Understanding Bipolar disorder
What is Bipolar Disorder?
Bipolar disorder is a brain disorder causing dramatic shifts in moods, energy level and thinking that can last days, weeks or months. In the past, it was called manic depression because of these shifts back and forth between euphoric, energetic and sad, hopeless, low-energy states. Symptoms often begin in the teens or early twenties.
Bipolar disorder can be debilitating, affecting school, career and relationships. However, with proper treatment and maintenance, a person with bipolar disorder can lead a happy, productive and fulfilling life.
Bipolar disorder is often confusing because symptoms vary in length, intensity and combination. Some people feel depressed most of the time. Some fluctuate often between extremes. And others have only a few disruptions over a lifetime.
Manic symptoms. During a manic episode, a person with bipolar disorder may become reckless and use poor judgment. Some quit their job, gamble away their savings, run up credit card debts or engage in inappropriate sexual activity.
In severe cases, manic episodes include delusions and hallucinations.
Depressive symptoms. With bipolar depression, a person may feel sad, hopeless, irritable, guilty, moody, restless, move and speak slowly, sleep too much, have trouble concentrating and gain weight. A depressive episode can lead to psychotic depression (losing contact with reality) or even suicidal.
Bipolar depression is different from major depressive disorder and requires different treatment. In fact, many antidepressants can make bipolar disorder worse, making an accurate diagnosis extremely important.
To obtain the correct diagnosis, the first step is a series of tests which will include a physical exam to rule out medical problems that could cause the symptoms, a psychological evaluation, interviews with close family or friends and mood charting.
Diagnosing bipolar disorder can be difficult because symptoms may not be distinctly manic or depressive. For example, some experience mixed states which can combine high energy with a low mood leading to agitation, insomnia, distractibility and racing thoughts.
Another complicating factor is bipolar disorder symptoms overlap with those of other mental illnesses, and having bipolar disorder often goes hand-in-hand with other mental and physical issues, which must be addressed to make treatment effective. These include:
- Addiction. About half with bipolar disorder also have a substance use disorder–most often alcohol. Often they are self-medicating to help manage their symptoms such as sleep problems or racing thoughts.
- Anxiety disorders. Usually social anxiety or generalized anxiety disorder.
- Attention-deficit/hyperactivity disorder (ADHD). Typically involves overlapping symptoms including distractibility, impulsiveness and over-activity.
- Post-traumatic stress disorder.
- Physical health problems. People with bipolar disorder are prone to heart disease, thyroid problems, migraines, diabetes and obesity.
Who is at Risk?
More than two of every 100 people have bipolar disorder. Although we don’t yet know what causes bipolar disorder, research shows there is a genetic factor. People with a parent or sibling diagnosed with bipolar disorder have an increased chance of also developing a bipolar disorder.
The structure of the brain could be a contributing factor, too, with physical changes, neurotransmitter imbalances, thyroid problems and disturbances of circadian rhythms causing symptoms.
A high level of cortisol (the “stress hormone”) is also linked to bipolar disorder. For some, major life changes (getting married, going off to college, losing a loved one, getting fired), drug or alcohol abuses, medication, seasonal changes or sleep deprivation can trigger the first episode or make symptoms worse.
Treating and Managing Symptoms
Although bipolar disorder cannot be cured, the right treatment makes it possible to enjoy a successful career, a happy family life and satisfying relationships.
Initially, treatment focuses on balancing moods. Once the symptoms are under control, the biological and psychological aspects can be addressed. Treatment may include:
Medications. Often a combination of mood stabilizers, antipsychotics, antidepressants and anti-anxiety medications.
Psychotherapy. Approaches may include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), psychoeducation, family therapy or social rhythm therapy.
Hospitalization. If symptoms are severe or there is risk of self-harm.
ECT and TMS. If medication is not effective or causing debilitating side effects, Electroconvulsive Therapy (ECT) or Transcranial Magnetic Stimulation (TMS) may be treatment options.
Find support. Spending time with healthy, positive people and/or a support group can help sticking to treatment easier.
Healthy lifestyle. Moderate physical exercise, staying hydrated and getting plenty of sleep can help keep moods steady. Incorporating good stress management tools such as meditation, yoga and other relaxation techniques can also be helpful.
How Pine Rest Can Help
Pine Rest provides compassionate care, beginning with an assessment and diagnosis, and then following through with medication management and ongoing treatment.
Our staff can help people manage their symptoms, change thought patterns and behaviors, handle daily routines and improve relationships.
Treatment options include inpatient hospitalization, hospital-based day treatment programs, outpatient counseling and therapy, and substance use treatment in a variety of settings.
Pine Rest Services for Bipolar Disorder
Our outpatient services consist of a wide range of counseling and therapy options including Cognitive behavioral therapy and dialectical behavior therapy as well as specialty services including electroconvulsive therapy and transcranial magnetic stimulation.
To schedule a new outpatient appointment, call 866.852.4001.
For immediate help, call our Contact Center at 800.678.5500.
Additional Resources on Bipolar Disorder
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