Aliyah was a peppy 18-year-old who had everything together insofar as external appearances indicated. In her first year of college, she is popular within her circle of friends, excels at intramural sports, and is willing to put in long hours studying to make the Dean’s List. By all accounts, she is a driven, successful person. However, there is a downward counterpart to her drive at school and social life. When her depressive episodes hit….they hit!!! She experiences periods of intense sadness and and retreats to her “depression cave,” where she makes up excuses for not spending time with friends, smokes marijuana, and makes up excuses to get late extensions on her schoolwork. Aliyah is worried that if she doesn’t get help, this is going to damage her collegiate experience.
Pete is sick and tired of taking his medication. After having been diagnosed with Bipolar Disorder Type I nearly 12 months ago, he can’t seem to remember what the big deal was. In fact, he’s recently decided he doesn’t particularly want to feel “normal” anymore, and has even gone as far as to suggest that he is actually more productive when manic. Though this isn’t necessarily totally inaccurate, friends and family know that he was also erratic, grandiose, narcissistic, and just generally not pleasant to be around when manic. The last time Pete stopped taking his medication, he ended up in the hospital for dehydration and lack of sleep.
Lyda was shocked when her partner sat her down to talk about her mood swings. Lyda assumed that these episodes were because of her period, but her partner thinks something else is going on, pointing out that she is losing weight and essentially not sleeping, and to make matters worse, that she doesn’t seem to notice. Lyda tried to explain that she is just happy now and has a lot of energy, but her partner wants her to talk to a counselor. She just wants her partner off her back.
What is Bipolar Disorder?
The National Institute of Mental Health reports that around 2.6% of adults, and less than 3% of adolescents in America have Bipolar Disorder. Furthermore, researchers are beginning to study children with symptoms of early-onset Bipolar Disorder.
From a clinical perspective Bipolar Disorder can be somewhat difficult to describe for at least two reasons: a) because of the nature of the disorder, and b) because so many portrayals of bipolar disorder in popular culture such as movies and TV-shows often paint an inaccurate picture.
To gain clarity, it may help to start out by noting that Bipolar Disorder was once known as “manic-depression.” That terminology, though no longer considered politically correct, did nonetheless adequately describe the two “poles” — at one end, individuals experience intense activity (manic episodes or mania), and at the other, they experience periods of strong emotional lows (depressive episodes or depression).
But wait — there are two types of Bipolar Disorder?
Absolutely! There are two kinds of Bipolar Disorder commonly diagnosed, and some related disorders was well. Each type is defined by the severity and duration of the manic and depressive episodes experienced. Portrayals of Bipolar Disorder in popular culture often only display one type (Type I) of the disorder, typically because the mania characteristics of Bipolar Type I are flamboyant, excessive, and often, dangerous. Bipolar Type II is also frequently experienced in our culture as well, but may be harder to see because of the less severe nature of its mania.
Bipolar Type I is the most severe of all the Bipolar Disorders. Individuals with Bipolar I experience manic episodes for more than seven days and depressive episodes for more than two weeks. In certain cases, the manic episodes are so severe that the individual must be placed in hospital care. At times, there may be a mixing of manic and depressive symptoms.
Manic episodes typically involve:
- Sharp increase in talkativeness
- Larger amounts of energy than normal
- The inability to sleep or quiet their mind
- Feelings of tension, distress, or frustration
- Extreme increase in efforts to achieve a goal, including the belief that one can achieve more in a set period than possible
- (The desire to engage in) Risky behaviors such as drug use, unprotected sex, compulsive purchases, etc.
Depressive episodes typically involve:
- Intense sadness
- Hopelessness and helplessness
- Lack of energy, sleepiness, and lethargy
- An inability to concentrate and remember important things
- Suicidal Ideation
- Lack of hunger or insatiable hunger
Bipolar Type II is similar to Type I, but without extreme manic episodes. Instead, individuals experience what are known as hypomanic episodes or hypomania (hypo = below or less severe), alongside the classic Type I depressive episodes. Hypomanic episodes are essentially a less severe form of mania, and often do little to impair function or decrease quality of life. In fact, they are often experienced positively as an increase in one’s drive toward productivity and creativity.
Cyclothymic Disorder is a pattern of hypomanic symptoms along with depressive symptoms but that happen infrequently and are not severe enough to warrant a diagnosis of either Bipolar Disorder or a Major Depressive Disorder.
Unspecified Bipolar Disorder is a type of Bipolar Disorder in which an individual’s symptoms fail to meet full criteria but are still significant enough to warrant a mental health diagnosis, and are not better accounted for by another disorder.
The Impact of Culture on Diagnosis
Remember that mental health diagnoses are essentially a cluster of behaviors that appear together which our culture has determined are unhealthy. Contrary to popular belief, what appears as mentally unhealthy in one culture (e.g., racial or ethnic group, country, gender, etc.) may not be considered unhealthy in another. One of the ways in which this is most evident is the level at which U.S. culture may under-diagnose Bipolar Disorder Type II. Because the hypomanic pole of Type II is often experienced as an increase in goal-directed behavior as mentioned above, it often slips under the radar of many mental health practitioners, who simply ignore it and diagnose persons instead with simple Major Depressive Disorder. In fact, one might even argue that within our culture, Bipolar Type II has another name — success! How often do we hear stories about hard-driving CEO’s who work crazy hours getting things accomplished, but who also playfully indulge with recreational drugs or spending, and still more occasionally have periods of depression?! This imagery is so frequently part of our capitalist folklore that we don’t even think of it as terribly abnormal.
How do I get help for my Bipolar Disorder?
If you meet the criteria above, it may be time to start counseling in St. Louis for Bipolar Disorder. Change Inc. can be part of your healing process — we can help! Remember that Bipolar Disorder is what you have, not why you have it. In other words, many people have Bipolar Disorder and are living happy and successful lives. If you aren’t, it isn’t simply because you have the disorder, but often, because it is being treated ineffectively.
In particular, research indicates that a combination of medication and talk therapy is the most effective treatment modality. If you’d like to try a few things on your own first, consider these:
- Look to get on a routine. If you already have one, look for disruptions within it — they are often the biggest triggers. Although the fast-pace, technologically driven culture in which we find ourselves does not necessarily seem to value routine, for persons with Bipolar Disorder, it is key. In fact, the often their daily routine/rhythm is disrupted, the more likely they are to tend toward mood destabilization. Try to identify what disrupts your daily routine, and see what creative ways you can come up with to remedy those issues.
- Get some sleep! Research has concluded that sleep is vital in regulating Bipolar Disorder. Even when not experiencing typical Bipolar Mood symptoms, disturbed sleep or lack of sleep is correlated with a disruption in overall routine (see above) and often triggers episodes for those with Bipolar Disorder. Monitor the number of hours you sleep in a simple, easy-to-use journal on your phone or in a notebook you can keep by your bed. In one column, simply write the amount of hours of sleep you got, and in the next, write your corresponding mood and energy state for that day. You will notice a correlation between sleep and mood!!!
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