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Bipolar Disorder

I wish I could keep this to myself. I don’t want anyone to know about it.

Bipolar can be misunderstood by those who have it and those who don’t.

Sometimes I think the worst part of bipolar disorder is accepting the diagnosis and living with the label. There is still an unfair stigma attached to it and most people don’t understand it well enough.

People throw around the term to anyone who happens to have a mood swing. Doing this is an insult to the people who live with this chronic condition every day and who should be admired for their courage and determination.

It’s like saying to someone who loses focus on something that they have ADD (Attention Deficit Disorder). There may be no harm intended but it’s unfair and unkind.

The label is not relevant or important. What matters is what’s happening to you, how it affects your life and what can be done about it. As a compromise for clarity, throughout this page, I will use the term “bipolar” and drop the word “disorder”.

What is bipolar?

Bipolar is a mental health condition that causes dramatic shifts in a person’s mood, energy, and ability to think clearly. People with bipolar experience high and low moods—known as mania and depression—which differ from the typical ups-and-downs most people experience. These shifts generally happen in distinct, sustained episodes, having varying frequency and usually lasting for life. It’s a chronic condition for which there is no cure.

About 4.5% of adults in the U.S. experience some form of bipolar at some time in their lives. This represents about 9 million people. Bipolar affects men and women equally, and typically begins in early adulthood.

Bipolar is not easy to diagnose. Some people have bipolar for years before the illness is identified. A doctor needs to diagnose you by evaluating the nature and severity of your symptoms.

If left untreated, bipolar usually worsens. However, with a good treatment plan including psychotherapy, medication, a healthy lifestyle, a regular schedule, and early identification of symptoms, most people live well with the condition.

Sticking to a medication protocol is a necessity. You must see an experienced psychiatrist. Medication will help manage your symptoms and put you in a position to live your life in relative stability. You may need to be on medication the rest of your life. As hard as this may be to accept, it’s better than living a chaotic life.

Having bipolar is a chronic condition, but it’s not who you are. It’s not your identity. Symptoms are part of the condition, and when they flare up, it’s the condition acting out, not you. It’s important to separate the voice of the illness from the voice of the real you.

Scientists have not yet discovered a single cause of bipolar. Currently, they believe several factors may contribute, including:

  • Genetics. The chances of developing bipolar are increased if a child’s parents or siblings have it. But the role of genetics is not absolute. A child from a family with a history of bipolar may never develop it. Studies of identical twins have found that even if one twin develops the condition, the other may not.
  • Stress. A stressful event such as a death in the family, an illness, a difficult relationship, divorce or financial problems can trigger a manic or depressive episode. Thus, a person’s handling of stress may also play a role in the development of the illness.
  • Brain structure and function. Brain scans cannot diagnose bipolar, yet researchers have identified subtle differences in the average size or activation of some brain structures in people with a bipolar condition.

What does having bipolar mean?

There are two main types of bipolar:
Bipolar 1 is defined by manic episodes that last at least seven days, or by manic symptoms that are so severe that the person may need hospital care. Depressive episodes occur as well, typically lasting at least two weeks. With Bipolar 1, there is a severe decrease in daily functioning.

Bipolar 2 is defined by a pattern of depressive episodes and hypomanic episodes. Hypomanic episodes last at least four consecutive days, and are present most of the day. They have similar symptoms to manic episodes but are less severe and don’t interfere much with daily functioning.

A manic episode lasts at least one week, nearly every day, for most of the day. It also causes a severe decline in everyday functioning. Symptoms include:

  • Inflated opinion of self
  • Decreased need for sleep
  • More talkative than usual
  • Racing thoughts
  • Unable to focus or concentrate
  • Increased goal directed activity; either at work, socially or sexually
  • Excessive behavior with negative consequences such as spending money or casual sex

A major depressive episode is present for at least two weeks, and results in a depressed mood most of the day, nearly every day. It results in a severe decline in everyday functioning. Symptoms include:

  • Inability to feel pleasure
  • Sleeping too much or too little
  • Weight loss or gain
  • Physical restlessness or slowing down
  • Loss of energy or fatigue
  • Feelings of worthlessness or guilt
  • Inability to focus or concentrate
  • Recurrent thoughts of death or suicide

Here’s how untreated bipolar can negatively affect the way you live:

  • Impulsive decision making such as quitting a job without having another one.
  • Self-medication with drugs and alcohol.
  • Volatile relationships with family, friends, and loved ones.
  • Financial distress from spending too much money.
  • Sexually transmitted diseases from promiscuous sexual activity.
  • Irrational behavior such as becoming angry at a situation that hasn't happened.
  • Poor work performance.

There are a number of treatment options.

Bipolar is treated and managed in a number of ways:

  • Psychotherapy, such as experiential therapy, emotion-based therapy, family therapy, and cognitive behavioral therapy. Talk therapy is highly recommended and produces the best results when paired with medication.
  • Medications, such as mood stabilizers, antipsychotic medications and, to a lesser extent, antidepressants. This is a necessity.
  • Complementary health approaches, such as aerobic exercise, mindfulness, meditation, faith, and prayer can be supportive.
  • Awareness of stressors and having regular patterns of activity and sleep.
  • Engaging your support system by disclosing to trusted people that you may need help.
  • Recognizing the early signs of relapse and having a plan in place before it occurs.

Here's some of what we’ll do together.

Here are examples of the benefits of psychotherapy and areas that I will focus on:

  • Becoming aware of harmful automatic thoughts and reactions, with methods of adjusting.
  • Awareness of your stressors and identifying ways to cope with stress.
  • Exploring your relationships with family and friends, and making necessary adjustments.
  • Exploring your romantic relationships and assessing required changes.
  • Learning relaxation and mindfulness techniques.
  • Cultivating regular patterns of activity and sleep.
  • Assistance in engaging your support system.
  • Recognizing early signs of relapse and having a plan in place before it occurs.
  • Becoming tuned in to your body and mind so you are aware of what’s happening to you at any given time.
  • Managing any specific areas of difficulty such as money, work, relationships, and self-care.
  • Helping you stay consistent with medications.
  • Preventing self-medication with alcohol or non-prescription drugs.
  • Assessing what has happened to your sense of self and integrating where necessary.
  • Working with your psychiatrist to make sure your treatment is the best it can be.

I’ll never get it under control.

Most people who get proper treatment and stick with the plan get their lives under control. It’s important to educate yourself and take responsibility for your own well-being. You must also use the resources that are available to help you.

I can’t accept I have this condition.

The harsh reality is that you may not be able to have everything you want. You may have to make compromises and adjustments to the way you live. However, this can also open doors to having a more meaningful, purposeful life.

Nothing seems to be working.

Every so often you need to evaluate how you’re doing. Sometimes medication and other treatments need to be changed. That’s why a good psychiatrist and psychotherapist are essential.

You don’t have to suffer.

The benefit of psychotherapy is having someone to help you with issues related to self- image, relationships, work, and life. You can’t control it but you can manage it so you can have a happy, fulfilling life.

Please don't hesitate to contact me for a free consultation.

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