Mood and anxiety · Uncategorized

Bipolar Disorder

new-doc-2017-11-18-13-15-51_5.jpgBipolar disorder, also called manic depressive disorder, is a mental illness that produces unusual extremes of emotion.  These mood states are severe enough to cause problems in the sufferer’s life.  Read on for more information.

Does having mood swings mean you have bipolar disorder? 

Not necessarily. We all have natural fluctuations in our mood.  There’ll be times when you’re down, and there’ll be times when you’re feeling pretty good.  Normal mood swings don’t last too long – a couple of hours to a couple of days, or longer when you’re stressed or in love – and they don’t cause major problems in your life.  On the other hand, if your mood swings are extremely intense and causing problems, talk to your doctor about your concerns.  But remember, don’t diagnose yourself.  There are mental illnesses other than bipolar disorder that can cause mood swings, like borderline personality disorder.

What are the signs and symptoms of bipolar disorder? 

People with bipolar disorder tend to have distinct periods of mood abnormalities that are different from their normal personality.  These moods range from very despondent and hopeless to extremely high, elated, or agitated.  These highs and lows can affect sleep, motivation to do things, energy and activity levels, interactions with others, speech patterns, and even how the body metabolizes medications. Psychiatrists classify bipolar mood states as depression, mania, hypomania, or mixed episodes:

Depression is a sad mood and/or inability to feel joy that’s lasted at least 2 weeks.  A person who is depressed may struggle with hopelessness, helplessness, lack of energy, low self-esteem, excessive guilt, sleeping too much or too little, eating too much or too little, slowed thinking, and thoughts of death or suicide.  Sometimes a person with depression can develop hallucinations or strange thoughts, usually distressing ones, like being culpable for the end of the world or being monitored by the FBI. Depression always interferes with the ability to live day-to-day life.

Mania is a state of euphoria or extreme irritability and excessive goal-oriented activity.  It marked by increased self-confidence, grandiosity, diminished need for sleep, pleasure-seeking, speaking fast and jumping from subject to subject, making impulsive and risky decisions (like overspending or having reckless sex), and racing thoughts.  Sometimes a person with mania can develop hallucinations or strange thoughts, often positive ones, like having special powers or being able to talk directly to God.  Mania lasts at least seven days and always interferes with day-to-day functioning.

Hypomania is a low-grade mania.  It lasts at least four days and doesn’t cause major problems in functioning.  It is distinct from a person’s “usual” personality.

A mixed episode happens when a person has symptoms of both mania and depression.  An example would be a grandiose but depressed person with excessive energy, diminished need for sleep, overspending, and suicidal thoughts.

How do borderline personality mood swings differ from those seen in bipolar disorder? 

The mood swings seen in borderline personality disorder are marked by intense, reactive, destructive emotions that last hours to days and tends to switch on and off quickly, depending on what’s going on in the environment.  They don’t meet criteria for any of the mood episodes described above.  Manic depressives tend to have extended mood episodes that last much longer than a couple days, and the mood isn’t always a response to what’s going on around them.

What are the different types of bipolar?

There are at least four forms:

Bipolar 1 Disorder is defined by having at least one manic episode. A person with this type of bipolar can also have depression, hypomania, or mixed episodes, but not necessarily.  Type 1 has the earliest onset and runs equally in men and women.

Bipolar 2 Disorder is defined by having depression & hypomania, but never a full-blown manic period. This type of bipolar is more common in women.  Individuals tend to suffer from depression more than hypomania.

Cyclothymia is a milder form of bipolar. A person with cyclothymia suffers from mood swings but never meets full clinical criteria for depression, hypomania, or mania.  These mood swings last for at least two years and interfere with life enough to cause problems.

Other types of bipolar disorder include bipolar symptoms that don’t match the three groupings above.

What treatments are available? 

Treatment starts with a thorough evaluation. You’ll need a psychiatric assessment to assess exactly what’s going on.  Is this bipolar disorder, or something else?  Is there more than one mental health diagnosis?  Once diagnosed with bipolar disorder, the treatment is at least threefold: medications, therapy, and good self care. Typically psychiatrists will prescribe mood-stabilizers, like Lithium, anticonvulsants, or antipsychotics, to help with mood swings.  Omega-3 Fatty Acids can also help with mood-stabilization. Antidepressants are occasionally used for depression, albeit with care; they can cause mania or worsening mood swings.  Co-occurring mental disorders must be treated, like anxiety or substance use disorders.  Psychotherapy is key for stress management, learning coping skills, and building resilience.

For more articles on living with bipolar disorder, check out tips for living better with bipolar (link pending) or medications for bipolar disorder and mood swings.

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