Bipolar Disorder

and other mood disorders


BIPOLAR DISORDER, (a.k.a manic depression) is a complex and complicating mood disorder. Yet it can be very interesting, intriguing, and seductive to the person who lives with this. I know, I have bipolar disorder.

I've only known for sure I was bipolar for a few years, but I've talked with many who've lived it their whole lives, people who have lost loved ones to the disease by suicide. My own immature experiences seem fragmental compared to others.

Here I have decided to come open about this illness. I know there are many text book definitions, and diagnosis of bipolar disorder, but here I have tried to make it sound more personal and more understandable. This information is to inform the public, and those who think their child, parent, or loved one may have a mood disorder.


Disclaimer: I am not a doctor! This information is here to help people understand this disorder, and to encourage those who think themselves or a loved one has it to get help! Remember just because these symptoms or experiences may sound like you or someone you know that DOES NOT mean that you have a mood disorder. Seek out a professional who can diagnose you correctly. Thank you!!


What is Bipolar Disorder?
What is depression?
What is mania?
What is hypomania?
Differences between Unipolar and Bipolar
Treatments
Conclusions
List of Books and Resources


What is Bipolar Disorder?

Bipolar Disorder is believed to be caused by a chemical imbalance in the brain. It's also thought to be heriditary since many people who have the disease have relatives with a depressive disorder. Bipolar disorder involves cycles of depression and hypomania or mania. Change of mood can be rapid or gradual. An episode of depression or mania can last days or years in some cases. Most people's symptoms start in their late teens to early 20's.

The key to recognizing Bipolar Disorder is the presence of a hypomanic or manic episode. Otherwise if there is not yet a manic episode but there is the depression, a diagnosis of Major Depression is probably best called for until a manic episode has occurred. Mania is the difference between unipolar (major depression) and bipolar (manic depression).

There are six classifications of bipolar disorder. The first two, referred to as bipolar I and bipolar II, are the most common. Bipolar I is the classic case of bipolar, it is recognized by long episodes of depression and mania. People with Bipolar II have said they have longer depressions and only hypomania's (mild mania). Mania is uncommon without depression. They say what comes up must come down, so any sign of mania will lead to a diagnosis of manic-depression. There can also be "mixed" states where mania and depression are in one episode and rapid cycling, when the changes of mood are fast and frequent.

Please understand that you do not have to have ALL of the symptoms of mania or depression to have bipolar disorder or any other mood disorder. Symptoms can vary and the illness is individual to each person. The DMS-IV says you should at least have 3 or 4 of the symptoms that last at least 2 weeks for depression and 1 week for mania.


What is depression?

Depression is recognized as a depressed mood, irritability (especially among children and young adults), loss of interest and inability to do the things you usually enjoy. Sleep disturbance is common, with either insomnia (inability to sleep) or hypersomnia (sleeping to long). Appetite changes are commonly visible with either increased appetite or decreased appetite. These symptoms and other symptoms should last at least 2 weeks. (Remember you don't have to have ALL of the symptoms to be depressed.)

Here is a list of symptoms common for a depressive episode:

  • lack of energy, tired, fatigued
  • feeling sad, unhappy, feeling like life just sucks
  • loss of concentration, memory
  • despair, hopelessness, feeling worthless
  • moving and speaking more slowly than usual
  • difficulty doing things and/or getting things done
  • self critical thoughts, loss of self-esteem
  • feeling helpless
  • withdrawel, social withdrawel
  • appetite changes, sleep disturbances
  • irritability, restlessness
  • feeling life is not worth living
  • feeling dead or detached
  • morbid thoughts, thoughts about death
  • suicidal thoughts, ideas, actions
  • destructive behavior
  • emotional or physical pain
  • delusions of guilt, possibly hallucinations
  • lack of personal hygiene, not taking care of oneself


What is mania?

Mania is an unfound elation, recognized by extreme talkativeness, grandiose plans and new ideas, new bursts of creativity, pressured, constant speech with jokes, plays on words, ryhming, distractibility, flight of ideas, speech difficult to interpret. This can make a manic person socially intrusive, flamboyant, and lack inhibitions. At first the mania feels good, often starts off with hypomania the milder form of mania, but then everything seems to get out of control, paranoia and delusions start to occur (sometimes hallucinations). (Remember you don't have to have ALL the symptoms of mania to be manic.)

Here are a list of symptoms common for a manic episode:

  • a distinct period of abnormal and persistant elevated, expansive or irritable mood.
  • grandiosity, inflated self-esteem
  • decreased need for sleep
  • being more talkative than usual,rapid speech,sometimes difficult to interpret
  • attention easily distracted by unimportant objects or events in the subject's environment
  • more goals, and goal oriented activities, with work,school and sexually
  • agitation
  • involvement in activites that can have harmful consequences such as promiscuity, overspending
  • mood disturbance is so severe that it impairs occupational functioning, relationships, or social activities.
  • feeling full of energy
  • creative thinking, and pursuits
  • laughing inappropraitely, inappropriate humor
  • increase in activites,speeded up thinking
  • financial extravagances
  • disorientation,disjointed thinking
  • insomnia, exhaustion
  • weight loss
  • paranoia, delusions, hallucinations
  • violent behavior, hostility,impulsive behavior
  • increased sexuality
  • heightened perceptions, increase in religious thinking


What is hypomania?

