Bipolar Disorder

What is bipolar disorder?

We've all heard various things about bipolar disorder, some accurate and some stigmatizing and incorrect. Today, I want to delve into the distinctions between bipolar 1 and 2, the experiences of those living with the condition, and the most effective ways to manage its symptoms. Firstly, it's important to recognize that individuals with bipolar disorder can lead fulfilling lives when receiving proper treatment. It's common for public discourse to focus on those who struggle to manage their symptoms, but it's vital to understand that they do not represent everyone with bipolar disorder. Additionally, individuals with mental illness are accountable for their actions and may simply require professional support to make positive choices. Displaying compassion and understanding as they work towards managing their symptoms is incredibly beneficial. It's also helpful to grasp the diagnostic criteria for bipolar 1 and bipolar 2, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). While the DSM is not exhaustive, it provides a framework for identifying symptoms and understanding the diagnostic process.

Bipolar 1 disorder

To be diagnosed with bipolar 1 disorder, an individual must meet the criteria for a manic episode. This manic episode could have occurred following a hypomanic episode, or not, and may be followed by a depressive episode, or not. However, a manic episode is necessary for a diagnosis of bipolar 1 disorder. A manic episode lasts for at least one week and is characterized by a distinct period of abnormally and persistently elevated, expansive, or irritable mood. Additionally, there may be an increase in goal-oriented behavior, such as starting numerous new projects, deciding to clean the entire house, or initiating a new business. During this week or more, the individual must experience three or more of the following symptoms: inflated self-esteem or grandiosity, decreased need for sleep, and being more talkative than usual or feeling a pressure to keep talking. When someone is in my office experiencing this, it's as if I can't get a word in edgewise because they're speaking so quickly and pressured, with all the words stringing together. This is another symptom - they'll have a flight of ideas or feel like their thoughts are racing, making it hard for them to focus. They also exhibit distractibility, being easily drawn to unimportant or irrelevant external stimuli, and making jokes about it, like saying "oh squirrel," as they talk about one thing while thinking of many other things happening simultaneously, Other thoughts may divert attention and increase goal-directed activity, whether socially or at work. Additionally, individuals may experience psychomotor agitation, making it difficult to sit still and causing irritability. The agitation and excessive energy associated with bipolar disorder are often overlooked. Furthermore, excessive involvement in high-risk activities, such as impulsive spending or risky investments, may occur, It is crucial to note that manic episodes are not triggered by substances or other medical conditions; they are a result of bipolar disorder itself. Many of my patients experience a sense of well-being during mania. They have an abundance of thoughts and ideas, feel invincible, and have little need for sleep. They can be highly productive and feel unstoppable, but this state is short-lived. Afterward, many report feeling ashamed, sad, and regretful about their actions. During manic episodes, individuals may make poor decisions such as excessive spending, engaging in risky sexual behavior, and impulsively pursuing grandiose ideas. They may also reach out to others in an overly enthusiastic manner, often at inappropriate times. Coming down from this state and facing the consequences of their actions can be challenging, especially if these actions were made public through social media or other means. Seeking professional help and rest are crucial during these times.

Bipolar 2 disorder

Bipolar 2 disorder is often overlooked or overshadowed by bipolar 1. Many people are unaware of the distinction between the two. It's important to understand that bipolar 1 and bipolar 2 can manifest differently. For a more comprehensive understanding of both disorders, you can refer to my video series linked at the end of this video. To receive a bipolar 2 diagnosis, specific criteria regarding hypomanic and major depressive episodes must be met, While hypomania shares similarities with the manic episodes experienced in bipolar 1, it is generally less severe and shorter in duration. Recognizing the signs of elevated mood or decreased need for sleep in bipolar 1 patients during hypomania is crucial, and prompt psychiatric evaluation is recommended. I strive to prevent my bipolar 2 patients from experiencing full-blown mania, as hypomania can be just as uncomfortable and upsetting. The main issue I observe in these patients is the occurrence of major depressive episodes, characterized by a depressed mood, loss of enjoyment in activities, changes in appetite or sleep patterns, fatigue, inability to concentrate, thoughts of death or suicide, agitation, slowed thoughts and actions, lasting for most days over a two-week period. Many individuals with bipolar disorder spend the majority of their time in a major depressive episode. However, when they visit a psychiatrist, they are often prescribed an antidepressant, which can trigger hypomanic or manic episodes. This realization often occurs for those with bipolar 2 while for those with bipolar 1, it may be noticed earlier, typically during their first manic episode.

Conclusion

When managing bipolar disorder, it's essential to seek the expertise of a psychiatrist to undergo a thorough assessment and identify a suitable medication regimen. While some individuals express concerns about the impact of medication on their creativity or sense of self, it is crucial to prioritize the use of mood stabilizers and atypical antipsychotics to prevent extreme mood swings and their potential consequences. It is advisable to ask questions about potential side effects, duration of treatment, and explore alternative medication options to find the most effective and personalized solution. In addition to medication, engaging with a therapist can provide valuable support in comprehending and managing the experience of bipolar disorder because like I said everyone experiences different early signs of hypomania or mania, which can provide tools to manage the subsequent depressive symptoms. Just like our physical health, individuals with bipolar disorder require a supportive and understanding mental health team. It may also be beneficial to implement measures to prevent destructive behavior, such as imposing limits on financial accounts or allowing trusted individuals to change social media passwords when sensing an episode approaching. By being proactive in self-care, such as adjusting sleep patterns, we can maintain stability. Ultimately, this content aims to enhance understanding of bipolar disorder and dispel misconceptions, highlighting the importance of proper treatment and support for individuals to lead fulfilling lives.