This blog looks at bipolar disorder and provides a clearer picture of this condition, what it involves, the types of bipolar disorder a person may be diagnosed with, its symptoms and causes, and how it impacts one’s overall quality of life.

Formerly known as “manic depression,” Bipolar Disorder is a condition in which a person experiences extreme changes in mood, energy, behavior, thinking, and daily functioning. As a result, a person struggling with bipolar disorder may find it difficult to manage everyday tasks and to maintain healthy interpersonal relationships. This difficulty with relationships is particularly damaging to the well-being of the individual suffering with bipolar disorder as it can result in feelings of loneliness and isolation, which can exacerbate the already challenging symptoms of the condition.

“Manic-depressive illness—marked as it is by extraordinary and confusing fluctuations in mood, personality, thinking, and behavior—inevitably has powerful and often painful effects on relationships”[1], explains Kay Redfield Jamison, Ph.D, professor of psychiatry at Johns Hopkins University School of Medicine and author of Touched with Fire and An Unquiet Mind, which focus on Bipolar Disorder and what Jamison has learned since her diagnosis.

Jamison’s own experiences with Bipolar Disorder from early adulthood have given her, and subsequently us, valuable insight into the condition.

“Moods are by nature compelling, contagious, and profoundly interpersonal, and alter the perceptions and behaviors not only of those who have them but also of those who are related or closely associated.”[2]


Understanding Bipolar Disorder

There are three main types of Bipolar Disorder:

  • Bipolar 1 Disorder
  • Bipolar 2 Disorder
  • Cyclothymic Disorder, or Cyclothymia

Each  type is diagnosable depending on the severity of one’s symptoms. However, the following three types of experiences or “episodes” are common to Bipolar 1 and Bipolar 2:

Mania

During a manic episode, a person will exhibit higher levels of energy than usual for at least a week, seem to be in an elevated mood or easily irritable, and experience some of the following changes in behavior, as outlined in the Diagnostics and Statistics Manual, Fifth Edition.[3]

  • More talkative than usual, rapid speech
  • More easily distracted
  • Reckless behavior
  • Racing thoughts
  • A sense of very high self-esteem
  • Over-scheduling (taking on more responsibilities than could reasonably be accomplished)
  • Delusional thinking

Family and friends are likely to notice these changes in behavior. The affected individual may experience difficulties relating to work, social life, and responsibilities. Hospitalization may even be required.

Hypomania

Less severe than a manic episode, a hypomanic episode may last for four consecutive days. Though there are changes in behavior, like in a manic episode, hypomanic episodes don’t usually result in the same problems, and functionality is not completely reduced.

Major Depressive Episode

A person who experiences a major depressive episode goes through a period of at least two weeks during which they experience five or more of the following symptoms, as explained by the National Institute of Mental Health[4]:

  • Feelings of sadness, despair, helplessness, hopelessness, and worthlessness
  • Apathy towards activities or interests that were once enjoyable
  • Problems with sleep – too much or too little
  • Increase or decrease in appetite
  • Extreme fatigue
  • Poor concentration
  • Regular thoughts of death and/or suicide

Types of Bipolar Disorder

As mentioned earlier, there are three main types of Bipolar Disorder that a person may be diagnosed with. There are more, but they are generally referred to as “other specified and unspecified bipolar and related disorders.” According to the National Institute of Mental Health[5], the three types are:

Bipolar 1 Disorder

Bipolar 1 Disorder is characterized by a manic episode that lasts at least one week or mania that is of such a high severity that hospitalization is required. Major Depressive Episodes are also involved in Bipolar 1 and typically last at least two weeks.

Bipolar 2 Disorder

Bipolar 2 Disorder is similar to Bipolar 1, except it is generally less severe. Instead of experiencing a manic episode, a person with Bipolar 2 Disorder will experience hypomania and major depressive episodes.