The predominate mood for a hypomanic episode is elevated, expansive, and/or irritated mood, and also some of the other symptoms of mania. Hypomania is not severe enough to cause marked impairment. Delusions are never present in hypomania. Most people enjoy their hypomanic episodes. It's a time when their creativity is at it's height, activities left undone during a depression are completed, new ideas and interests bud, confidence and self-esteem are returned, social activities are increased. In Bipolar I, hypomania leads to the disorientation of mania.


Differences between Unipolar and Bipolar

"The following guidelines by Dr. Ivan Goldberg are used to see the possibilities that someone with a current depression may have Bipolar Disorder:"

  • a history of bipolarity in the family
  • oversleeping and overeating when depressed
  • when depressed can still laugh and joke (often morbidly)
  • anyone with a history of frequent depressive epsisodes
  • a history of being given the drug lithium (mood stabilizer)

"Bipolars, when depressed, typically sleep more than usual and are lethargic. Unipolars on the other hand, tend to have insomnia and agitation.

Unipolar depression (major depression), usually has a later age onset than does bipolar disorder, the average ages being thirty-six and twenty-eight..

More relatives of people with bipolar disorder have affective disorders than do the relatives of those with unipolar depression."


Treatments

Treatment for Bipolar Disorder is usually psychotherapy and administered medication(s). During psychotherapy you talk to your therapist, psychiatrist, or counsellor about what is on your mind, in what they call "free association". It's a good way of working out problems, and talking about feelings and thoughts that you are experiencing, and a way to get some answers. Medications include:

  • mood stabilizers
  • anti-manics
  • anti-psychotics
  • anti-depressants

The most common drug to date used is Lithium which is an anti-manic drug. Most people say that it works best for the classic form of bipolar, Bipolar I. Most recently anti-convulsants such as Carbamazepine (Tegretol) have been used. Anti-depressants most of the time should not be used alone for bipolar disorder. They can sometimes throw the person taking them into a hypomanic or manic episode. But used in combination with a mood stabilizier they work well.

There is no cure for Bipolar Disorder, but with psychotherapy and drug treatments, you can get back your life and live "normally". Even when on medication the mood swings of manic depression will come and go and you'll have good moods as well as the bad moods and episodes. A lot of people when first diagnosed do not take their medications like they are suppose to. Sometimes the reasons for doing so is they feel their creative abilities will be hampered. They love their highs too much. Some don't take it because it's part of their self-destructiveness. And like my own psychiatrist has said, "Some don't take it because they're afraid to be happy, sometimes they don't want to deal with the responsibilities."

I encourage those who think they have a problem to get help, because you can't do it alone and this disease just doesn't go away. Without treatment it can get worse over time. Suicide is always a threat. If someone tells you they are suicidal don't think they are joking or trying to just get some attention. Please support them and be there for them and most importantly LISTEN. You can't tell someone that has a mood disorder to "snap out of it" or tell them that they are just "weak" and expect a full recovery.

Hospitalization is sometimes neccesary when the depression or mania is so severe that the person could harm themselves or others. At first the thought of going to a hospital is a scary one. In your mind you see all those asylums in the movies and think you'll be locked up forever. This is not true. With the right hospital and the right doctor you'll be on your way to getting better soon. There are some people who have had nightmare experiences, at the time when hospitals were less "caring" of their patients, and there are some crummy psychiatrists and mental health professionals still out there. Psychiatric hospitals that I have been to have been "pleasant", as far as pleasant could be at the time. Don't be afraid to get help. You owe yourself that. If the closest hospital is too far away, go to the emergency room for the time being. You can stay there for a few hours or for a night. Most people when first going through the depressions think that there is no hope for them, no one can help them, and that no medication will work for them. Please understand that most everyone feels this way at first, and most do find a light at the end of the tunnel and it's the sun, not a train. :)


Conclusions

Most bipolar people give and contribute a lot to the world. They are all types of people, most are creative, a lot are interested in the arts. There are many things in this world that would be lacking if people with Bipolar disorder were not here. As I have stated time and time again, it is a gift and a curse. The gifts are the creativity, the drive, empathy, the ability to touch other people's lives. The curse is the wish to die, the hopelessness, the disoriented manias. People with mental illness's need your support and your encouragement, not your pity or your ignorance. As with people who are blind who cannot see the world with their eyes but can see with another eye. Even the blind might shame you with their sight. And this could mean someone with any kind of disorder. I believe when something is taken away from you, you are given something that replaces that, and in the case of a blind person, sometimes the blind value their inner sight, more than the perceptions of light of the eye. Thank you for reading this and I hope you go away from here with a better understanding of bipolar disorder and other mood disorders.


List of Books and Resources

Here is a list of books for further reading on bipolar disorder:

An Unquiet Mind: A Memoir of Moods and Madness
Author: Kay Redfield Jamison


Touched with Fire: Manic-depressive illness and the Artistic Temperment
Author: Kay Redfield Jamison


A Brillian Madness: Living with Manic Depressive Illness
Author: Patty Duke, Gloria Hockman


We Heard the Angels of Madness: One Family's Struggle with Manic-depression
Authors: Diane and Lisa Berger


Diagnostic and Statistical Manual of Mental Disorders, 4th edition, DMS-IV


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