Living life in extremes

Coping with bipolar disorder

Bipolar disorder, also known as manic depressive disorder, wreaks havoc on one out of every 100 lives in America. It affects men and women equally and is increasingly diagnosed in children. Described as feelings of extreme highs and lows, it can devastate a person’s life. Consider Jane who enters a manic state.

She’s extremely happy and feels superhuman. Her need for her pain medication has diminished. She becomes extremely motivated and stays up all night emptying all her cabinets and closets.

As her mania progresses, Jane becomes distracted and decides to go shopping leaving the closets empty and the floors full. At the store, Jane loses impulse control, spending hundreds of dollars that her family does not have. She doesn’t eat or sleep for days. As Jane senses that she is out of control, she feels “wired” and becomes irritable and more irrational.

During her manic state, which may last days or weeks, Jane may become paranoid and make impulsive decisions that damage relationships, endanger her health, jeopardize her career and cause her family financial ruin.

But mania is only one side of the problem.

Moods can quickly swing in the other direction, becoming extremely low during the depressive state. A person may want to sleep all the time, wrestle with thoughts of hopelessness and may even attempt suicide. Many times people in depressive states will seek medical attention. Since the provider only sees one side of the condition, it is often misdiagnosed as depression.

Since there is no definitive cause of bipolar disorder, there is no known cure. It can be successfully treated with a combination of medication and psychotherapy.

Bipolar disorders are classified according to the pattern and severity of the symptoms. A patient suffering with one type may develop another.

Bipolar disorder I is characterized by at least one manic episode or mixed episode (symptoms of both mania and depression occurring simultaneously) and one or more depressive episode, that lasts for at least 7 days.

Untreated mania may last at least a week, or it can last for months. Typically, depressive episodes may last 6 - 12 months, if left untreated.

Bipolar disorder II is characterized by episodes of predominantly major depressive symptoms, with occasional episodes of hypomania, less severe and shorter periods of euphoric-type symptoms, which last for at least 4 days. Bipolar II patients may have significantly more depressive episodes, and shorter periods of wellness between episodes. Bipolar II disorder associated with a high risk for suicide.

Cyclothymic disorder is has less severe, but more chronic symptoms than either bipolar disorder II or I. The hypomanic symptoms tend toward irritability as compared to the more euphoric symptoms of bipolar II. Single episodes of cyclothymic disorder may last for more than 2 months. The condition may proceed full-blown bipolar disorder or it may continue as a low-grade chronic condition.

Bipolar disorder not otherwise specified (NOS) are bipolar disorder conditions that do not meet other specified criteria.

Bipolar disorder with rapid cycling involves four or more manic, hypomanic or depressive episodes within a 12-month period. Mood swings can shift rapidly from mania to depression over the course of several days or hours. Rapid cycling can occur with any type of bipolar disorder. The condition is usually temporary.

If you have a loved one coping with bipolar disorder, you can help by learning everything you can. This knowledge will help you understand the disorder and help you identify the early warning signs of an oncoming episode. You can help by encouraging healthy behavior choices.

For more information on bipolar disorder, contact Ministry Health Care’s Behavioral Health Department.

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