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Understanding bipolar disorder

Understanding bipolar disorder

As we get older, we may go through mood swings every now and then, and this is commonly experienced by many. However, when these shifts in mood become more intense and affect our day-to-day life, it might be a sign of bipolar disorder at play.

It’s important to tell the difference between natural mood changes and the ones that are more extreme. Catching the signs of bipolar disorder early on and getting timely treatment, can help us better understand and manage the intense emotions that come with it.

What is bipolar disorder?

Bipolar disorder is a mental health condition that causes us to have recurring and extreme mood episodes.

These can be either:

Depressive

When we’re noticeably
and persistently sad

Manic/Hypomanic

When we’re noticeably and
persistently happy or irritable

These mood episodes, unlike our typical responses to everyday situations and stresses, can be quite unpredictable, sometimes stretching on for days, weeks, or even longer. They can create significant challenges in our lives, often affecting our personal and professional relationships.

What is bipolar disorder?

How does it affect us?

Depending on the type of episode we experience, we may find ourselves dealing with different kinds of intense and extreme emotions.

Feeling euphoric/energetic during a manic episode
During a manic/hypomanic episode, we may feel:
  • Euphoric (immense joy)
  • Unusually energetic for our age
  • Agitated
  • An inflated sense of self-esteem
Feeling sad and hopeless during a depressive episode
During a depressive episode, we may feel:
  • Sad
  • Hopeless
  • A loss of interest in most activities

Since these states can have a major impact on our quality of sleep, energy, judgment, and behaviour, going through our daily life may become challenging for us. In severe cases, they may even lead to serious consequences such as thoughts about self-harm or suicide, overspending, or other risk-taking behaviours. However, even in the most challenging times, we can find healthier ways to deal with our struggles with the right support and mindset.

Common misconceptions:

Common bipolar disorder misconception: Only young people get bipolar disorder

What people may think:

Only young people get bipolar disorder.

Common bipolar disorder misconception: bipolar disorder is just mood swings.

What people may think:

Bipolar disorder is just mood swings.

Common bipolar disorder misconception: Bipolar disorder medications are addictive and affects our overall health.

What people may think:

Bipolar disorder medications are addictive and affects our overall health.

Causes

While we still don’t know the exact cause of bipolar disorder, it is usually a combination of genetic, psychological, and environmental factors that leads to someone developing it.

Signs and symptoms

Diagnosis

Healthcare professionals may conduct several different assessments to check if one has bipolar disorder.

Physical evaluation

  • A physical examination may be carried to rule out if there are other physical conditions or side effects from existing medications that might be causing symptoms
  • This may involve:
    • Inquiries on past medical and medication history
    • Physical examinations and blood tests
    • Neuroimaging studies

Psychiatric evaluation

  • Healthcare professionals may conduct an assessment to know more about an individual’s feelings, thoughts, and behaviours
  • This may involve:
    • A psychological questionnaire
    • Gathering of more information from family and confidants with permission of the individual

The individual may also be asked to record their daily mood, sleep, or other behaviours that may help reach a diagnosis in the form of a mood diary.

Healthcare professionals may conduct several assessments to diagnose bipolar disorder.

Treatment

Bipolar disorder treatment

Treatment will depend on symptoms, age, general health and severity of condition. Although the effects of bipolar disorder can be overwhelming, it can be effectively treated with medication, counselling, and brain stimulation therapies.

Throughout the treatment process, one can count on a team of dedicated healthcare professionals for support. This may include a:

Medical doctor specialising in mental health conditions (i.e. a psychiatrist)

Psychologist

Social worker

Occupational therapist

Case manager

Pharmacist

Nurse

Healthcare professionals may prescribe certain medications to help treat bipolar disorder. One may incorrectly assume that they do not need to take their medication when experiencing mania, especially in hopes of prolonging their elevated moods. However, it is important that individuals follow their full medication plan prescribed by their healthcare professionals. This helps one to properly treat and manage their symptoms.

Medications

  • 1 or more medications may be used to help balance extreme emotions
  • These may include mood stabilisers, antipsychotic medications, antidepressants, or anti-anxiety medications
  • Avoid drinking alcohol close to medication times as this may cause excessive drowsiness
  • Healthcare professionals will advise if there is a need to adjust their diet (though there is usually no need to)
  • Prescribed medications can be taken without worry as they are not known to be addictive

Duration

  • Medications may be prescribed for 6 months or longer, depending on the pattern and severity of one’s disorder
  • While it may take 1-2 weeks or longer for changes in mood to occur, one may notice improvements in sleep earlier
  • Even after feeling better, long-term medication therapy may be required to prevent more episodes from recurring
  • Based on one’s needs, healthcare professionals will adjust medications accordingly

Side effects

  • Just as with other medications, it is normal to experience some mild side effects
  • These may include nausea, stomach discomfort, dizziness, drowsiness, dry mouth, and constipation
  • Normally, the effects will go away on its own over time, and there is no need to worry

It is normal to be nervous or overwhelmed by the medications or its side effects. If one has any concerns, they can reach out to healthcare professionals for support. If they would like to stop their medications, they should discuss and make the decision together with the healthcare professionals so that they can advise them on the best course of action.

Medication therapy as a bipolar disorder treatment

In addition to medications, healthcare professionals are likely to recommend counselling, psychological therapy, or family therapy. This can help improve an individual’s ability to manage their emotions and daily activities and reduce the probability of recurrence of mood episode.

During therapy sessions one may learn how to:

  • Identify triggers for episodes
  • Develop healthy coping strategies
  • Take medications as prescribed
  • Solve interpersonal problems
  • Maintain regular daily routines
  • Enhance communication skills
  • Manage negative emotions effectively

Therapy sessions may be conducted individually (one-on-one) or in groups.

In individual therapy, one can acquire valuable skills to effectively manage their symptoms. For instance, they can learn helpful techniques, like setting phone reminders to stay on track with their medication schedule.

In parallel, family therapy equips one’s loved ones with the tools to provide support and assist them in managing their symptoms. For instance, they can play a crucial role in ensuring they take their medications as prescribed by checking in with them regularly.

Through both these types of therapies, an individual can not only learn how to better manage their symptoms, but also build a good support network of family and friends who understand their needs.

Counselling, psychological and family therapy as a bipolar disorder treatment

If one’s bipolar disorder does not respond well to medications, or they are unable to tolerate prescribed medications due to their side effects, healthcare professionals may recommend a course of brain stimulation therapy. This may come in the form of electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS).

In ECT, a person’s brain is treated with small controlled electrical currents over a brief period. It is a safe and effective treatment for both manic and depressive episodes.

On the other hand, in TMS, the neural circuits in the brain are stimulated using magnetic fields to help regulate mood during depressive episodes.

Brain stimulation therapy as a bipolar disorder treatment

Managing bipolar disorder

Although bipolar disorder may affect the way someone thinks or acts, it does not have to define them. To complement their treatment and manage their symptoms, one can try these strategies:

Managing bipolar disorder by learning how to cope with stress

Learn how to cope with stress

Managing bipolar disorder by developing and maintaining a healthy lifestyle

Develop and maintain a healthy lifestyle

Managing bipolar disorder by paying attention to its warning signs.

Pay attention to the warning signs

Managing bipolar disorder by building a support network

Build a support network

Managing bipolar disorder and devising a recovery plan

Devise a recovery plan