Bipolar

Bipolar

Bipolar Disorder, formerly called manic depression, is a mental condition causing irregular cycles of extreme mood swings affecting changes in levels of energy, activity, emotions, and concentration. Bipolar disorder includes cycling between periods of mania and depression. Mania is defined by intense feelings of euphoria causing extremely elevated mood. Euphoria can lead to more serious cases of mania, known as psychosis, causing delusions and hallucinations with destructive behaviors. The depressive cycles after mania tend to cause suicidality emphasizing the severity of this disorder. 

While bipolar disorder is most commonly found in adults, children can also present with early signs though are not officially diagnosed until later in life (around 18 years). Children tend to be diagnosed with major depressive disorder prior to bipolar. 

Here are some common symptoms of bipolar disorder:

✅ feeling on top of the world                    ✅ risky behaviors
✅ rapid, pressured speech                        ✅ changes in eating patterns
✅ racing thoughts                                       ✅ exaggerated self confidence              
✅ increased spending of money             ✅ changes in sleep patterns                
✅ distractibility

✅ feeling on top of the world
✅ rapid, pressured speech
✅ racing thoughts
✅ increased spending of money
✅ distractibility
✅ changes in sleep patterns 
✅ exaggerated self confidence
✅ changes in eating patterns
✅ risky behaviors

Causes of Bipolar

A strong genetic link has shown bipolar disorder can be passed genetically from a parent to a child. Abnormalities in the structure and functions of the brain can increase the risk of developing the disorder. Finally, environmental factors like extreme stress, traumatic experiences, and physical illness can make one more susceptible to developing bipolar disorder. While research seems to have proven that causes of bipolar disorder, there are still many myths abound. The following includes causes and myths about the causes of bipolar disorder:

💡  genetics (hereditary)                      ❌ substance abuse
💡  structure of your brain                    ❌ bad parenting
💡  environmental factors                    ❌ diet
💡  traumatic events                              ❌ immunizations

💡 genetics (hereditary)                       
💡  structure of your brain
💡  environmental factors
💡  traumatic events 
❌ substance abuse
                    
❌ bad parenting
❌ diet
❌ immunizations

Misconceptions About Bipolar

There are many misconceptions leading to stigmas associated with bipolar disorder. Bipolar is typically stigmatized as it is associated with more extreme episodes specifically related to mania. The social stigma surrounding bipolar can become internalized beliefs causing a person to experience shame as their identities do not reflect society’s norms. Individuals with bipolar are more than their disorder. Here are some misconception about bipolar disorder:

🚫  just mood swings                                         🚫  a character flaw
🚫  being overly emotional                               🚫  a choice
🚫  having multiple personalities                    🚫  inability to maintain relationships
🚫  in ability to hold a job                                  🚫  inability to stick to daily routine
🚫  a constant switch between high and low moods

🚫  just mood swings
🚫  a character flaw
🚫  being overly emotional
🚫  a choice
🚫  having multiple personalities
🚫  inability to maintain relationships
🚫  in ability to hold a job
🚫  inability to stick to daily routine
🚫  a constant switch between high and low moods

Signs and Symptoms of Bipolar

Bipolar disorder is a mental health diagnosis marked by extreme changes in mood. While mood change may seem typical or normal, those associated with bipolar disorder present differently. Therefore it’s important to recognize the difference. The following are signs and symptoms associate with manic and depressive phases of bipolar disorder:

Symptoms of a manic episode:                  
🔸 feeling overly elated
🔸 racing thoughts
🔸 talking fast and switching topics
🔸 feeling unusually powerful 
🔸 making impulsive decisions 
🔸 engaging in risky behavior 
🔸 decreased need for sleep
🔸 loss of appetite
🔸 restlessness 
🔸 usual overconfidence

 

 

