We ask ‘What is Bipolar Disorder?’ Our guest author, a writer and blogger from the UK explains.
My History and a Little History
Whilst in my early twenties, I was diagnosed with Bipolar Affective Disorder, a psychiatric mood disorder. Females like myself, generally begin presenting with symptoms in their early twenties, whilst males a little earlier, usually during late adolescence. However, though I may have presented with symptoms of mania in my twenties, I had been dealing with severe depression since I was fourteen years old.
The term Bipolar Disorder is recent in origin. In the 1902, German psychiatrist Emil Kraepelin began studying those who experienced pervasive mood swings, later coining the term Manic Depression to describe these problematic cycles that his patients seemed to exhibit.
Manic Depression was the term used for many years until the associated stigma – mania taken from the word maniac – served to make the Diagnostic and Statistical Manual of Mental Disorders (DSM) to change it to Bipolar Affective Disorder in 1980. Some sufferers welcomed this change, whilst others felt that the older term more accurately described their experiences of the illness.
Who it Affects and Symptoms
Bipolar Disorder affects men and women equally, though women are prone to having more depressive episodes and more inclined to suffer from rapid cycling and, as with all mental illnesses, it does not discriminate by age, class or culture. The symptoms of mania are as follows:
- feeling very happy, elated or
- feeling overjoyed
- talking very quickly
- feeling full of energy
- feeling self-important
- feeling full of great new ideas and having important plans
- being easily distracted
- being easily irritated or agitated
- being delusional, having hallucinations and disturbed or illogical thinking
- not feeling like sleeping
- not eating
- doing things that often have disastrous consequences, such as spending large sums of money on expensive and sometimes unaffordable items
- making decisions, or saying things, that are out of character and that others see as being risky or harmful
There is a milder form of mania referred to as Hypomania, which some people may experience. Hypomania is a less severe manifestation of the disorder and for some people can be quite an enjoyable experience where they feel very productive and creative. Additionally, there are different types of Bipolar Disorder, for instance in Bipolar type II some people only experience hypomania’s and depressions, rather than suffering from the acute form of mania associated with Bipolar type I. The symptoms of depression are as follows:
- feeling sad and hopeless
- lacking in energy
- difficulty concentrating and remembering things
- loss of interest in everyday activities
- feelings of emptiness or worthlessness
- feelings of guilt and despair
- feeling pessimistic about everything
- being delusional, having hallucinations and disturbed or illogical thinking
- lack of appetite
- difficulty sleeping
- waking up early
- suicidal thoughts
Bipolar Disorder can be a devastating illness, even more so if left undiagnosed. Statistically it can take up to 12.5 years to receive an accurate diagnosis. Many people unfortunately are diagnosed with other psychiatric illnesses such as Depression, Major Depressive Disorder, Borderline Personality Disorder and so forth before they receive a correct diagnosis.
Unlike physical illnesses, which can be diagnosed through physical examination and blood work, psychiatry is more of a watch and wait process. The lack of clarity and numerous inaccurate diagnoses’ can be frustrating, however, it is important to realise that a correct understanding takes time and patience to achieve. Tips that may help receive an accurate diagnosis are:
- If you are concerned that you may have Bipolar Disorder, make an appointment with your GP immediately as your GP can refer to your local mental health service for an evaluation.
- Be brutally honest – a professional cannot make a correct diagnosis if they do not have all the facts.
- Talk to your family – they may well have noticed changes in your mood and therefore can provide feedback which can be useful as we try to understand what is happening; they can also be a valuable source of information during appointments.
- Keep a mood diary, chart your moods, emotions and activity levels each day. Sometimes scoring your moods can be also be helpful ; ie 0 = severely depressed, 5 = normal mood, 10 = full blown mania. This will not only help you develop a clearer understanding but will also be particularly useful to your psychiatrist.
