Bipolar Disorder definition
Bipolar disorder is sometimes known as a bipolar affective disorder, manic depression (an old fashioned term not used very often now), or cyclothymia, a title which is used to describe a milder form of bipolar disorder.
Bipolar disorder is characterised by periods of extremely high energy often followed by periods of very low mood or depression.
The manic phases of bipolar disorder are further broken down according to their severity and given the titles hyper-mania and hypomania.
Hyper mania, the more severe form of mania can be experienced as very high energy, racing thoughts, feelings of powerfulness and genius, feeling that people aren’t ‘getting’ or keeping up with their ideas and insights and sometimes intense irritation about this. Sometimes there is a feeling of being on a mission or sometimes extreme sexual urges, there is often no regard for societal norms or limits or for the thoughts and feelings of others, and no perception of risk or danger.
To those close to the person suffering from mania all of this may look as if the person is obsessed by pursuing their latest, often very unusual or unreasonable, ideas is acting uncharacteristically loud and brash. They may dress in a way that they wouldn’t normally dress – more provocatively, more colourfully or without usual regard for cleanliness or neatness. They may notice that the person is going for very long periods without sleep or food, is uncharacteristically sexually promiscuous and is acting in a disinhibited, sometimes risky or dangerous manner. They may be on a short fuse and be speaking so quickly they are tripping over their words or be skipping from subject to subject, irrationally amused or angered by their thoughts or word associations.
The person suffering from mania may also display psychotic symptoms including delusions (fixed, false beliefs), or hallucinations (most common are auditory hallucinations – hearing things that aren’t there such as voices or music, or visual hallucinations – seeing things that aren’t there such as insects or frightening entities).
If the hyper-manic episode goes on for an extended time (more than ten days or so), you may notice that they become agitated and unable to deal with themselves or others. They are tired but still feel compelled to be very active and are unable to sleep for long or indeed, at all. They may also be very short-tempered and irrational. At this time, they may self-medicate with alcohol or drugs to try and control their feelings, and self-harm is also fairly common when people are desperate to find a sense of centeredness and peace.
Hypomania may present very similarly to hyper mania, but less severely and for a shorter length of time. There is not usually any psychosis present in hypomania.
Manic phases are often followed fairly rapidly by periods of depression which can be characterised by the sufferer becoming listless and apathetic. They may not be able to ‘feel’ anything other than emptiness, extreme sadness or despair.
They may present as under active, eat more than usual or less than usual. They may show no emotion and may not care about personal hygiene or the usual day to day activities of life and work. They may sleep most of the day or very little at all. Many people suffering from depression wake up very early in the morning and find it difficult to go back to sleep, mornings are often the most difficult time of the day in depression, with early evening bringing a slight feeling of relief. Concentration may be affected so the sufferer may not be able to read or watch the TV.
People may become suicidal or express feelings of being ‘apart’, not really there or out of their body observing themselves and their surroundings. They may be very emotional or display no emotions at all.
It is important that symptoms of mania or depression be reported to a Dr, who will most probably rule out any physical causes for the symptoms before referring to the person experiencing the symptoms to a psychiatrist.
The psychiatrist may diagnose:
Bipolar 1 – if there has been at least one period of hyper-mania which has lasted for more than seven days. Usually, a psychiatrist will look for depressive episodes too, but these aren’t always present in bipolar 1.
Bipolar 2 – if there has been at least one period of hypomania and at least one period of depression
Cyclothymia – this is normally diagnosed over a longer period of time that Bipolar 1 or Bipolar 2. The psychiatrist will look for periods of mild depression and periods of mild hypomania over the course of two years. In cyclothymia, the periods of mania and depression may be shorter lasting than in bipolar 1 and 2.
Bipolar Disorder Treatments
Bipolar disorder treatments usually include medication to stabilise the mood, in the past Lithium was the main treatment, but more modern medication regimes will often include sodium valproate. Anti-psychotic medications are prescribed for sufferers experiencing psychotic symptoms and anti-depressants for those experiencing depression. Other medications are sometimes prescribed to help re-establish a healthy sleep pattern.
Counselling and other ‘talking therapies’ are often extremely valuable when a person suffering from Bipolar disorder has managed to find some sense of normalcy in their mental health. Cognitive Behavioural Therapy (CBT), specialist nurse input to talk about triggers and recognition of the warning signs of an approaching mania or depression and working on self-care skills to help prevent further episodes from occurring.
What to do if you have concerns about a loved one
If the person is unwilling to visit a Dr, or if they don’t feel that there is anything wrong, you can contact a GP and let them know your concerns. If the person has already been diagnosed as having Bipolar disorder, they may have a contact number for their local ‘crisis team’, or you can contact their GP, Mental Health Social Worker or the team on the hospital ward if they have been admitted to a psychiatric unit in the past.
If you feel the behaviour of the person suffering from Bipolar disorder is dangerous to themselves, you or anyone else, or if they are expressing suicidal ideas you can call 999. Both the ambulance service and the police can help.