How to Understand Bipolar Disorder

Bipolar disorder, once known as manic depression, is a brain disorder that creates severe mood swings ranging from mania (overly up and/or irritable) to depression (overly down, lethargic and hopeless). Episodes vary in length and can be moderate to extreme. Bipolar disorder can be difficult to diagnose, and many people suffer for years as their symptoms are explained away or mistaken for other disorders. When treated, most people with bipolar disorder can live full, happy and productive lives.

Instructions

Difficulty: Easy

1. Know who is affected by this disorder. Typical onset occurs in the late teens and early adulthood, but older persons and children can develop the disorder as well. Children are most likely to develop bipolar disorder if their parents have it. Children show more irritability and their moods can cycle rapidly. Adolescents usually show classic symptoms found in adults.
2. Understand the signs of mania: high energy, exuberance, rapid speech, restlessness, lack of concentration, racing thoughts, extreme irritability, and unrealistic ideas about one’s self, power or abilities. Other symptoms include poor judgment, wild spending, increased sex drive, little need for sleep, drug abuse (particularly cocaine and alcohol), aggressive, intrusive or seductive behavior and a belief that nothing is wrong. There is a manic episode when three or more symptoms persist for a week or more. If irritability is present, four more symptoms are needed to diagnose it as mania.
3. Think of symptoms on a continuum. A moderate manic episode (called hypomania) leads to a heightened sense of well-being and an enhanced ability to function. Depressive episodes can be moderate to severe. Without treatment, any of these moods can slide into full-blown mania or a severe episode of depression.
4. Understand the signs of depressive episodes: hopelessness, sadness, anxiety, guilt, decreased sex drive, lack of energy, appetite or weight changes, irritability, sleep disturbances (too much or little), poor concentration and memory, chronic unexplained pain, and thoughts of death or suicide.
5. Know how serious this disorder can get. Severe episodes of mania or depression can include symptoms of psychosis. Hallucinations (seeing or hearing or sensing what is not there) and delusions (false and/or exaggerated beliefs about one’s self, power, identity) are serious. When manic, the person may believe she is the President or a famous movie star. When depressive, she may she has committed a heinous act, or that she's ruined financially. This psychosis may be misdiagnosed as schizophrenia.
   
6. Understand that some experience a mixed bipolar state whereby symptoms of mania and depression occur together.
   
7. Get a diagnosis. Bipolar disorder is tricky to diagnose because there are no blood tests or scans for it. A diagnosis is made with a careful consideration of the symptoms and their patterns. To speed up the diagnostic process, keep a detailed journal of symptoms, medication side effects and any events that could be influencing moods.
8. Know the types of bipolar disorder. Bipolar I is the classic form and is characterized by mood swings from mania and depression. Bipolar II includes hypomania alternating with depression. Rapid cycling includes more than four episodes per year (some experience several episodes per week or day). Rapid cycling is more common in women. Most people are symptom-free between episodes but nearly a third of bipolar people experience residual symptoms.
9. Understand the treatment. Most persons with this disorder can be stabilized with treatment, but treatment needs to be ongoing to be effective. Medications are necessary in nearly all cases for successful management. Cognitive therapy helps to counteract negative thoughts and behaviors. Psychoeducational therapy teaches about the disorder. Social rhythm and interpersonal therapies help with relationships and daily life. Family therapy helps with coping and stress.
10. Check thyroid function regularly. It coincides with this disorder, especially in rapid cyclers.
11. Be aware of other conditions commonly associated with bipolar disorder. Anxiety disorders, post-traumatic stress disorder and obsessive compulsive disorder may also present and may be treated separately or concurrently. Alcohol and drug abuse is common as patients often try to mask symptoms.
12. Keep a journal. Note symptoms, changes and side effects of medications. The more proactive you are as a patient or as a loved one, the easier it will be to deal with bipolar disorder.