Having Bipolar Disorder Does Not Make You Crazy
Do you sometimes find yourself experiencing intense moments of joy and happiness followed by a sense of debilitating despair or depression? Do you ever grapple with a myriad of emotions and find yourself wondering if there's something wrong with you or fear that you're going crazy? Are you full of energy one day and can hardly get out of bed the next? If you've answered yes to these questions, you might have bipolar disorder.
Most people have heard of Bipolar Disorder and it is commonly known as the illness where you're happy one minute and sad the next. It's not an inaccurate definition. Bipolar Disorder, also referred to as Manic-Depressive illness is a brain disorder which causes extreme shifts in mood. The moods are usually polar opposites, for instance going from extreme joy to intense sadness, hence the name 'Bipolar'. The shifts in moods are referred to as episodes of mania, hypomania and depression. Depending on the type of bipolar, each episode can last anywhere from a few weeks to a few months and even years! These episodes are interspersed with stable periods where the person experiences no symptoms and is normal.
Mania and hypomania refer to the episodes where the person is on a 'high', when they are full of energy and feel they can conquer the world. The depression episode brings the person crashing down from the high into the deepest despair.
This might all sound confusing but being bipolar does not mean you're crazy. It simply means you have an illness that needs to be treated. Unfortunately it is not a curable illness, it is a serious condition and needs proper medical treatment as soon as possible. But it is also an illness that can be managed well by seeking treatment and using the appropriate medication and you can go on to lead a completely normal life.
Bipolar disorder, the signs & symptoms
Even though mania and hypomania are categorized as two separate kinds of episodes, they share very similar characteristics and the symptoms are largely the same. Of the two, mania is more dangerous and severe. It can lead to a psychosis and hospitalization. In order to be diagnosed with a hypomanic or manic episode, at least three or more of the following symptoms have to be present:
- Very high levels of energy, overly active and agitated
- Unusually upbeat, too happy, too cheerful
- Extremely talkative, fast-paced
- Being distracted
- Sense of euphoria, of being invincible
- Problems sleeping i.e. needing less sleep
- Thoughts are racing and jumping from idea to the next
- Reckless, irresponsible behavior i.e. spending a lot of money, going on a shopping spree or abusing drugs and alcohol
- Very high sex drive, engaging in promiscuous behavior
The episodes of 'high' characterized by the symptoms above are often followed by moments of major depression. Bipolar depression is defined as periods of time where five or more of the symptoms below are present:
- Feeling depressed, sad, lonely and hopeless
- Crying for no reason
- Lack of interest or joy in activities and things that usually brought pleasure i.e. listening to music or playing sports
- Irregularity with sleep patterns, either sleeping too much or not enough
- Fluctuating weight and appetite, gaining or losing weight without trying to
- Loss of energy
- Slow, lethargic movements
- Lack of self-confidence, feeling worthless or guilty
- Suicidal thoughts or attempts
Bipolar disorder is broken down into four distinct categories and types, which include episodes of hypomania, depression and mania.
- Bipolar I Disorder: means the individual experiences full blown manic episodes, which last for at least 7 days. Hypomanic or depressive episodes might occur before or right after a manic episode and may last up to two weeks. Sometimes the manic episodes can be so severe the individual needs to be hospitalized immediately. With Bipolar I it is also possible to experience depression and manic symptoms at once.
- Bipolar II Disorder: means the individual has experienced one or more major depressive episode and at least hypomanic episode at some point but never a manic episode. It's a common misconception that Bipolar II is a less severe form of bipolar compared to Bipolar I. However, this is not the case. Bipolar II has a separate diagnosis and can be just as detrimental to the individual's well being because the depressive episodes last for much longer and can have episodes of mixed features - when opposite mood (manic, hypomanic or depression) symptoms are experienced simultaneously. For instance the individual may be extremely active and energetic while dealing with bouts of hopelessness and despair.
- Cyclothymic Disorder: the individual experiences periods of depression that alternate with periods of hypomania.
- Rapid-cycling: Experiencing multiple mood episodes (four or more) during a period of 1 year. This type of disorder increases the risk of going through severe depression as well as suicide.
- Others: when an individual experiences symptoms of bipolar disorder that don't match any of the criteria of any of the types discussed above. The symptoms can arise as a result of taking certain kinds of drugs, alcohol or because the person is suffering from an illness such as multiple sclerosis.
Some individuals who suffer from bipolar disorder enjoy the high moments. How can they not? The feelings of euphoria, of invincibility, of being full of energy can all be very intoxicating and leave the individual feeling empowered and strong. They may not even realize their behavior is abnormal. The burden thus often falls on the family or other people such as friends, co-workers or educators to point out there's a problem and urge the patient to seek help.