Symptoms of a depressive episode: 
🔹 feeling hopeless, stuck, empty
🔹 change in appetite 
🔹 change of weight
🔹 thoughts of suicide
🔹 preoccupation with death
🔹 feeling severe fatigue 
🔹 talking slowly and forgetting a lot
🔹 having difficulty making decisions
🔹 unable to complete simple tasks
🔹 withdrawing from friends and family
🔹 loss of interest in normal activities
🔹 change in sleeping pattern

Symptoms of a manic episode:                  
🔸 feeling overly elated
🔸 racing thoughts
🔸 talking fast and switching topics
🔸 feeling unusually powerful 
🔸 making impulsive decisions 
🔸 engaging in risky behavior 
🔸 decreased need for sleep
🔸 loss of appetite
🔸 restlessness 
🔸 usual overconfidence

Symptoms of a depressive episode: 
🔹 feeling hopeless, stuck, empty                                                                        🔹 change in appetite 
🔹 change of weight
🔹 thoughts of suicide
🔹 preoccupation with death
🔹 feeling severe fatigue 
🔹 talking slowly and forgetting a lot
🔹 having difficulty making decisions
🔹 unable to complete simple tasks
🔹 withdrawing from friends and family
🔹 loss of interest in normal activities
🔹 change in sleeping pattern

Diagnosing Bipolar

The diagnostic process is completed with the assistance and guidelines created by the Diagnostic and Statistical Manual of Mental Disorders, which aims to explain mental disorders. To clarify, the DSM-5 creates and defines labels to categorize people, however we must remember that everyone is different and no two cases are quite the same. 

In order to be diagnosed, one must experience manic/depressive episodes where symptoms occur during most of the day, almost everyday. The most common symptom is one or more manic episodes lasting for at least a week or resulting in hospitalization. Depressive episodes must be experienced for two weeks.

Bipolar is also rarely diagnosed in young children due the age group’s typical experiences with frequent mood swings and changes in behavior. Though a history of bipolar disorder in a family will cause healthcare providers to remain mindful of a potential future diagnosis. 

Manic episode are marked by the persistence of 3 or more of the following symptoms:

​⚠️   Inflated self-esteem
⚠️   Decreased need for sleep
⚠️   More talkative than usual
⚠️   Short attention span
⚠️   Increase in goal-directed activities
⚠️   Excessive involvement in many activities that typically can result in negative consequences

Hypomania has specific characteristic that vary a bit from one person to another but ten to include:

⚠️   inappropriate behavior
⚠️   over the top reactions
⚠️   hypersexuality and/or inappropriate sexual advances
⚠️   taking chances you would not normally
⚠️   lack of sleep
⚠️   increased spending of money
⚠️   increased pacing of motor skill
⚠️   unusual irritability, excitement, hostility, or aggression 

Depressive episode are diagnosed by the persistence of 5 or more of the following symptoms:

⚠️   Significant weight changes 
⚠️   Fatigue or loss of energy
⚠️   Depressed mood most of the day, almost every day
⚠️   Diminished interest or pleasure in almost all activities
⚠️   Insomnia or hypersomnia
⚠️   Recurrent suicidal thoughts or actions
⚠️   Diminished ability to think/concentrate
⚠️   Feelings of worthlessness or excessive guilt

Below are descriptions of the four different types of bipolar disorder:

Bipolar I: 

⚠️  appearance of at least one manic episode that lasts 7 days or more
⚠️  followed by a depressive episode that lasts at least two weeks
⚠️  may go days without sleeping, but still feels rested

Bipolar II:

⚠️  experience one major depressive episode that lasts two or more weeks
⚠️  hypomanic episodes that last about four days
⚠️  no mania 

Cyclothymia: 

⚠️  at least 2 years (1 year in adolescents) of multiple periods with hypomanic symptoms
⚠️ hypomanic and depressive episodes are shorter and less severe than bipolar I and bipolar II
⚠️  experiencing 1-2 months of a stable mood 
⚠️  causes distress or impairment in social, occupational, or other functioning

Bipolar due to another medical or substance abuse disorder (dual-diagnosis):

⚠️  prominent or persistent elevated or depressed mood
⚠️  causes distress or impairment in social, occupational, or other functioning
⚠️  symptoms are a direct consequence of another medical condition or substance abuse

