can help adherence. Finally, aim to take your medicines at the same time every day for the best results.
Healthy Coping Mechanisms Are An Integral Part Of Recovery
Healthy coping mechanisms are integral to recovery because they teach you to pivot and adapt to life changes and stressors. Learning the skills necessary to handle events that trigger episodes allows you to diffuse the severity of a manic, hypomanic or depressive episode.
Additionally, you can predict patterns or cycles of behavior that lead to episodes and eliminate these behavioral triggers. An example of behavioral patterns that trigger episodes could be regular alcohol abuse or drugs to manage stress or anxiety. Instead of relying on these unhealthy habits, find coping mechanisms that help you deal with the stress, hurt, or frustration you’re dealing with.
Being a part of a support group and staying active in therapy will help you overcome these humps and teach you healthy ways to manage these situations and disappointments without damaging actions that increase the severity of bipolar symptoms.
Believe it or not, you may need to eliminate certain people from your life. Engaging in a toxic or unhealthy friendship that encourages harmful coping mechanisms or triggers episodes will make managing your condition harder. Having a friend that engages in risky behavior, abuses alcohol regularly, or uses drugs will tempt you to partake in these behaviors.
This is dangerous because adding drugs and alcohol into the mix makes you more susceptible to having an episode. In addition, the side effects of drug and alcohol abuse can also mimic episodes making managing your condition challenging. Lastly, drugs and alcohol interfere with your medication causing it to become less effective. Therefore, stepping away from such friendships can improve your overall health.
A Common Misconception About Bipolar Disorder
Many have a common misconception regarding this condition, thinking everyone is a “little bipolar.” This stigmatization of bipolar disorder harms patients because it minimizes the reality of the disease by insinuating it’s false. It’s a form of gaslighting that creates doubt in the patients’ minds, causing them to question their perception of their symptoms and lived experiences. And it increases shame causing you to go undiagnosed and untreated, which increases the progression and negative impact it has on a person’s life.
However, bipolar disorder requires specific criteria to obtain an accurate diagnosis. For example, experiencing frustrations, irritability, and shifting into a relaxed or calm state does not qualify you as bipolar. It’s normal to encounter a range of emotions within a given day as you encounter various situations.
The difference is that mood and emotional changes persist for more extended periods. There isn’t a quick resolution. These polarizing shifts can lead to severe changes in behavior, cognition, and ability to function normally. They interfere with your ability to work and execute daily tasks and cause a strain on your personal and professional relationships.
A depressive episode that lasts for weeks or a manic/hypomanic episode that causes abnormal and disruptive behavior for prolonged periods is not something to be taken lightly. The way they impact your life can be devastating and, for many, lead to an increase in suicide, self-harm, and other unhealthy coping mechanisms. Hence, working with a psychiatrist to uncover the root cause of such behavior, whether situational or bipolar disorder, is imperative.
It’s Important To Understand Bipolar Disorder
It’s important to understand because over 10 million people in the U.S alone have bipolar disorder. Symptoms can be present in teenagers, but a diagnosis isn’t usually reached until 25 years of age and, in many cases, longer. Understanding bipolar can help decrease the stigma and misinformation about what it is and how it impacts patients. This is important because when you have bipolar, you need a support system that can help you. Additionally, it’s an essential part of one’s recovery process.
Also, knowing more about bipolar disorder means you can better support your family and friends that currently have and are managing bipolar disorder. Instead of judging or diminishing what they’re experiencing with their mental health, you can support them in the appropriate ways and let them know that you love them.
This means that they don’t have to struggle and suffer, and it also helps prevent that person from participating in self-harm, damaging coping mechanisms, and decreasing the risk of suicide. Plus, it makes you a safe space to talk freely about what they’re going through and experiencing without fear of judgment.
Lastly, it’s important because we need more allies to increase awareness, decrease stigma, and advocate for bipolar patients. You face a lot of judgment and prejudicial treatment with bipolar. In addition, having co-morbidities and learning disabilities interfere with academic and work performance. However, implementing accommodations can increase productivity and success in these areas.
Having the support and compassion from allies means fewer jobs lost, higher education to increase skills, and lead to higher-paying jobs. And it means a healthy, supportive environment for bipolar patients to thrive. We need grace, mercy, love, and understanding because no one asks or chooses to have bipolar. It’s a condition theorized to occur due to genetic, environmental, and biological factors. However, having a supportive, caring community can make life easier for bipolar patients.
American Psychiatric Association “What Is Bipolar Disorder” reviewed by Molly Howland, M.D.
Alex El Sehamy, M.D., APA/APAF Fellow January 2021