Bipolar Disorder

Bipolar disorder (also known as bipolar affective disorder, manic-depressive illness or affective psychosis) is a disorder of the brain that causes severe shifts in mood, energy and activity levels.

The disorder is categorized as extreme shifts between euphoric happiness (mania or hyper mania) to depressive lows in which the sufferer feels sad and hopeless as well as loses all pleasure in most activities — even those that they normally enjoy. The shifts in overall mood are different in nature to various mood cycles of a non-affected person due to their overall severity as well as the unpredictable nature of when they’ll happen. In some, they may only experience these severe shifts a few times a year, while others report that they’ll shift back and forth multiple times daily. These shifts in overall mental well being can lead to a variety of other disorders such as insomnia, eating disorders, as well as social issues such as inability to maintain relationships or steady employment.

Signs, Symptoms & Risk Factors

Those with bipolar disorder typically experience intense shifts in mood from their normal “control” mood. These shifts are classified as “mood episodes” and range from overly excited and euphoric (manic) to sad, depressed, or hopeless (depressive). On occasion, moods may exhibit both states of mania and depression, which is commonly referred to as a “mixed state.” Those who are experiencing mixed state symptoms are often highly energetic, confused and agitated while having trouble sleeping, experiencing changes in appetite and feeling very sad or hopeless. This often leads to increased suicidal thoughts or behavior and should be considered high risk.

Extreme changes in lifestyle, energy levels, sleep and behavior are often the early warning signs of a person affected by bipolar disorder. People with extreme episodes of either mania or depression often have psychotic symptoms as well. These symptoms are typically hallucinations or delusions. Because of these symptoms, people affected with bipolar disorder are often misdiagnosed with other mental ailments, such as schizophrenia. Bipolar disorder often develops in the late teens or early 20’s. Over half of all cases start before the age of 25 with some people reporting signs of symptoms in early childhood while others develop the disorder later in life.

Types of Bipolar Disorder

Diagnosis of bipolar disorder uses guidelines from the Diagnostic and Statistical Manual of Mental Disorders (DSM). To have an effective diagnosis, symptoms must be a severe shift from the baseline personality. The four basic types of bipolar disorder are:

1. Bipolar 1 Disorder: defined by mixed or manic episodes that last at least seven days, or by manic episodes that are so severe they require immediate medical care.
2. Bipolar 2 Disorder: defined by occurrences of depressive or hypomanic episodes, but no actual manic or mixed episodes.
3. Bipolar Disorder Not Otherwise Specified (BP-NOS): diagnosed only when symptoms of the illness exist but to not meet Bipolar 1 or Bipolar 2 criteria.
4. Cyclothymic Disorder or Cyclothymia: the mildest form of bipolar disorder. Those affected have episodes of mild depression or hypomania that are present for at least two years, but aren’t severe enough to meet the requirements of one of the other classifications.

Methods Used in Therapy for Bipolar Disorder.

Bipolar disorder can’t be cured, but it can be treated effectively under the supervisions of professionals. Treatments are generally geared around controlling the intense mood shifts that are present in those with the disease.

Treatments are on going throughout the lifespan of those affected and are generally composed of mood stabilizing medications and on-going visits with a professional therapist in order to monitor symptoms and adjust medications or dosage.

Medication

• Mood Stabilizers are usually the first choice to treat bipolar disorder. Lithium, Depakote, Lamictal, Neurotin, Topamax, and Trileptal are popular choices for treating bipolar disorder.
• Atypical antipsychotics are often used to treat symptoms, though generally in correlation with other medication, such as antidepressants. Zyprexa, Abilify, Seroquel, Risperdal and Geodon are often prescribed.
• Antidepressants such as Prozac, Paxil, Zoloft and Wellbutrin are examples of antidepressants that are often prescribed to treat depressive symptoms of bipolar disorder. Taking only antidepressants can often increase your risk of shifting between mania or hypomania. To prevent this shift in mood, doctors usually require mood-stabilizing medications as well.

Psychotherapy

Psychotherapy is often used in combination with medication and can be an effective treatment for bipolar disorder. Common psychotherapy treatments include:

• Cognitive Behavioral Therapy helps those with bipolar disorder learn to change harmful or negative thought patterns, which often lead to episodes of mania or depressive behavior.
• Family-focused Therapy involves family members and details coping strategies as well as recognizing patterns and onset behavior for episodes.
• Interpersonal and Social Rhythm Therapy helps people affected by bipolar disorder improve their relationships with loved ones as well as learn to manage their daily routines such as sleep and eating schedules.
• Psychoeducation teaches those affected how to recognize problem behavior as well as the patterns that lead to episodes. This sort of psychotherapy is typically done in a group setting.

Why Hire a Therapist?

It’s important to note that bipolar disorder isn’t curable. This means that the treatment is on-going, and that finding a qualified therapist with a specialty in these types of disorders is often the best way to go about living a relatively normal life. Therapists are there to discuss your needs, your symptoms, and adjust dosages on medication — or try new medications altogether while you are trying to work out the best course of treatment for your specific version of the disorder.

What to Look for When Finding a Therapist.

Since bipolar disorder is so often misdiagnosed as any number of other ailments, it’s important to find a therapist with experience in this particular disorder. While a specialist isn’t necessarily needed for mild cases, you do want to find a therapist that is willing to work with you over the long term in order to get the treatment you need in order to go about your everyday life.