What is Bipolar Disorder

Bipolar disorder, previously referred to as manic depression, is a chronic mental illness that is characterized by extremely severe fluctuations of high and low changes in mood, behaviour, activity, energy, thinking, and concentration. “Bi’ means two and “Polar” means poles, so you can think of the periods of elevated moods (“highs”) and inflated moods (“lows”) as the two pillars of mood. Episodes of mood changes can last for days, weeks, or even months.

The “high” is known as mania, or hypomania if it is less severe and the symptoms of psychosis are not present. During a manic episode you might feel abnormally excited, confident, irritable, impulsive and delusional. While during a depressive episode, you might feel unhappy, hopeless, indifferent and lack energy levels. Hypomanic episodes are milder symptoms of mania and tend to be less troublesome.

What are the signs & symptoms of Bipolar Disorder

Like most other conditions, bipolar disorder can look different on different people because the symptoms vary in frequency, pattern and severity. Some people are more susceptible to mania or depression, while others may experience mania and depression at the same time (this is known as mixed episodes), and others may alternate equally between manic and depressive episodes. Bipolar disorder has four types of mood episodes, each with distinctive symptoms.

Manic Episode:

• Feeling unusually elated, high, or extremely irritable

• Experiencing jumpiness accompanied by being active

• Having racing thoughts

• Experiencing a decreased need for sleep yet feeling energetic

• Racing speech and jumping quickly from one topic to the next

• Impaired judgement and impulsive behaviour

• Being unable to concentrate and focus

• Hallucinations and delusions (in severe instances)

• Excessive appetite for pleasurable activities

• An unusual sense of importance, power, or talent

Hypo-mania:

Because hypo-mania is not as severe as mania, you are likely to feel euphoric, productive and energetic. You will also be more likely to carry on with your daily tasks without losing connection to reality. Although it is milder than mania it can result in impaired judgement that can affect some aspects in your life. It can also escalate to a full-blown manic episode or be followed by a depressive episode.

Depression:

• Feeling down, or sad and anxious

• Feeling restless and slowed down

• Having trouble making decisions or concentrating

• Trouble with interrupted sleep patterns such as trouble falling asleep or the opposite

• Losing interest in most activities

• Feeling hopeless and worthless

• Constant thoughts about dying or committing suicide

Mixed Episode:

A mixed episode, as mentioned earlier, is experiencing both the features of mania and depression at once. Experiencing depression in conjunction with anxiety, distractability, irritability , insomnia, and racing thoughts are some of the common signs you may experience. Because both manic and depressive states are at play, a high risk of suicide is possible.

Rapid Cycling:

Rapid cycling is when you experience four or more episodes (mood swings) within a period of 12 months and tends to occur when your bipolar disorder symptoms are not treated as should. These could either be episodes of mania, hypo-mania or even depression which occur very quickly over a period of hours or even days.

The Types of Bipolar Disorder

Bipolar I Disorder:

Bipolar Type 1 Disorder is defined by a pattern which contains episodes of mania that last at least seven days or when your manic symptoms have become so severe that hospitalisation is needed. Depressive episodes do occur separately as well but typically last at least two weeks. Mixed episodes are also possible because of the mood disturbance that takes place.

Bipolar II Disorder:

Bipolar Type 2 Disorder is defined by a pattern which contains episodes of depression and hypomania.

Cyclothymic Disorder:

Cyclothymic Disorder, also known as cyclothymia, is defined by persistent symptoms of hypomania and depression. Because these symptoms are not intense, they do not last long enough to qualify as a hypomanic or depressive episode. It is common for the symptoms to occur for at least one year in children and teenagers and two years in adults.

Causes, triggers & complications:

The causes of bipolar disorder are not yet completely understood, although both genetic and environmental appear to be factors. External psychological and environmental factors are usually referred to as triggers which can set off episodes of mania, depression or make the existing symptoms worse. It is important to remember that most bipolar disorder episodes do occur without obvious triggers.

In most cases, the first episode happens during teenage years or early adulthood. The symptoms come and go which can be very confusing for diagnosis. As a result, many people with bipolar disorder are misdiagnosed and are subjected to unnecessary suffering. Without proper treatment, bipolar disorder can worsen and affect your school or job performance, damage your relationships and disrupt your day to day functioning. Although bipolar disorder is a lifelong illness, taking the fist step by recognizing the problem will help you feel better and get your life back on track.

Substance Abuse:

Even though substance abuse is not a primary cause of bipolar disorder, it is likely to worsen the cause of the illness and set off an episode. Recreational drugs like ecstasy, amphetamines and cocaine tend to be the culprits in bringing on mania, while alcohol and tranquilizers bring on depression.

Stress:

Stressful situations and life events can play a huge factor in triggering bipolar disorder. These situations and life events could be anything from the death of a loved one, an altercation the turned sour with a close friend, getting fired from your job or leaving home for university.

Sleep Deprivation:

Mania episodes can be caused by loss of sleep. It is important to practice sleep hygiene as even a few hours of sleep skipped can trigger a mania.

Medication:

It’s important to note that taking the right medication can help a great in your recovery. For some people, certain medications such as antidepressants can trigger mania for obvious reasons. You should always take precautions when it comes to what drugs you take and how they can affect you. Be sure to keep an eye out for the number of times you take in caffeine and over the counter meds such as flu medicine to avoid the emotional burden caused by mania.

Seasonal Changes:

It is believed that manic and depressive episodes are likely to follow a seasonal pattern. Manic episodes are mostly common during the summer, whereas depressive episodes are more common during winter, spring and autumn. This is different for everyone.

Coping Mechanisms, a Self-help Guide

Bipolar disorder can be extremely challenging, especially if left untreated. These are a few ways you can make it a tad bit easier for yourself, a loved one or a friend. 

• Get to learning as much as you can about your condition. The more you know, the better you’ll assist in your recovery. Start taking treatment measures:

 Taking medication prescribed by your psychiatrist can help keep your symptoms at bay. I’m not saying that it’ll be easy finding your fit but that you’ll need to try several different medications and work closely with your psychiatrist prior to finding the ones that work best for you. Mood stabilizers such as lithium and anti-psychotics help in the prevention and reduction of episodes and the severity at which they may occur.

Remember to try to understand the risks and benefits of your medications and not to go cold turkey on your meds as well. Also speak to your Dr should you have a concern or so forth.

• Keep up with your psychotherapy sessions:                                                                                                                                                                                   

• Take up exercising:

• Keep a mood dairy:

• Always show up to your therapy and medical appointments

• Take your medications as prescribed

• Encourage a healthy lifestyle and make sure to get enough sleep

• Learn to recognize your mood swings and their triggers

• Be patient because recovery takes a long time and is not easy

• Stick to your treatment plans

• Pay attention to warning signs

• Avoid the intake of alcohol and recreational drugs

• Get support by either joining a support group or speaking to a close family member or friend

WHEN TO GET HELP:

Seeking help is usually the first yet hardest step towards mental health stability. Most people tend to feel hesitant and anxious about handling what will come next all on their own. You need to remember that asking for help is okay, even if you’re unsure of the mental problem that you might be experiencing. Should you experience any of the symptoms that are associated with bipolar disorder seek help and support, there are a whole lot of options that you might find suitable and more easily available for you. Suffering in silence is not okay.

Should you believe or be convinced that someone you know or care about might be in danger:

• Be there for them emotionally
• Take harmful objects away
• Don’t try to take matters into your own hands! Once you’ve got grasp of the situation find out whether the person is receiving psychiatric treatment or not
• Get the person professional help
• Call the emergency hospital number or rush the person to the ER if the symptoms are getting out of control

Contacts To Keep Aware Of In Crisis

• 082 911
• South African Depression and Anxiety Group: 0800 708 090
• Suicide Crisis Line: 0800 567 567 or SMS 31393
• LifeLine South Africa: 0860 322 322/011 728 1347
• ChildLine South Africa: 0800 055 555