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THE INS & OUTS OF BIPOLAR DISORDER

You’ve probably heard of bipolar disorder before, but how much do you actually know about it? Well first off, it’s way more common than you think! In fact, 2.8% of adults in the U.S. have been diagnosed with it- that’s about 5 million, so if you’re suffering with it; you are absolutely not alone. But what is bipolar disorder? Bipolar disorder is a mental disorder that causes extreme and unusual changes in energy, mood, activity levels, and affects your ability to carry out day-to-day tasks.

Residential Treatment Center for Bipolar Disorder in Teenagers
courtesy of Elk River Treatment Program

For many people who suffer with bipolar disorder, these shifts cause them to go through periods of depression that can last for two or more weeks, as well as periods of mania or manic episodes which can last for several days or weeks. Depending on the person diagnosed with bipolar disorder, one can experience several of these extreme shifts in mood multiple times a year or only occasionally. Like any mental illness, bipolar disorder can affect people differently depending on the severity, the stage of treatment they are in, the events going on in their lives or the type of bipolar disorder they have. That’s right: there‘s more than one type of bipolar disorder; there’s actually three, but we’ll get into that later. All three types of bipolar disorders involve distinct shifts in energy, mood, and activity levels which range from periods of manic episodes to periods of depressive episodes that characterize this disorder. But what exactly is mania? 

Mania-Related Memory Bias Predicts Manic Episodes in Bipolar Disorder -  Psychiatry Advisor
courtesy of Getty Images

Mania is a period of extreme high energy or mood associated with bipolar disorder that is very different from the way the person suffering regularly thinks or behaves and can last from several days, to weeks, to even months. This can cause serious problems in the person suffering’s life, in relationships, work and school. Mania affects everyone differently and also appears in different ways, but some of the symptoms that mania generally includes are: high levels of energy, feeling “euphoric” (feeling extremely excited, happy or even “high”), feeling invincible, mind racing, easily distracted or annoyed, speaking very quickly (medically referred to as “pressured speech”), not sleeping, intense anxiety, impulsive behavior, and even feeling detached from reality (psychosis). These psychotic symptoms that people suffering with bipolar disorder can experience during a manic episode include: experiencing hallucinations, speaking in a way that seems disorganized or bizarre to others, feeling like they are being watched, and feeling  fearful or suspicious of certain people in the form of paranoia. However, some individuals suffering with bipolar disorder do not experience these psychotic symptoms and actually experience a less intense form of mania called hypomania. Hypomania does not impact the individuals daily life as severely as regular mania and is most commonly found in bipolar II and cyclothymia

There are different types of bipolar disorder that can be identified through their differing symptoms. Those who have Bipolar I Disorder have either severe manic episodes with depressive features, or severe depressive episodes with manic features. Bipolar II Disorder, however, doesn’t involve mania, but severe depressive episodes with periods of mild mood elevation. Cyclothymic Disorder is a less noticed, frequently untreated form of bipolar disorder. It’s characterized by brief periods of hypomania and depressive episodes, though they may be less extensive. This lasts one to two years, commonly among children and adolescents, and is often overlooked due to the appearance of the person simply being difficult. Bipolar Disorder resulting from medical or substance abuse has no real pattern for identification within the other three types of bipolar disorder, so it falls into this fourth type. It’s only identified by abnormal mood changes.

Photo by Andrea Piacquadio on Pexels.com

Mania is a mood disturbance severe enough to require hospitalization. It’s present in those with Bipolar I, and may also alternate with depressive episodes. Manic episodes may be triggered by stress, lack of sleep, and antidepressants. They can last up to seven days, or longer. Some of the more severe symptoms are psychotic features: hallucinations, auditory or visual; grandiose delusions; paranoid thoughts. Hypomania, on the other hand, is also a mood disturbance that while noticeable, is not severe enough to require hospitalization. It could be described as a milder mood elevation, present in those with Bipolar II. This may also alternate with depressive episodes. A period of hypomania can also last a few days, but is overall less severe than mania. Both are mood disturbances that can cause someone to become abnormally energized. However, they present themselves on different scales of severity. Both may be triggered by new or overwhelming situations like using recreational drugs, partaking in creative projects, staying out late, listening to loud music, etc. There are many common symptoms between the two as well, including but not limited to: higher-than-normal energy level, restlessness, decreased need for sleep, grandiosity or increased self esteem, a racing mind, increased sexual drive, and engaging in risky behavior.

Photo by August de Richelieu on Pexels.com

There is no known cause of bipolar disorder. Research does show, however, that a combination of factors may contribute to the development of bipolar disorder. Heredity being one of them, as studies have shown that bipolar disorder runs in families. Having a family history of bipolar disorder does not guarantee the development of it within any person, however it does mean that the chances are larger. It can show itself in any of the four forms within the same family, meaning that genes may not determine if or how you develop bipolar disorder. Research done on brain structure also shows that those with bipolar disorder may have a different brain structure than those without bipolar disorder or another psychiatric disorder. The significance of these changes is still unknown, but may help doctors better understand bipolar disorder and possibly identify a cause for it and possible treatment options. There are some environmental causes that can trigger bipolar disorder, such as stressful events or major life changes. Examples of triggers include:

1. The onset of a medical problem or loss of a loved one.

2. Substance abuse; an estimated 60% of individuals with bipolar disorder are dependent on drugs or alcohol

3. The changing of the seasons can put those with seasonal depression at risk of developing bipolar disorder. Those with anxiety may also be at risk. Some other factors that could be considered are: Pharmacological: Antidepressant medication may trigger manic episodes. Neurophysiological: Changes in the gray and white matter in the brain may lead to bipolar disorder. Psychodynamic: Mania can occur as a defense mechanism against depression.

Photo by Tima Miroshnichenko on Pexels.com

Now that we’ve covered what causes someone to have this affliction, let’s get into what those with it experience. The symptoms of bipolar disorder vary from person to person, but the most common marks of it include: manic episodes, unpredictable changes in mood or behavior, times of depressions, and mixed episodes. When a mixed episode happens, it is both manic and depressive, which then leads to significant changes in activity and energy levels, and stretches over longer periods of time. The usual duration of an episode is an hour, but it is not uncommon for it to last a week or two. While this can be extremely hard on an individual and their loved ones, there are treatments available. Once a patient is diagnosed a doctor will either prescribe them with medication, psychotherapy, or both. The medicine can include antidepressants, mood stabilizers, or different antipsychotics. 

Being a person who lives with bipolar disorder is difficult. It upends your emotions, your outlook on life, and it is not easy to get others to understand what you’re going through. However, it does not mean you cannot live a typical life or that you are not alike to others. You are incredibly strong and you can do whatever you set your mind to. 


This posting was written by Roselinn Pardo, Emily Kidd and Ksenija Krivokapic from Revive’s blog team.

The research was done by Sivani Manoj, Anchita Ganesh and Myat Thador from Revive’s research team


CITATIONS

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