In this post I will attempt to describe, through my personal experiences, what bipolar disorder is. I am not a doctor or a form of mental health practitioner, but have lived with this disorder for many years.
A Mood Disorder, A Mental Illness
Bipolar disorder is a mental illness classified as a mood disorder, where the person affected will have mood episodes of two extremes, depression and mania. These episodes shift in a cycle throughout the person’s life and can have a massive impact on functionality.
When we think of mood, we think of happiness, sadness, anger etc and these emotions can all be impacted by a mood disorder however the mood episode is much more of an extreme experience than the work “mood” really describes. A mood episode cannot be shifted by making someone laugh, like you could in the case of a bad mood, or a relaxing bath. These things may help minimally, but a mood episode is something that is almost impossible to override.
Depression in Bipolar Disorder is experienced in the same way as unipolar or “regular” depression. As with all variations of depression, this can have a huge detrimental impact on the individuals functioning. A person with depression will experience a combination for the following symptoms.
- feeling down, upset or tearful
- feeling tired or sluggish
- not finding enjoyment in things
- experiencing low self-esteem and lacking in confidence
- feeling guilty, worthless or hopeless
- feeling agitated and tense
- experiencing suicidal thoughts or feelings
Everybody experiences depression differently, whether it is bipolar depression or not, the severity of the symptoms can vary as well as which symptom is present, but the key to identifying this as a depression episode in bipolar disorder is the length of time and the impact on functionality. To be classed as a depression episode for Bipolar Disorder diagnosis, at least four of these symptoms must be present for most of the day, every day for two weeks.
That is not to say that in reality, living with Bipolar, that depression episodes cannot be shorter than this, each episode will vary as well as each individual’s experience, however this is the minimum for a diagnosis.
whilst there is a minimum time scale for the diagnosis of a depression episode in Bipolar Disorder, disgnosis of this actually falls down the the inditification of a manic episode.
The other type of mood episode experienced with Bipolar Disorder is Mania, classified as an extremely elevated mood. however, that does not mean that everything experienced within this episode is a positive experience. For some, sometimes mania can feel amazing, but it comes with its own string of issues and almost always is followed by a crash into depression.
The symptoms of a manic episode include:
- feeling happy, euphoric, with a sense of heightened wellbeing
- having lots of energy
- feeling sociable
- experiencing racing thoughts
- feeling extremely creative and full of ideas and plans
- feeling like you can perform tasks better and more quickly than normal
- being impatient, irritable or angry
- feeling confident, with high self-esteem
- experiencing hyper-sexuality, feeling attractive, flirtatious with more sexual desire
- feeling restless, on edge and having difficulty relaxing
- experiencing heightened senses – colours may seem brighter, sounds are louder and things are more beautiful than usual
- psychosis, experiencing hallucinations and delusions
Just as in Bipolar Depression, there is a minimum criteria for diagnosing a manic episode. Three of these symptoms must be present for all or most of the day for at least one week, and must have a noticeable impact on the individuals functionality.
There is a lesser form of mania, known as HypoMania which consists of the person experiencing these same symptoms but to a lesser degree, most likely in hypomania the person is still functioning but a noticeable difference in behaviour can be seen. Having hypomania without full blown mania will lead to a diagnosis of Bipolar Disorder 2 or Bipolar Depression depending on where in the world you live, this still falls under the categorisation of Bipolar Disorder. Hypomanic symptoms must be present for at least 4 days to receive diagnosis.
With Bipolar Disorder, the person will shift between these mood episodes almost in a cycle. Sometimes the mood episodes come on slowly, they can be identified and the person can take action towards minimising the impact of the episode, and sometimes they will come on so intensely and so quickly it is like just waking up and all of a sudden being depressed or manic. the person will go through these shifts throughout their whole life, however a person with Bipolar Disorder does not always have to be in an episode. We can go days, weeks, months even years with no symptoms of Bipolar, no episodes, then one day it is like it never disappeared. For a lot of people newly diagnosed, these spells of normality can lead us to questioning our diagnosis, wondering if we made it all up.
As Bipolar Episodes can come in cycles, and can also at times be identified at early onset, for some people it is possible to predict moods and cycles, however Bipolar Episodes can both be triggered by stressors, or brought on seemingly for no reason, which can hinder the accuracy of attempting to track and monitor the episodes. For some, keeping a mood diary is a very useful tool to spot and deal with episodes as they begin to surface.
To complicate matters, it is possible for somebody with Bipolar Disorder to experience a mixed episode, this is where symptoms of depression are experienced alongside symptoms of mania. For more on this see my post here.
Treatment and Cure
There is no test for Bipolar, and there is no cure. A person who correctly receives a diagnosis for Bipolar will be Bipolar for the rest of their life.
The agreed view in the medical field is that the best approach to treating Bipolar Disorder is medication to stabilise the brain. With all forms of medicine, there are those who choose a more holistic approach. It is important to work alongside professionals to find a treatment plan that works for you. See my advice on overcoming Bipolar depression here.