Understanding Common Mental Health Disorders: Bipolar Disorder

Bipolar Disorder (formerly called manic-depression) is a mental health disorder that causes unusual shifts in mood, energy, activity levels, concentration, and ability to complete daily tasks. In clinical practice, people often describe themselves as having Bipolar Disorder when they experience sudden, intense changes in mood in response to some type of stressor which is not necessarily an indicator of the disorder. Those diagnosed with Bipolar Disorder have moods which range from periods of extremely elevated mood which can last several days (known as manic episodes) to profoundly depressed mood which can last for weeks to months (known as depressive episode). Below Gabby’s story illustrates how symptoms of Bipolar Disorder are different than sudden changes in mood in response to a stressor:

Gabby recently started college. During Gabby’s senior year of high school her parents shared they noticed a short period which lasted approximately 4 days where their daughter seemed to be extremely motivated and had a lot of energy. She did not seem to need much sleep and spent hours finishing homework assignments and college applications, catching up on chores and tasks around the house which she previously avoided, and creating several art projects. However, this period was followed by several months of extreme depression where Gabby did not have motivation to do schoolwork or daily tasks, stopped doing things she previously enjoyed, spending less time with her friends, sleeping excessively, and thoughts of hurting herself and death. Her parents attributed this to the stress of finishing high school and applying for college. Gabby’s returned to her “normal self” towards the end of the school year.

In the fall, Gabby moved approximately two hours away to attend college and began living in a dorm. Gabby’s roommate became concerned shortly after moving in with Gabby. She indicated that Gabby had a few episodes when she hardly slept for several days, talked rapidly and excessively about different things which made it difficult to follow during conversations, worked excessively on multiple projects, stayed at parties extremely late, and talked about making large amounts of money selling her art projects in the community. These episodes were almost always followed by what her roommate described as being extremely depressed. Gabby’s parents became aware of these changes after she called home shortly after the spring semester began to ask for money. Gabby told her parents she needed money to pay for college expenses because she spent a large amount of her student loan money on new clothes and shoes, a trip for spring break, and decorations for remodeling her dorm. Gabby’s parents decided it would be best for their daughter to attend school closer to home. When they arrived to help Gabby pack a week later, they found their daughter laying in bed crying. When Gabby’s parents asked her roommate about her mood, she said Gabby had been in bed for almost two days and had mentioned hurting herself several times. Gabby moved home with her parents but continued to show a similar pattern in her mood. Her parents decided they needed to seek additional help after they discovered their daughter had been cutting herself when she was depressed. Gabby was referred to a psychiatrist and diagnosed with Bipolar Disorder.

Facts and Symptoms of Bipolar Disorder

Approximately 3% of people in the US suffer from Bipolar Disorder each year. This disorder occurs in men and women at the same rates and is typically diagnosed in late adolescence or early adulthood. Symptoms will differ depending on if the person is currently experiencing a manic or depressive episode but they can also have periods of time where they do not seem to experience any symptoms. This chart explains the symptoms of both manic and depressive episodes:

Symptoms of a Manic Episode

• Feel very “up,” “high,” elated, or irritable

• Feel “jumpy” or “wired”

• Decreased need for sleep

• Loss of appetite

• Talk very fast about several different things

• Racing thoughts

• Think they can do several things at once

• Engage in risky behaviors (e.g. drink or use substances excessively, spend large amounts of money, unusual risky sexual behaviors) which show poor judgement

• Believe they are unusually important, talented, or powerful

Symptoms of a Depressive Episode

• Feel very sad, “down,” empty, or hopeless

• Feel slowed down or restless

• Have trouble falling or staying asleep or sleep too much

• Experience changes in appetite and weight

• Talk very slowly or have trouble joining conversations because they have nothing to say

• Trouble with attention and making decisions

• Feel unable to do even simple tasks

• Show little interest in almost all activities or an inability to experience pleasure

• Feel hopeless or worthless, think about death or suicide

People with Bipolar Disorder often have been diagnosed with co-occuring mental health problems, such as anxiety, Attention-Deficit/Hyperactivity Disorder (ADHD), alcohol or substance abuse disorders, psychosis, and eating disorders. Most people who suffer from this disorder. Approximately 82% of people with a Bipolar Disorder suffer severe impairment that makes it difficult for them to live independently and perform activities of daily living.

Most research suggests there are several factors that contribute to a person’s chance of being diagnosed with Bipolar Disorder but brain structure and genetics play a large role. Those who have a parent or sibling with the diagnosis are at significantly higher risk of being diagnosed themselves. Studies also suggest brain structure of those with this diagnosis are different than those without the diagnosis. However, at this time brain imaging is not typically used to make a diagnosis. Bipolar disorder is diagnosed by examining a person’s history and symptoms.

Treatment for Bipolar Disorder

Bipolar Disorder is a lifelong illness. Therefore, long-term continuous treatment can help people manage these symptoms. Medication and psychotherapy (i.e. talk therapy) are the most common treatments for Bipolar Disorder. Treatment is most effective when the person receives a combination of medication and psychotherapy.

Typically, antipsychotics or mood stabilizers are first choice medications for treating Bipolar Disorder. Additional medications may be added to help manage symptoms of anxiety, problems sleeping, and depression. These medications can cause significant side effects which lead to people abruptly stopping their medications. It is essential to talk with your health care provider about the risks and benefits of medication. Talk with your health care provider prior to stopping medication for Bipolar Disorder as suddenly stopping these medications can lead to a “rebound” or worsening of symptoms.

Psychotherapy, also known as talk therapy, can also help manage the symptoms of Bipolar Disorder. Therapy can help the person identify and change troubling thoughts, emotions, and behaviors. Learning to identify triggers and warning signs of a manic or depressive episode can be useful in managing symptoms before they become severe. It also provides support, education, and guidance to people with Bipolar Disorder and their families.

In addition to psychotherapy and medication, there are several things a person with Bipolar Disorder can do to manage their symptoms, including developing a support network, creating structure and routines into their lives, practicing healthy habits (i.e. regular exercise, healthy eating, and good sleep hygiene), and tracking their symptoms over time. Remember, Bipolar Disorder is a lifelong condition. It may take time to find the right treatment for you or your loved one but people who are committed to treatment are able to live meaningful and productive lives!

Suicide hotlines are an important resource for helping people who suffer from Bipolar Disorder. The National Suicide Prevention Hotline is free and can be accessed 24/7. Below is the information for the National Suicide Prevention Lifeline:

· Phone: 1800-273-8255

· Website: www.suicidepreventionlifeline.org

It is important to get appropriate treatment for Bipolar Disorder to get relief from symptoms and help you feel more like yourself. Gateway Behavioral Health Consultants specializes in treating mood disorders in teens and adults through therapy services. Dr. Ritchie will be hosting a live Q&A on June 23rd at 6pm to answer your questions about treatment for mental health disorders.

For more information about services provided at Gateway Behavioral Health Consultants, click the following link to sign up for our newsletter (https://www.gbhconsultants.com/contact) or contact us at our office via phone (314-325-2685) or email (gbhconsultants@gmail.com).

References:

Bipolar Disorder. (2017, November). Retrieved May 18, 2020, from https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml

Bipolar Disorder. (2020, January). Retrieved May 18, 2020, from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml