Bipolar Disorder – Part 1

 I recently read an interesting account from someone describing what it’s like to have bipolar disorder, which used to be called manic depressive disorder. It is a mental illness that causes dramatic shifts in a person’s mood, energy and the ability to think clearly. The resultant lack of insight  compounds both its effects and the ability for the sufferer to get well. 

WHAT IS BIPOLAR DISORDER?

People with bipolar therefore experience high and low moods(mania and depression) which differ from the typical ups-and-downs most people experience.

In this series of three posts I want to describe the impact of the disease and a little toward awareness, education, understanding and management.

HOW COMMON IS BIPOLAR DISORDER DIAGNOSED?

Screening, consideration, diagnosis, treatment and support for BP is poor at best, appalling at worst. Incidentally BPD is the acronym for Borderline Personality Disorder as disease that is often confused, linked or associated with BP. Bipolar and Borderline Personality are two mental illnesses that can cause significant disability and disruption in someone’s life.

Yet despite being commonly grouped together or even used interchangeably in movies, TV, and other pop culture references, they are two separate and distinct illnesses that have different diagnostic criteria and require different treatments. 

HOW COMMON IS BIPLOR DISORDER IN THE US?

The average age-of-onset is about 25, but it can occur in the teens, or more uncommonly, in childhood. The condition affects men and women equally, with with around 2.8% of the U.S. population (328.5M), diagnosed with bipolar disorder and almost 83% of those cases classified as severe.

HOW COMMON IS BIPLOR DISORDER IN CANADA?

Approximately 1% of Canadians  (Pop 35M) , aged 15 years and over reported symptoms that met the criteria for a bipolar disorder in the previous 12 months. About 1 in 50 adults aged 25-44 years or 45-64 years reported symptoms consistent with bipolar disorder at some point in their lifetime

HOW COMMON IS BIPLOR DISORDER IN THE UK?

In 2013, there were almost 4 million cases of mood disorders, including bipolar disorder, in the UK (Pop 65.5M), . In 2014, younger people were more likely to have bipolar than older people – 3.4% of 16-24 year olds screened positive but only 0.4% of 65-74 year olds screened positive.

HOW COMMONLY IS BIPLOR DISORDER DIAGNOSED?

Unfortunately, if left untreated, bipolar disorder usually worsens. With treatment including psychotherapy, medications, a healthy lifestyle, a regular life schedule with adequate quality sleep and the early identification of symptoms, many people manage well with the condition.

THE SYMPTOMS OF BIPOLAR DISORDER

Symptoms and their severity can vary. A person with bipolar disorder may have distinct manic or depressed states but may also have extended periods—sometimes years—without symptoms. A person can also experience both extremes simultaneously or in rapid sequence.

Severe bipolar episodes of mania or depression may include psychotic symptoms such as hallucinations or delusions. Usually, these psychotic symptoms mirror a person’s extreme mood.

People with bipolar disorder who have psychotic symptoms can be wrongly diagnosed as having schizophrenia.  They are also frequently misdiagnosed as depressed and by treating “the depression” the swings may become much worse.

Most of the time, people in manic states are unaware of the negative consequences of their actions. When people are depressed, even minor decisions such as what to eat for dinner can be overwhelming.

THE SYMPTOMS OF BIPOLAR DISORDER – MANIA 

To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania.

THE SYMPTOMS OF BIPOLAR DISORDER – HYPOMANIA

Hypomania is a milder form of mania that doesn’t include psychotic episodes. Psychosis is characterized by an impaired relationship with reality. People who are experiencing psychosis may have either hallucinations, delusions or impaired insight or decision making.

People with hypomania can often function well in social situations or at work. Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life; others may experience them only rarely. This is indicated in the term “Rapid cycling bipolar”.

RAPID CYCLING BIPOLAR DISORDER

Rapid cycling is a term used when a person with bipolar disorder experiences four or more mood swings (episodes) within a twelve-month period. An episode may consist of depression, mania, or hypomania.

Although someone with bipolar may find an elevated mood of mania appealing—especially if it occurs after depression—the “high” does not stop at a comfortable or controllable level.

Moods can rapidly become more irritable, behaviour more unpredictable and judgment more impaired. During periods of mania, people frequently behave impulsively, make reckless decisions and take unusual risks.

Most of the time, people in manic states are unaware of the negative consequences of their actions.

With bipolar disorder, suicide is an ever-present danger because some people become suicidal even in manic states. Learning from prior episodes what kinds of behaviour signals “red flags” of manic behaviour can help manage the symptoms of the illness.

THE SYMPTOMS OF BIPOLAR DISORDER – DEPRESSION

The lows of bipolar depression are often so debilitating that people may be unable to get out of bed. Typically, people experiencing a depressive episode have difficulty falling and staying asleep, while others sleep far more than usual.

When people are depressed, even minor decisions such as what to eat for dinner can be overwhelming. They may become obsessed with feelings of loss, personal failure, guilt or helplessness; this negative thinking can lead to thoughts of suicide.

The depressive symptoms that obstruct a person’s ability to function must be present nearly every day for a period of at least two weeks for a diagnosis.

Depression associated with bipolar disorder over depression alone, may be more difficult to treat and require a customized treatment plan.

This book, Bipolar Disorder has been totally revised and reorganized to reflect the dramatic improvements in the treatment of the illness and numerous scientific breakthroughs.

To be continued …

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