What is Bipolar?
Bipolar is an extremely serious mental health condition, previously called manic depression, and sometimes referred to as bipolar affective disorder. There are serious repercussions for sufferer and their friends and family, especially if it is not diagnosed and treated. Four percent of people will suffer a form of bipolar in their life; it is equally prevalent between men and women.
Bipolar is a condition in which people go back and forth between moods (poles) and experience periods of a very good or irritable mood and the opposite pole, depression. These changes are called mood swings, and can happen very quickly. It is a cyclical disorder with episodes of depression and mania coming and going. It is a lifelong condition with exact causes and cures unknown, although effective treatment and management enables people with bipolar to live healthy and complete lives.
The first episodes of bipolar are normally experienced in late adolescence. The elevated moods are called mania, or if milder, hypomania. The elevated (high) and depressive (low) moods can occur simultaneously. This is called a mixed state.
People who experience mania often experience depressive episodes. They can also occur concurrently in what is called a ‘mixed state’ or rapidly cycle between each other.
The three types of bipolar are bipolar type I (mania and depression), type II (hypomania and depression) and Cyclothymia (hypomania and mild depression). They are distinguished by the nature and severity of mood episodes. Like major depression bipolar exists on a spectrum and like major depression it is important to get a proper diagnosis as treatment pathways can differ according to the type.
Bipolar is a lethal illness. Statistics point to the fact that 20% (likely much more) who suffer bipolar will attempt suicide at one point in their life.
Many people who are diagnosed with bipolar abuse alcohol and drugs to cope with their condition. Often the results are dire, sometimes fatal when this happens. The good news is that with proper treatment and management people can live fulfilling and rich lives.
People can beat bipolar, by this we mean people with bipolar can still live rich, fulfilling and meaningful lives – we are not suggesting the condition can be eliminated or abolished as there remains no definite evidence that a cure exists.
Let’s look at mania:
“There’s a whole spectrum of symptoms and mood changes that have been found in bipolar disorder,” says Michael Aronson, MD, a clinical psychiatrist and consultant for WebMD. “It’s not always dramatic mood swings. In fact, some people seem to get along just fine. The manic periods can be very, very productive. They think things are going great.”
The danger comes, he says, when the mania grows much worse. “The change can be very dramatic, with catastrophic results. People can get involved in reckless behavior, spend a lot of money, there may be sexual promiscuity, sexual risks.”
Mania is an elevated (high) mood, for some it can lead to a euphoric experience. These are the classic signs of a manic or hypomanic episode. Pubmed Health has an excellent list of bipolar symptoms. They are repeated and elaborated on here:
This is when manic concentration is severely impaired and easily noticeable by others. People in an episode are so caught up in their grandiose and rapid thoughts they struggle to absorb information in a methodical and systematic way. They want to press their opinions and ideas on others and struggle to comprehend and process information. This often results in lost objects, forgetfulness and if the person is in positions of responsibilities, evident failures and breakdown of these responsibilities.
Little need for sleep
Mania is often enjoyable for the sufferer they often are addicted to how brilliant and life changing they feel. They feel like they have unlimited energy, therefore sleep is not often wanted even if the sleep cycles are very much disturbed. Insomnia and short shallow sleeping is common.
As mentioned previously, actions and thoughts are frenzied and occupied with trying to divulge what are perceived as life changing truths, which skews proper judgement. During a manic episode self-centered thoughts and behaviour occur quite strongly.
Poor temper control
Emotional regulation is difficult, if not impossible when going through an episode unmedicated. Impulsivity, recklessness, stubbornness and pushiness are common when manic, as well as low tolerance for others’ opinions. This can result in leaving jobs, schools and relationships when problems and tensions arise.
Reckless behaviour and lack of self-control
This can be very difficult for families to come to grips with, as it often appears to be stubborn, bad and reckless behaviour. I used to work in a psychiatric hospital and spent much time speaking with families of patients with bipolar. Often they would bemoan and speak at length about their agitation with the manic phases. Patients would sometimes spend up to $60, 000 in a week and engage in very challenging behaviour, for example messing up and defacing their property. We don’t want to sugarcoat or gloss over these conditions. Bipolar is a very challenging experience for the person and the family.
Binge eating, drinking and or drug use
Sometimes the elevated feeling will instill a false sense of invincibility, so using drugs and alcohol to further the experience can be common.
Sex with many partners (promiscuity)
Having sex with many partners and experiencing an increased libido can occur. The risk for STDs, unwanted pregnancies, HIV and regretful behaviour increases with promiscuity.
Spending sprees and recklessness with money is common during a manic episode. You don’t need to have much money to do this either. People who are poor can blow welfare or low income easily on gambling and get lured into quick impulse and comfort buying. So, like gambling, bipolar can quickly deplete people of assets and income and consequently of relationships and families.
People in mania have an enormous amount of energy and normally function on only a couple of hours of sleep a night. Sometimes they can actually go days, even a week with no sleep and still have energy to spare. Often sweating and other nervous and agitated bodily symptoms can be detected. This increased energy will result in a hyperactive state in which the person is capable of a huge amount of work.