When I was first diagnosed, initially it felt like I had been handed a death sentence. As with any illness, there is a natural process that we all go through as we endeavour to accept the diagnosis that we have been given and the associated impact and implications of this. My own initial reaction was one of denial, as I tried to convince myself that there was nothing inherently wrong with me. I rallied against my psychiatrist, trivialised my previous experiences and refused to accept the reality of the situation.
When I did eventually begin to accept the fact, my feelings turned quickly to anger. Anger as I asked, ‘Why me?’ and ‘How did I end up with this?’ and even ‘Who am I’. I felt as though I had lost control, my understanding of my former identity felt under threat and I felt powerless and wondered whether my life would ever be the same again. I also realised that unlike a physical illness that others may understand, I had a mental illness and therefore I may have to deal with stigma, ignorance and a lack of understanding from others, for the remainder of my life.
If you have recently received a diagnosis, then giving yourself time to process and work through your feelings and emotions is crucial.
There is a vast amount of literature to be found through books or online resources about Bipolar Disorder and it is imperative that once you have a diagnosis that you then try to learn as much as possible about the disorder. Knowledge really is power!
Many people live with Bipolar Disorder in less than conventional ways and have achieved incredible success.
Every illness affects each person differently and mental illness is certainly no different. Therefore, it is important that you begin to understand your own ‘unique blend’ of Bipolar Disorder. psychiatrists do tend to stick rigidly to their textbooks and this can be problematic when one’s experiences do not fit within the black and white medical model. Additionally, many people live with Bipolar Disorder in less than conventional ways and have achieved incredible success, so do keep an open mind.
Your psychiatrist will want to discuss a drug regime. Ultimately, the choice of what medication to take should always reside with the patient. Some psychiatrists can be very forceful with drugs, so I would advise any sufferer to do some research and be clear in their own mind as to what medications and doses they are willing to take. Do not allow yourself to be pressured into any decisions.
Draw up a care plan. A care plan is a document that states all of your preferences concerning your mental health. For instance, which family member would you like to make decisions on your behalf, in the event that you become seriously mentally ill? What medications are you prepared to take? What would be the procedure if you became manic or depressed?
Sleep: It is the best medicine. Not only does sleep play a role in regulating mood but a lack of it, can lead to mood fluctuations leaving us vulnerable to experiencing either mania or depression.
Diet: Try to eat a healthy and balanced diet that not only supports your body but also supports your mind.
Exercise: Research has proven that exercise is good for depression and overall good for health. Not only will it keep you fit and healthy, it is also a useful way of channelling moods and emotions and a useful distraction tool.
Medication: If you use medication, try to get into a routine of taking it at the same time each day and try not to miss doses, as this can have a huge impact on your moods.
Routine: Routine is essential. However much we may decide that structure is not for us, routine will provide a sense of stability, familiarity and order within our lives.
Understanding and self-awareness: In order for us to manage our Bipolar Disorder, we have to understand ourselves – knowing yourself will help you to learn about your own particular blend of Bipolar Disorder, your cycles and how these manifest on a day-to-day basis. It will help you to discover what your own individual triggers are, what stresses are liable to effect your mood and ways of dealing with these things effectively. Taking time for yourself each day, relaxation and distraction techniques, time for self and meditation which helps to calm mind and body and lower stress levels are all incredibly important.
Self-Responsibility: Our illness is ours to manage. Taking responsibility may feel frightening in the beginning. We may feel overwhelmed, it may feel too much to manage or we may get into destructive patterns of allowing others to take responsibility and/or care for us. However, owning and managing our own illness will create a sense of autonomy, higher self-esteem and confidence and be far ore more rewarding overall.
Communication: It is not always easy to talk about how we are feeling but it is imperative if we are going to allow others to know what is happening and find the support and assistance that we will sometimes need.
All of the above tools for self-management are interlinked. The goal is incorporate them all into your life, rather than simply using one or two for maximum effect. Bipolar Disorder is treatable and manageable. If you are concerned that either you or someone you love may be suffering, please visit your GP and express your concerns. It is never too late to reach out!