What Causes Bipolar Disorder?
Medical science has yet to determine exactly what causes someone to develop a bipolar disorder. It affects both men and women, although women are more prone to 'rapid cycling' than men. Diagnosis is generally made in the late teen years or during the early 20s since that's when symptoms begin to appear, in some very rare cases, a diagnosis may be made in childhood.
Research has shown that biology and genetics also play a significant role in developing bipolar disorder.
Biology: Studies have shown irregularities in how neurotransmitters (brain chemicals) function in people with bipolar disorder.
Genetics: The disorder is usually more common in people who have relatives with the condition and it is an illness, which tends to 'run in the family'. While scientists have determined genes have something to do with getting the illness, they have yet to determine which genes and how.
Abusing drugs and alcohol can also put someone at a higher risk for developing the illness. An individual's environment and lifestyle, being the victim of abuse or going through a traumatic, stressful event can also worsen the symptoms of bipolar when the disorder is already present.
Often, the hardest hurdle to overcome is accepting the illness. This is true for both the individual and their loved ones. But remember, there is no shame in being ill- this is an illness that is entirely beyond your control and the best thing you can do for yourself and your family is to get help right away.
Diagnosing Bipolar Disorder:
Unfortunately, there is no one sure fire blood test or exam, which points to bipolar disorder, instead several different types of evaluations are conducted by various health professionals in order to render the diagnosis. These evaluations include:
- Physical Examination
- Psychological Examination
- Mood Charting
While these are all useful, the best way of diagnosing the illness is to be frank and open with your doctor. The diagnosis may not be completely straightforward and might take some time because some illnesses such as a substance abuse problem, borderline personality disorder or schizophrenia have similar symptoms so it's important to detail your symptoms, the number of episodes, their severity etc. The more information you can provide, the quicker the doctor can eliminate other illnesses and disorders.
The doctor will also ask you questions about any history of mental illness in the family and may ask you to complete a mood questionnaire. . It might be a good idea to track your symptoms in a journal and write down everything you've been feeling and going through. They will use the information you provided and use criteria outlined in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine whether you are suffering from Bipolar Disorder and if so what type of bipolar disorder.
Once the illness has been determined, the doctor will start working on a treatment plan with you. Like most illnesses, the sooner you diagnose and treat the disorder, the better it is.
The most effective way of managing bipolar disorder is through medication. Hypomania and depression are treated using different kinds of drugs. Mood stabilizers are also given to patients in order to keep their mood steady. The types of medication and doses work on a trial and error basis, the doctor will keep giving you different doses to see what works best for your illness. Along with medication, psychotherapy (i.e. counseling and therapy) may also be recommended for yourself and loved ones as living with Bipolar can be challenging for everyone involved. In some severe cases (psychosis, attempted suicide) the patient may need to be hospitalized for a period of time.
One of the pitfalls with taking medications and getting treatment for Bipolar Disorder is that the individual starts to feel better and they feel normal. This can lead them to think they are cured and therefore no longer need to take their medications. However, this is dangerous because when medication is stopped, the symptoms will invariably come back and the individual is back at square one again.
It's important to understand and remember Bipolar Disorder is a lifelong illness and there is no cure (yet) so faithfully following the treatment plan outlined by your doctor is the surest way of making sure the illness does not take over your life.
Some individuals suffering from Bipolar Disorder may also be dealing with other mental illnesses or have a substance abuse problem. The medical health professional will also diagnose those issues and treat them. No two people have the exact same symptoms therefore every treatment plan is customized to suit the patient's needs.
Most people who seek and get treatment go on to live healthy, successful lives. Bipolar does not have to define who you are. But for some people, the illness becomes too hard to manage and they may become depressed, be consumed with thoughts of suicide or self-harm, they may be obsessed with the idea of death and may distance themselves completely from friends and family.
If you notice these warning signs in a loved one or feel overwhelmed with these emotions yourself, seek help immediately. Call 911 or go to the nearest hospital and speak to someone as soon as possible. Hotlines are also available 24 hours a day to talk you through your problems.
Bipolar Disorder is not something you can leave untreated forever without severe consequences either for yourself or your family. Over time, the symptoms will continue to get worse and may eventually lead to death. So if you suspect you may have the illness or suspect a loved one may have it, please get help.
This is an illness which affects close to 3% of the population in North America, you are not alone. Your life means something to someone, so get the help you need today.