Mood Swings (Bipolar) Anyone?

Are you Bipolar? Do you get “diagnosed” by family and friends who think you are Bipolar? Bipolar disorder, also known as manic depressive, is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal mood swings we all experience, the symptoms of bipolar disorder are destructive in nature. They can result in damaged relationships, poor job or school performance, and even suicide. However, there is good news--Bipolar disorder is treatable and manageable, if the appropriate steps are taken to identify the illness and treat with proper medication and therapeutic services. People with this illness can lead full and productive lives.

About 5.7 million American adults, age 18 and older, have bipolar disorder. Bipolar disorder typically develops in late adolescence or early adulthood; however, some people have their first symptoms during childhood or develop them late in life. Clinicians have a difficult time diagnosing someone at an early age for multiple reasons, and it is often not recognized as an illness during those years. As a result, people may suffer for years before it is properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is long-term.

The primary symptoms of Bipolar disorder are periods of dramatic mood swings—from overly “high” and/or irritable, to sad and hopeless, and then back again, often with periods of normal mood in between. The illness has two (bi) strongly contrasting phases (polar): 1) Bipolar mania or hypo-mania and 2) depression. The periods of highs and lows are called episodes of mania and depression.

A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Thus, even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania can become severe mania in some people or can switch into depression. Severe episodes of mania or depression include symptoms of psychosis (or psychotic symptoms). Common psychotic symptoms are hallucinations (hearing, seeing, or otherwise sensing the presence of things not actually there) and delusions (false, strongly held beliefs not influenced by logical reasoning or explained by a person’s usual cultural concepts). Psychotic symptoms in bipolar disorder tend to reflect the extreme mood state at the time. For example, delusions of grandiosity, such as believing one is God or has special powers or wealth, may occur during mania; delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed some terrible crime, may appear during depression. People with bipolar disorder who have these symptoms many times are diagnosed as having schizophrenia, another severe mental illness.

Symptoms of Manic Phase

• Increased energy, activity, and restlessness

• Racing thoughts and talking very fast, jumping from one idea to another

• Excessively “high,” overly good, euphoric mood

• Unrealistic beliefs in one’s abilities and powers

• Spending sprees

• Distractibility, cannot concentrate well

• Little sleep needed

• Denial that anything is wrong

• Poor judgment

• Extreme irritability

• Provocative, intrusive, or aggressive behavior

• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications

Symptoms of Depressive Phase

• Feelings of sadness, worthlessness, or guilt

• Poor appetite or eating too much

• Lack of energy

• Loss of interest in and withdrawal from usual activities

• Trouble sleeping or sleeping too much

• Nervousness and worry

• Irritability or restlessness

• Inability to think or concentrate

• Increased risk-taking behavior, including reckless driving or substance abuse

• Chronic pain or other physical problems that do not respond to treatment

• Abuse of drugs, medications and alcohol

• Repeated thoughts of death or suicide

Food for Thought

The diagnosis of Bipolar is not a death sentence; it is a way of life like any other health issue. I have worked with individuals with this diagnosis. I have found the process to be both rewarding and challenging. The process is rewarding to observe the individual gaining skills that will assist him or her live a healthier life by learning of the medical condition, providing therapy, and if needed, obtaining proper medications from his/her medical provider. The treatment for bipolar may include Lithium, antipsychotics, anticonvulsants, and benzodiazepines. Many people who have Bipolar disorder keep taking the medications prescribed for years or decades after their last manic episode to stay healthy. Additionally, throughout the lifespan of the individual taking medication, there may have to be some adjustments made to the medication due to tolerance to the dosage, or the medication becomes completely ineffective and there has to be changes. Unfortunately, there are other individuals who decide to take themselves off the medication, as is the case with other mental health issues, because the individual often feels that he or she no longer needs the medication due to the absence of negative symptoms, others encourage the individual to discontinue the medication, or they are just tired of taking medications. When this occurs, often the individual goes into a tailspin of negative symptoms/ behaviors. One of the most common that I have observed is grandiosity and over spending to a point that the individual has no money. I encourage those who are diagnosed with Bipolar to consult with his/her medical provider if he/she feels the medication is no longer working or that it is causing other symptoms, as opposed to completely stopping the medicine.

Individuals with bipolar disorder can lead healthy and productive lives when the illness is effectively treated. Without treatment, however, the natural course of bipolar disorder tends to worsen. Over time, a person may suffer more frequent (more rapid-cycling) and more severe manic and depressive episodes than those experienced when the illness first appeared. But in most cases, proper treatment can help reduce the frequency and severity of episodes and can help people with bipolar disorder maintain a good quality of life.