The Good News About Bipolar Disorder
There’s a lot of good news about treating bipolar disorder. We now know that treating it during the first episode can change the course of the illness lifelong. We’re gaining a huge new understanding on when to use an atypical antipsychotic (that is, more often), when to use a “mood stabilizer” (that is, less often), and when to use an antidepressant (again, more often). Psychosocial therapies for bipolar disorder help a lot by preventing relapse over time. A “psychoeducational” approach might be the most helpful. These therapies are now built into any treatment plan. So be encouraged. All is getting better. As always, we remain on your side to praise what works, debunk anything that doesn’t work, and encourage you to better health and better care. So read on about bipolar disorder.
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Defining Bipolar Disorder (Manic Depression) – Mood Changes in Opposite Directions
Bipolar means 2 poles. Like a north and a south pole, but in this case it’s a manic and a depressed pole. For a long time bipolar disorder was called manic depression. Both mania and depression are caused by the physical brain changes of bipolar disorder, and each of these two physical brain states affect a person’s behavior and their life in specific ways. These effects are mostly the opposite of each other.
Bipolar Disorder Signs & Symptoms
Below we go into more detail on the signs and symptoms of mania, of depression, and of “not-quite-mania”. For the person with bipolar disorder, the times of mania might last a few weeks or months. The depressed times, on the other hand, can last a few years. The normal mood in the middle is harder to predict, but it can last a lot longer with the right medicine. The not-quite-manic mood is even harder to predict and, as good as it might seem, it’s dangerous.
Bipolar Mania Signs and Symptoms – The Sped-Up Pole of Bipolar Disorder
Mania can show different faces. It can be an up mood, full of energy, optimism, and self-confidence. On the other hand, it can also be irritable, angry, and high-energy hostile. Some people, when manic, have changing moods, at times happy and at other times angry. The inability to predict which mood will come next is scary for the people around them.
More on Signs and Symptoms of Mania
Mania is much more than feeling “up”. There is such a thing as feeling too good (though it’s hard for most of us to imagine!) and mania is feeling way too good. Mania is not just up and sped-up, it also involves a loss of judgment. This is a big problem. In short, a person, when manic, just doesn’t get it. When manic, an individual feels that nothing can go wrong. Even in really bad situations, they falsely believe it’s all going to be okay. And, since nothing can ever go wrong, they take risks, big risks, that they shouldn’t take, that no one should take. They can’t see the risk, can’t see any possible downside. They can feel super capable or even powerful. As a result, they might take big risks with money, or with sex, or with relationships. It can get ugly.
Even More Signs and Symptoms of Mania
When manic, people have big energy surges, and these drive the need to be far too active. And since they view the world as free of any risk, active high energy is a problem. Another possible problem for the manic person is fast, non-stop talking. Their thoughts and comments can hop from one topic to another faster than people around them can keep up, faster than people around them can think. But if helpful people try to slow them down, a person in the middle of a manic episode can easily get irritable and nasty angry.
Bipolar Depression Signs and Symptoms – The Depressed Pole of Bipolar Disorder
People with bipolar depression are, well, depressed, but in this case, really depressed. An ordinary sad mood is familiar to everyone. This bipolar depressed mood is not only worse, it’s just plain completely different, a completely different type of mood. It’s a brain-based medical condition that is an extreme form of gloom and pessimism. They have little energy and don’t do much. They can’t sleep or sleep too much, are not hungry or eat too much. Nothing is fun or enjoyable. They can’t think clearly, can’t concentrate, and are forgetful. They’re tired and slow, feeling worried, anxious, and empty. At the worst, they can think they know for certain that life is not worth living and attempt suicide. At times, sadly, they succeed at taking their own life.
