RECOGNIZING BIPOLAR DISORDER:
What is Bipolar Disorder?
Bipolar disorder, previously know as manic-depressive illness, affects millions of people each year. For those affected by bipolar disorder, life is an emotional roller coaster of intense highs and crippling lows. Many treatment options are available to help control these extreme changes in mood. Although there is no cure, with proper treatment, many people diagnosed with bipolar disorder can live normal lives. Until recently, bipolar disorder was known as manic depression. The word bipolar is now used to indicate the 2 poles, or extremes, that characterize the disorder. Bipolar disorder can affect a person's ability to experience a normal range of mood. If you picture a globe, the North Pole would be mania, and the South Pole would be depression. Every time you experience symptoms at one pole for at least 1 week, it is called an episode. Experiencing 4 or more episodes of mania and/or depression in a year is called rapid-cycling bipolar disorder.
As defined by the American Psychiatric Association, bipolar disorder includes 4 main mood episodes—Mania, Hypomania, Depression, and Mixed Mood.
Types of Mood Episodes Associated With Bipolar Disorder1
Manic Episode (Mania) is a distinct period during which there is an abnormally and constantly elevated, expansive, or irritable mood, lasting at least 1 week.
Hypomanic Episode (Hypomania) is a milder form of mania that lasts at least 4 days.
Major Depressive Episode (Depression) is a period during which there is either depressed mood or the loss of interest or pleasure in nearly all activities, lasting for at least 2 weeks.
Mixed Episode is a period of time during which a person experiences both manic and major depressive symptoms nearly every day for at least 1 week.
Types of Bipolar Disorder
Bipolar I Disorder2
One or more manic episodes or mixed episodes and often 1 or more major depressive episodes. Depressive episode may last for several weeks or months, alternating with intense symptoms of mania that may last just as long. Between episodes, there may be periods of normal functioning. Symptoms may also be related to seasonal changes.
Bipolar II Disorder2
One or more major depressive episodes accompanied by at least
1 hypomanic episode. Hypomanic episodes have symptoms similar to manic episodes but are less severe. Between episodes, there may be periods of normal functioning. Symptoms may also be related to seasonal changes.
Cyclothymic Disorder2
Chronic fluctuating mood disturbance involving periods of hypomanic symptoms and periods of depressive symptoms. It is a milder form of bipolar disorder; the periods of both depressive and hypomanic symptoms are shorter, less severe, and do not occur with regularity. Many, but not all, people with cyclothymic disorder may ultimately develop a more severe form of bipolar disorder.
Bipolar Disorder Not Otherwise Specified
When the bipolar disorder is not characterized by any of the above mentioned types of bipolar disorder.1 The experiences of bipolar disorder vary from person to person. Occasionally someone will experience the symptoms of a manic episode and a major depressive episode, but not fit into the above mentioned types of bipolar disorder. This is known as Bipolar Disorder Not Otherwise Specified. Just like the other types of bipolar disorder, Bipolar Disorder Not Otherwise Specified is a treatable disorder.
Recognizing Bipolar Disorder
Due to the changing nature of its symptoms, bipolar disorder can be difficult to recognize. For example, you may remember periods when you felt depressed, but fail to recall periods when you felt unusually "high" and energetic. To make an accurate diagnosis, a doctor needs to know all of the extended periods of "ups" and "downs" you have experienced in your life.
Bipolar disorder affects different people in different ways, and the Signs & Symptoms often vary from person to person.
The best way to recognize bipolar disorder is to understand its different types and look for specific symptoms.
Bipolar Signs and Symptoms
Mania (Manic Episode)
Mania often begins with an intense burst of energy, creativity, and social ease. People with mania typically deny that anything is wrong, and angrily blame anyone who points out a problem.1
In a manic episode, the following symptoms are present for at least
1 week1:
- needing little sleep yet having great amounts of energy
- talking so fast that others cannot keep up with the thought pattern
- having racing thoughts
- being so easily distracted that their attention shifts between many topics in just a few minutes.
- Having an inflated feeling of power, greatness or importance
- Doing reckless things without concern about possible bad consequences (eg. Spending too much money, engaging in inappropriate sexual activity, or making foolish business investments)
In severe cases, the person may also experience hallucinations or delusions.