Conditions Commonly Mistaken for Bipolar

Bipolar disorder is commonly overdiagnosed, missed, or mistaken for other diagnoses. More complete and accurate diagnostic evaluations are needed to improve the detection of this condition. It has been surmised that the aggressive marketing of pharmaceutical companies has contributed to the problem of misdiagnosis. Here is a list of condition commonly mistaken for bipolar disorder:

✳️  Substance use disorder
✳️  Borderline personality disorder
✳️  Attention deficit hyperactivity disorder (ADHD)
✳️  Anxiety
✳️  Post Traumatic Stress Disorder (PTSD)
✳️  Conduct Disorder

Treating Bipolar

Bipolar can have serious long-term consequences if it goes untreated. To create the proper treatment plan, those living with bipolar disorder may consider the following treatment options:

🧬  medication management              🧬  lifestyle changes 
🧬  cognitive behavioral therapy         🧬  tracking mood changes
🧬  psychoeducation                              🧬  exercise regularly
🧬  family therapy                                   🧬  acupuncture
🧬  routine eating and sleeping           🧬  interpersonal and social rhythm therapy

🧬  medication management
🧬  lifestyle changes 
🧬  cognitive behavioral therapy
🧬  tracking mood changes
🧬  psychoeducation
🧬  exercise regularly
🧬  family therapy
🧬  acupuncture
🧬  routine eating and sleeping
🧬  interpersonal and social rhythm therapy

Healthcare Professionals Who Treat Bipolar

For the best results in a successful treatment of bipolar disorder, seek providers that have specialities in the assessment, treatment, diagnosis, and continuing support of patients diagnosed with bipolar disorder. 

Many medical and mental health providers are familiar with the diagnosis of bipolar disorder.  However if your chosen provider is not, they should always provide a knowledgeable referral source. Specialized providers will have the capabilities to diagnose using various testing methods to decrease the likelihood of misdiagnoses and unnecessary treatments. 

If you choose to utilize medication, psychotherapy should always be incorporated in treatment planning. 

The following are professionals involved in the treatment of bipolar disorder:

🧠 physicians                         🧠 social workers
🧠 psychiatrists                     🧠 pediatricians
🧠 psychologists                   🧠 nurse practitioners

🧠 physicians
🧠 social workers
🧠 psychiatrists
🧠 pediatricians
🧠 psychologists
🧠 nurse practitioners

Recognizing Immediate Need for Bipolar Treatment

Bipolar disorder is a serious disease that ranges widely in severity. For those who experience mania- risky behavior can put lead to great danger and for those who experience severe depression- suicide is a real threat. The following warning signs should alert you to the immediate need for treatment:

🚨 talking about wanting to die
🚨 searching for way to kill yourself
🚨 buying a gun or other weapon
🚨 expressing hopelessness or having no reason to live
🚨 talking about feeling stuck, trapped, or being in unbearable pain
🚨 stating feeling like being a burden to others
🚨 increased use of drugs and/or alcohol
🚨 reckless behavior
🚨 increased anxiousness
🚨 change in sleeping pattern
🚨 withdrawn or isolated
🚨 displaying rage 
🚨 talking about revenge
🚨 extreme mood swings

Bipolar Professional Organizations

Provided are some resources to help the start of seeking support for bipolar disorder. Though these are national links, consider narrowing options down by searching in your current location. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116765/
https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders
https://www.psycom.net/bipolar-definition-dsm-5/
https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
https://www.healthline.com/health/bipolar-disorder
https://ibpf.org/learn/resources/
https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961#:~:text=Treatment%20is%20best%20guided%20by,social%20worker%20and%20psychiatric%20nurse.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945875/#:~:text=As%20mentioned%20previously%2C%20the%20most,bipolar%20patients%20is%20unipolar%20depression.&text=An%20incorrect%20diagnosis%20of%20unipolar,episodes%20and%20trigger%20rapid%20cycling.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552549/