Bipolar Disorder
Bipolar disorder (also known as manic depression) is a treatable illness marked by extreme changes in mood, thought, energy and behavior. It is not a character flaw or a sign of personal weakness. Bipolar disorder is also known as manic depression because a person’s mood can alternate between the "poles" of mania (highs) and depression (lows). These changes in mood, or "mood swings," can last for hours, days, weeks or months.
Nearly six (6) million adult Americans are affected by bipolar disorder. It usually begins in late adolescence (often appearing as depression during the teen years), although it can start in early childhood or later in life. An equal number of men and women develop this illness (men tend to begin with a manic episode, women with a depressive episode), and it is found among all ages, races, ethnic groups, and social classes. The illness tends to run in families and appears to have a genetic link. Like depression and other serious illnesses, bipolar disorder can also negatively affect spouses and partners, family members, friends, and coworkers.
Symptoms of Mania: The "Highs" of Bipolar Disorder
- Heightened mood, exaggerated optimism and self-confidence
- Excessive irritability, aggressive behavior
- Decreased need for sleep without experiencing fatigue
- Grandiose thoughts, inflated sense of self-importance
- Racing speech, racing thoughts, flight of ideas
- Impulsiveness, poor judgment, easily distracted
- Reckless behavior
- In the most severe cases, delusions and hallucinations
Symptoms of Depression: The "Lows" of Bipolar Disorder
- Prolonged sadness or unexplained crying spells
- Significant changes in appetite and sleep patterns
- Irritability, anger, worry, agitation, anxiety
- Pessimism, indifference
- Loss of energy, persistent lethargy
- Feelings of guilt, worthlessness
- Inability to concentrate, indecisiveness
- Inability to take pleasure in former interests, social withdrawal
- Unexplained aches and pains
- Recurring thoughts of death or suicide
Medications for Depression and Bipolar Disorder
- Mood stabilizers
These medications help even out your highs and lows. Some mood stabilizer medications are called anticonvulsants, because they are also used to treat epilepsy. - Antidepressants
These medications help lift the symptoms of depression. There are several different classes and types of antidepressants to choose from. - Antipsychotics
These medications are primarily used to treat symptoms of mania. Even if you are not hallucinating or having delusions, these medications can help slow racing thoughts to a manageable speed.
Interpersonal therapy (IPT) was originally developed to treat depression. It has since been adapted for bipolar and other disorders. It is time-limited and goal-oriented, and addresses a person’s symptoms, social relationships and roles. IPT focuses on what is happening “here and now” and attempts to help a person change, rather than just understand his or her actions and reactions. The patient and therapist examine current and past relationships. IPT does not focus on unconscious or subconscious motivations, wishes or dreams. It looks at conscious, outward action and social adjustment. It does not try to change the personality, but rather to teach new skills that can lessen symptoms.
An IPT therapist is an active supporter of the patient on the wellness journey. The therapist does not assign homework, but may encourage a patient to engage in social activities. The therapist helps the patient review his or her symptoms and relate these symptoms to one of four things: grief over a loss, conflicts with others, changes in life status such as moving or changing jobs or isolation/ lack of social skills. The therapist and patient then work through specific situations, one by one, to relieve symptoms and stress.
Cognitive-behavioral therapy (CBT) combines cognitive therapy, which involves examining how thoughts affect emotions, and behavioral therapy, which involves changing a person’s reactions to challenging situations. CBT is goal-oriented and works best when the patient takes an active role. One aspect of CBT helps a person recognize the automatic thoughts or core beliefs that contribute to negative emotions. The therapist helps the person see that some of these thoughts and beliefs are false or don’t make sense and helps the person change them. Types of automatic thoughts may include focusing on one negative idea (an unkind person) and applying the negative quality to everything (the human race in general); viewing things as “all good” or “all bad”; or applying labels such as “loser,” “no good,” or “worthless.” Types of core beliefs may include, “I have to succeed at everything”; “Everyone has to love me”; “It’s a disaster if things don’t go the way I plan or expect”; or “I can’t change the miserable way I am.”