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While a lot of people will have heard of this mental illness, it is unlikely that many truly understand Bipolar Disorder and how it affects its sufferers. Awareness has been raised through the medium of television with series’ such as Eastenders, Holby City and Homeland running story lines centering around characters that are bipolar. While actresses Lacey Turner (Eastenders’ Stacey Slater), Camilla Arfwedson (Holby City’s Zosia March) and Claire Danes (Homeland’s Carrie Mathison) have all arguably portrayed the illness with a relatively high degree of accuracy, bipolar disorder has such a variety of symptoms that an in-depth explanation is required.
Bipolar disorder affects around 1 in 100 people. It is a chronic mental illness that can cause dramatic shifts in a person’s mood and ability to think clearly. The symptoms experienced from one sufferer to the next can vary greatly in severity and if left untreated, these symptoms usually become worse. The disorder is characterised by high moods, known as mania/manic episodes (or hypomania) and low moods, known as depressive episodes.
A person with bipolar disorder may experience distinct manic episodes and depressive episodes. However, it is possible to suffer from mixed episodes, during which you experience symptoms of depression and mania (or hypomania) simultaneously. These can be especially difficult to deal with, because it can be harder to work out what you’re feeling; your loved ones may struggle to know how best to help you and it is difficult to identify what help you require. People are often more likely to act on suicidal thoughts when experiencing a mixed state. Severe bipolar episodes of mania or depression may also bring on psychotic symptoms such as hallucinations or delusions.
In order to be diagnosed with bipolar disorder, a person must have experienced either mania or hypomania, which is simply a milder form of mania – compared with symptoms of mania, hypomanic symptoms are likely to feel more manageable and not last as long. These are some examples of typical feelings that people will experience during a manic episode:
- Happiness or euphoria
- Uncontrollable excitement
- Very confident or adventurous
- Easily distracted, as though your thoughts are racing
- Irritable and agitated
- Increased sexual energy
- Untouchable, as though you cannot be harmed
These sorts of feelings can result in people being more active than usual, talking a lot and very quickly, doing things that are out of character, losing social inhibitions, spending money excessively and taking risks. Some people will experience many episodes of mania or hypomania, whereas others will only experience them very rarely.
Depressive episodes on the other hand, produce a combination of physical and emotional symptoms that can negatively impact on a person’s ability to function in their everyday life. The level of depression can vary between mild and severe depending on the individual case. During a depressive episode, a person may experience the following feelings:
- Upset, tearful and low
- Tired or sluggish
- Low self-esteem
- Worthless or hopeless
Typical behaviours include not participating in activities you usually enjoy, a change in appetite, sleeping too much or too little, being withdrawn and perhaps self-harming or attempting suicide. However, not every person with bipolar disorder necessarily experiences these depressive states. It is also important to note that while they share some symptoms, bipolar depressive episodes and clinical depression are two different things and that we shouldn’t confuse them.
The exact causes of bipolar disorder are unknown, but there are few theories:
- Genetics – the chances of developing the disorder are increased if a family member also suffers from it. However, the role of genetics is not absolute and a child from a family with a history of the illness may never develop the disorder.
- Childhood trauma – there are some experts who believe you may develop the disorder if you experienced severe emotional stress during your childhood, such as sexual abuse, bereavement or neglect.
- Stress – a particularly stressful event, such as a serious illness, losing a loved one or financial difficulty can trigger the first bipolar episode.
- Brain chemistry – evidence reveals that bipolar symptoms can be treated with certain psychiatric medications which act on the neurotransmitters in your brain. This suggests that the disorder could be related to problems with the function of these neurotransmitters and this view has been supported by research.
It is important to note here that medication, drugs and alcohol cannot cause you to develop bipolar disorder but can cause bipolar moods and symptoms.
Treatment largely depends on the current episode that the patience is experiencing. For example, during depressive episodes you are likely to be offered medication, such as antidepressants, and psychotherapy like cognitive behavioural therapy (CBT). In contrast, during manic or hypomanic episodes you can be offered medication, such as Lithium, but are unlikely to be offered a talking treatment.
Mood stabilizers can be prescribed to prevent both manic and depressive episodes as well as antipsychotics if you are indeed experiencing psychotic symptoms. Self-management strategies can be a good way of dealing with bipolar disorder day to day, including a medication plan, crisis plans, mood management and recognising warning signs.
Advice for family and friends
It can be just as difficult for those watching their loved ones battle with bipolar disorder as it is for those suffering from the illness. The best advice for family and friends of people with bipolar is to be open, approachable and try to help the person feel not only supported but accepted. Learn their warning signs and triggers and help the sufferer to avoid these situations or learn to cope with them. When a person with bipolar disorder is episode-free, it is a good idea to make a plan with them on how to deal with their manic episodes. For example, you can help during these times by offering a second opinion on all decisions to avoid recklessness and by ensuring they stick to a normal routine. The best way to help is to simply listen and try to understand what that person is going through – support from a loved one can go a long way.
For further information on Bipolar disorder, you can visit these useful websites.
- National Alliance on Mental Illness (NAMI): https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder
- Mind: http://www.mind.org.uk/information-support/types-of-mental-health-problems/bipolar-disorder/about-bipolar-disorder/?o=1142#.Vp_OcSqLTDc
- Mental Health Foundation: https://www.mentalhealth.org.uk/a-to-z/b/bipolar-disorder