Bipolar Disorder Treatment
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The Special Case of Not-Quite-Mania and the Roller-Coaster Life
There is a “mood-in-the-middle” in bipolar disorder. Well, it’s not really in the exact middle. The exact middle is normal mood. This mood-in-the-middle is more sped up than normal mood but not as much as mania. An important difference to understand here is that the difference between this not-quite mania and full mania has less to do with sped-upness (if there is such a word!) and more to do with keeping or losing judgement, the ability to know what makes sense and what is just plain craziness. The person in a mood of not-quite mania still keeps good, common sense. When that person goes into full mania he/she loses the ability to tell what makes sense and what doesn’t.
More on the Not-Quite Manic Mood
This not-quite-manic mental state feels fine but is dangerous. It’s like quicksand or a rip tide. Everything seems fine, maybe better than fine, until, all of a sudden, it’s not fine anymore. The person with bipolar disorder who is in this not-quite manic state just feels really good. They can do really well with everything in life. It’s almost not possible for them to think that there’s anything wrong, and if their mood could stay right where it is, maybe nothing would be wrong. And people around the individual who do not know him or her might not see anything wrong, either. These individuals might see charisma and success. But people who know him or her well can see the change and understand that it’s a warning, like a bright yellow flashing light. Caution, a full manic episode might be on the way!
The Life History of the Successful Bipolar Person
People through the centuries have noticed that many individuals with bipolar disorder are quite successful. It’s true. Through his/her life the person with bipolar disorder might go through years of great success, big wins, the good life. That’s because, if they are in a state of not-quite mania, they keep good judgment but are sped-up. They think faster, see strategies, and understand situations that most people of normal mood don’t see. If they had control of their moods (which they don’t) and could stay not-quite manic, it might be great for them. But it doesn’t work that way. At some point, without them realizing it, this not-quite manic state slides into full mania. With real mania, the person’s judgement falls apart. All their successes will likely go down the drain.
Alternating Life Styles with Bipolar Disorder
People with bipolar disorder can become billionaires and yet die poor. They can be rich and world famous, liked and loved, yet end life by suicide at a young an age. (As an illustration in literature, do a search for the 1897 poem “Richard Cory” by Edwin Arlington Robinson. Paul Simon turned the poem into a song, “Richard Cory“, that Simon and Garfunkel recorded. It’s on their 2nd album, “Sounds of Silence”.)
Similarities with Both Mania and Depression
Both mania and the severe depression that is bipolar depression can land a person in a doctor’s office and maybe in the hospital. Both brain states need to be treated with medicine and medical care. There is no therapy that, by itself, works for mania or for bipolar depression. Both can and do destroy relationships, families, friendships, businesses, and lives. More and more medicines are being developed and approved to treat bipolar disorder, both the mania and the depression.
Bipolar Disorder is a Common Disorder
At least 1 out of every 100 people have bipolar disorder, and the percentage could be as high as 3 out of every 100. Doing the arithmetic, that calculates to 75 million to 225 million people worldwide. These are not small numbers. There are many people with bipolar disorder.
Once Bipolar Disorder Starts It Lasts a Lifetime
Bipolar disorder is the way a person’s brain is built. It’s a lifelong illness. Mania follows depression and depression comes after mania. There might or might not be a time of normal mood in between the mania and depression, as the individual goes from one mood extreme to the other.
The Cause of Bipolar Disorder Is Not Known
No clear and single cause for bipolar disorder has been found. There are risk factors that add up to make the likelihood of a person having bipolar disorder higher. A family history of bipolar disorder or schizophrenia, for example, and adverse life events at any age.
You Also Need a Bipolar Disorder Guide – Therapy
The roller coaster moods of bipolar disorder are frightening. It takes years for the person with bipolar disorder to understand what is happening to them. As with most medical conditions, medicines can’t solve everything. Call it education, call it psychotherapy, call is a “bipolar disorder user’s group”, but whatever the name, it’s a person who knows the territory and can be a guide. A guide for how to live better with the bipolar disorder.
National Institutes of Health, National Institute of Mental Health
National Library of Medicine (United States), MedlinePlus