Bipolar

Overview

Bipolar disorder is a spectrum mood disorder, meaning that the intensity of the disorder varies from person to person.  It is a biological illness with strong genetic components (it runs in families), and is worsened by changes in hormone levels, trauma to the nervous system (i.e., emotional shocks) and the consumption of street drugs.  Psychological stress or distress can trigger a bipolar episode.  Bipolar means having two opposite poles, in this case, depression on one end and mania on the other.  There are also a lot of variations in the sequence depressive and manic symptoms manifest.  Some sufferers experience mania and depression simultaneously.  Others experience depression first for months, and then, suddenly, mania.  someone will not be diagnosed as having bipolar disorder until manic behaviors are identified.

Common symptoms of depression include:

  • Difficulty with concentration and memory
  • Difficulty making decisions
  • Frequent thoughts about dying
  • Dwelling on past failures
  • Feelings of worthlessness
  • Feeling helpless and overwhelmed
  • Pessimism about the future
  • Loss of sex drive
  • Restlessness or pacing
  • Sleeping too much or insomnia
  • Keeping away from people
  • Frequent crying
  • Trouble starting or finishing projects
Again, the intesity and duration of those symptoms vary from person to person. 

Manic symptoms are of two general types:  High (eupphoria/excitement/elation) and agitation (anxiety/restlessness/anger/acerbic mood)

Signs of euphoria include:
  • Abnormally high "Esteem" or arrogance and entitlement
  • Decreased need for sleep which can lead to temporary psychosis
  • Talkativeness
  • Racing thoughts
  • High risk behaviors
Signs of agitation include:
  • Anger 
  • Volatile behavior
  • Looking anxious and unhappy
  • Ill treatment of others
  • Irrational thinking
With both euphoria and agitation, the person's brain no longer functions normally.  There is a strong scientific evidence that part of the frontal lobe that is responsible for demonstrating a notion of right and wrong, empathy for others, and capable of insight, foresight and hindsight is greatly compromised not only during mania but also several weeks following a manic episode.  The consequences of that impairment are far reaching.  Literally, during mania, whether euphoric or agitated, people lose their minds.  People act as if they had taken amphetamines:  they can think faster, feel hyper logical (cold logic), become very goal oriented, have a decrease need for sleep, can no longer evaluate the consequences of their behavior, and they no longer listen to feedback.

Treatment
Many people with bipolar disorder require pharmacological treatment to function.  Today, there are excellent choices of psychotropic medications.  Several initiatives bipolar sufferers can take to reach a balance include maintaining good sleep hygiene, life routines, and reducing stress, but sometimes the guidance of a professional therapist is recommended.  Typical therapies are Cognitive Behavioral Therapy, Family Therapy and/or Group Therapy is necessary.  The National Alliance for the Mentally Ill (NAMI) and their local chapters offer extensive and up-to-date information on the disorder and offers support groups for sufferers and their families.

Websites

National Institute of Mental Health 

National Allance for Mental Illness

Medscape Psychiatry & Mental Health

Books