Cyclothymic Disorder

Cyclothymic Disorder, or Cyclothymia, is diagnosed when a person has, for a period of at least two years, been experiencing symptoms of hypomania and symptoms of depressive episodes, but to a lesser degree than would be diagnosable for a hypomanic episode or a major depressive episode.

Causes of Bipolar Disorder

Identifying the cause of Bipolar Disorder is difficult, as no single cause is known. Instead, it is believed to occur as a result of various contributing factors, such as genetics and brain structure.

Genetics

A person’s likelihood of developing a bipolar disorder is 4 to 6 times higher, according to the American Academy of Child and Adolescent Psychiatry (AACAP), if a family member also has the condition.[6]

Brain Structure

The AACAP also explains that research has discovered that young people with bipolar disorder exhibit “neuropsychological deficits in the area of executive functioning which involves judgment, planning, and impulse control.”[7]

What are the health risks associated with Bipolar Disorder?

Bipolar disorders present some serious risks to a person’s health and well-being. Though people with Bipolar Disorder do live functional lives, treatment is needed in order to manage the symptoms. If treatment is not received, the disorder is likely to worsen.

Lack of treatment can lead to life-threatening behaviors. People with Bipolar Disorder are more likely to engage in high-risk behaviors, heavy substance misuse or abuse, self-destructive or self-injurious behaviors, and suicidal ideation.[8]

Preventing Progression

There are preventative strategies one can take to prevent Bipolar Disorder from getting worse. While these strategies won’t fully prevent the onset of symptoms or episodes, they can keep them manageable.

Awareness

If one can notice patterns of events, thoughts, and behaviors that signal the onset of a manic or depressive episode, then interventions and symptom management can take place early.

Reduce or Avoid Drugs and Alcohol

Symptoms can return or be exacerbated by using drugs and alcohol, so these substances are best avoided.

Be Strict with Medication

People suffering with Bipolar Disorder are often prescribed a combination of medications to manage their symptoms. These should be taken exactly as prescribed, as reducing dosage or discontinuation can be highly dangerous.

Bipolar Disorder is Manageable

Bipolar Disorder is a difficult condition to treat and deal with but with the effective symptom management and early intervention, those who are diagnosed can still live normal, functional lives. Like any condition, psychoeducation and preventative strategies are essential in promoting and maintaining one’s overall health and wellbeing.

For more information on how we can help with bipolar disorder, get in touch – call 800-219-0570 or email info@heatherhayes.com today.

Sources:

[1] Jamison, Kay R. Touched with Fire: Manic-depressive Illness and the Artistic Temperament. New York: Free Press, 1993. Print.

[2] ibid.

[3] Truschel, J., n.d. Bipolar Definition And DSM-5 Diagnostic Criteria. [online] Psycom.net – Mental Health Treatment Resource Since 1986. Available at: <https://www.psycom.net/bipolar-definition-dsm-5/#:~:text=Bipolar%20Disorder%20DSM%2D5%20Diagnostic%20Criteria&text=To%20be%20diagnosed%20with%20bipolar,the%20day%2C%20nearly%20every%20day.> [Accessed 19 July 2020].

[4] Nimh.nih.gov. n.d. NIMH » Bipolar Disorder. [online] Available at: <https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml> [Accessed 19 July 2020].

[5] Nimh.nih.gov. n.d. NIMH » Bipolar Disorder. [online] Available at: <https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml> [Accessed 19 July 2020].

[6] Aacap.org. n.d. Frequently Asked Questions. [online] Available at: <https://www.aacap.org//AACAP/Families_and_Youth/Resource_Centers/Bipolar_Disorder_Resource_Center/FAQ.aspx> [Accessed 19 July 2020].

[7] ibid.

[8] Aacap.org. n.d. Frequently Asked Questions. [online] Available at: <https://www.aacap.org//AACAP/Families_and_Youth/Resource_Centers/Bipolar_Disorder_Resource_Center/FAQ.aspx> [Accessed 19 July 2020].