“The fast ideas become too fast and there are far too many…overwhelming confusion replaces clarity…you stop keeping up with it—memory goes. Infectious humor ceases to amuse. Your friends become frightened…everything is now against the grain…you are irritable, angry, frightened, uncontrollable, and trapped."3
Hypomania (Hypomanic Episode)2
Hypomania is a milder form of mania that has similar but less severe symptoms. In a hypomanic episode symptoms are present for at least 4 days.
"At first when I'm high, it's tremendous…ideas are fast…like shooting stars you follow until brighter ones appear…all shyness disappears, the right words and gestures are suddenly there…uninteresting people, things, become intensely interesting. Sensuality is pervasive; the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria…you can do anything…but, somewhere this changes."3
Depression (Major Depressive Episode)2
In a major depressive episode, the following symptoms are present for at least 2 weeks:
the things one normally enjoys
Severe depression may also include hallucinations or delusions.
"I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless. [I am] haunt[ed]…with the total, the desperate hopelessness of it all…Others say, 'It's only temporary, it will pass, you will get over it.' But of course they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think, or care, then what on earth is the point?"3
In a mixed episode the symptoms of both a manic and major depressive episodes are experienced nearly every day for at least 1 week.2 This may be one of the most disabling episodes, as well as the greatest risk for suicide.1
References: 1. Kahn DA, Ross R, Printz DJ, Sachs GS. Treatment of bipolar disorder: a guide for patients and families. Postgrad Med Special Report. 2000(April):97-104. 2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Ed. Text Revision.
Why early diagnosis and treatment are important
It is important to get treatment for bipolar disorder as early as possible.
Many people with bipolar disorder do not know they have it. Some do not seek treatment because they are ashamed of what they feel, while others are incorrectly diagnosed with other illnesses, such as depression, anxiety, or schizophrenia.1,2 Without the appropriate treatment the disorder could become more difficult to treat.3
Getting the appropriate treatment for bipolar disorder can help alleviate the following risks1:
Learning how to recognize bipolar disorder may help someone receive an accurate diagnosis and appropriate treatment more quickly.
Suicidal impulses
Suicide claims the lives of about 1 in 5 people with bipolar disorder.1 The rate of suicide is higher when depression is untreated or is poorly managed.2 If the depression is severe, untreated, or mismanaged, the risk of suicide is greater.2
The Suicide Profile: Identifying an Increased Risk2
Because suicidal thoughts are unique and complex, it is difficult to predict which individuals will try or succeed in taking their own lives. Many personal, psychological, and medical factors enter into the equation. However, the following are some crucial factors that can signal you to an increased risk of suicide in your loved one:
Warning Signs2
It is important to be familiar with specific warning signs of a potential suicide attempt. Such "red flags" are recognizable and can alert you to the need for immediate help:
· Suicide Threats…People who threaten suicide should always be taken seriously. A person may directly state that he or she is thinking of suicide, or may make indirect comments like “everyone would be better off without me,” or “you’d be happier if I were never born.” Take these comments seriously, no matter how they are expressed.
· Sudden Change in personality or behavior. A sudden, extreme change in a person’s personality-for ex. , from shy to outgoing, or from outgoing to withdrawn—may be a red flag. The same goes for drastic mood swings (emotionally “high” one day and very “down” the next) or changes in eating and/or sleeping habits.
· High-risk activity. Activities that are uncharacteristically dangerous-like high-speed driving or having frequent, unprotected sex with anonymous partners –may signal an unspoken death wish.
· Personal crisis. Death of a loved one, divorce, job loss, or other personal crisis may be the “last straw” that makes a person with bipolar disorder attempt suicide.
· Giving away belongings. People who plan to take their own lives sometimes give away their treasured belongings, since they feel that they won’t need them anymore.
It is not uncommon for people to commit suicide as they are recovering from a long-lasting bout of depression.2 The individual may recognize the problems that bipolar disorder has caused and feels more hopeless than ever. But it is best to be on the alert, especially if the recovering individual still expresses feelings of hopelessness or negativity during this time.
Taken from: http://www.bipolar.com
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