Health information to help with symptoms of bipolar disorders.

What is Bipolar Disorder?

It is normal to experience ups-and-downs, good days and bad days and the occasional I should never have gotten out of bed day, but as a general rule it is important to retain an inner calm or a middle ground to which we always return.

However, individuals with Bipolar disorder experience extreme mood swings. They tend to lose their inner balance, finding themselves at the far ends of the emotional spectrum.

They may even find themselves alternating between periods of exuberant elation or mania, when anything seems possible, and periods of deep despairing depression that leaves them in bed for weeks and unable to function in their day-to-day lives.

Symptoms of Bipolar disorder (sometimes referred to as manic depression) differ greatly between individuals. Some may enter a state of hypomania which is a milder form of mania, while others may have full blown manic episodes.

These episodes often involve elaborate ideas, an elevated state of happiness and wild plans. For example, a person having a manic episode may max out three credit cards and start tearing down walls with the idea of building themselves a mansion.

At the time, these irrational ideas seem absolutely possible and will lead to great success and fortune. People with Bipolar disorder (manic phase) may have a contagious optimism where life is limitless and so is their energy.

Some individuals with Bipolar disorder may experience mixed states where the symptoms take the form of great restlessness, agitation and even rage. But what goes up must come down and, as a result, these manic states are often followed by periods of deep depressionas the individual comes down from their high.

Diagnosing Bipolar Disorder

When making an appointment with a health care practitioner, it is advisable to arrange for a close friend or family member to accompany you to the appointment. They will be able to help you provide a clearer picture of your symptoms and how they are affecting your daily life, as well as the lives of people closest to you.

A medical check may be necessary to ensure that the symptoms are not caused by thyroid problems or the effects of certain drugs in your system. If Bipolar disorder is confirmed, remember to ask your doctor about ALL possible treatment options, their long-term effectiveness and any potential side effects.

Who Suffers from Bipolar Disorder?

Bipolar disorder affects men and woman equally with the average age of onset being between 18 and 22. Although not as common, some cases of Bipolar disorder do begin in childhood, and can even have a late onset in middle aged men and women. Ranging from a severely debilitating medical condition, to a mildly disruptive ailment, the prognosis of Bipolar disorder depends on the severity of the symptoms.

However, with the appropriate treatment, the prognosis is often good. While there is no quick-fix cure, many treatment options are available to help manage the disorder, and it may be possible to lead a normal life free of the disruptions of manic and depressive episodes.

Symptoms of Bipolar Disorder

Bipolar disorder symptoms include alternating patterns of emotional lows (depression) and emotional highs (mania). Bipolar disorder symptoms vary between individuals, as do the patterns of mood swings and cycles.

While one person may be in an elated mood for half the day, and become depressed within an hour (rapid cycling), others may experience manic episodes for days or weeks on end, before slipping into a deeply depressed state for months (slow cycling).

It is also common for some individuals experiencing Bipolar disorder symptoms to have long periods of normal emotion and only the occasional depressive and manic episode.

Other Conditions Related to Bipolar Disorder

Bipolar disorder is related to other disorders or problems such as:

• Anxiety disorders
• Substance abuse
• Depression
• High suicide rates

Manic symptoms may include:

• Poor judgment
• Increased sex drive
• Agitation, irritability or rage
• Irrational, spontaneous behavior and recklessness
• Short temper, violent behavior
• Increased energy, activity and restlessness
• Decreased need for sleep
• Feeling a sense of euphoria or being in an excessively good mood
• Talking fast and jumping between ideas so that conversation may be difficult to follow
• Easily distracted and lack of concentration
• Feelings of grandeur or unrealistic beliefs about one’s own abilities
• Substance abuse
• Failure to recognize that there is a problem
• Exaggerated optimism and heightened self-esteem
• Excessive spending

Depression symptoms may include:

• Depressed mood
• Low self-esteem, feeling worthless or excessively guilty
• Low Sex Drive or diminished interest in sex
• Change in appetite or unintentional weight loss or gain
• Loss of pleasure or interest in previously enjoyed activities
• Sleep disturbances; difficulty falling or staying asleep (insomnia) or sleeping too much (hypersomnia)
• Difficulty thinking and concentrating
• Difficulty making decisions
• Fatigue or loss of energy
• Feeling agitated, restless, or physically slow to the degree that others begin to notice
• Physical complaints such as headaches and stomach aches
• Negative or Suicidal thoughts or intent, or continuous thoughts of death and self-harm
• Suicidal thoughts or intent, or continuous thoughts of death and self-harm

Types of Bipolar Disorder

• Bipolar I - A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life.
• Bipolar II - Similar to bipolar I disorder, with moods cycling between high and low over time. However, in bipolar II disorder, the "up" moods never reach full-on mania.
• Rapid Cycling - In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year.
• Slow Cycling - In slow cycling, a person with bipolar disorder experiences long periods of mania or depression.
• Mixed Bipolar - In most forms of bipolar disorder, moods alternate between elevated and depressed over time. But with mixed bipolar disorder, a person experiences both mania and depression simultaneously or in rapid sequence.
• Pediatric Bipolar disorder – Early onset bipolar disorder (bipolar disorder in children) 
• Cyclothymia - (cyclothymic disorder) is a relatively mild mood disorder. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder.

Bipolar Disorder in Children

Bipolar disorder in children is very rare, however, it does occur. Mood swings are an expected result of this disorder making parenting very challenging. Just like adults, the symptoms of Bipolar disorder in children vary, but there are a few symptoms that differ from those that regularly occur in an adult. Children with Bipolar disorder may exhibit separation anxiety, bed wetting, nightmares, uncontrollable tantrums, and no desires for play.

It has been observed that some children suffering from Bipolar disorder, may also have ADHD. Treating children for Bipolar disorder is not an easy task, which is why it is so important to discuss treatment options with a physician. When a treatment is agreed upon, keeping records of changes in behaviors is an excellent way for parents to track improvements of specific treatments.

Along with prescribed treatments, some parents find that a diet change tremendously helps maintain a positive mood in their child. Parents with children suffering from Bipolar disorder find it helpful to stay up-to-date regarding this disorder, by researching new treatments online, talking to their doctor and joining support groups.

What Causes Bipolar Disorder?

The cause of Bipolar disorder is not yet fully understood. The neurotransmitters that regulate mood, such as serotonin, seem to be out of balance and brain functioning differs in individuals with the disorder. Studies have shown that this phenomenon runs in families, which suggests a strong genetic component.

More than two-thirds of individuals with Bipolar disorder have at least one relative who have suffered either from the same condition or major depression. Other theories suggest that manic states could be triggered by drug abuse, sleep deprivation and stressful life events.

Help for Bipolar Disorder

One of the biggest difficulties with Bipolar disorder is that those suffering from the disorder are often unaware of the severity and disruption caused by their alternating mood states. In the throws of a manic episode, the individual is usually convinced that there is absolutely nothing abnormal about his or her behavior, and may even assert that they have never felt better.

For this reason, it is often family, friends or health care practitioners who notice that there is a serious problem and suggest professional help. Left untreated, the effects of Bipolar disorder can be very disruptive and even fatal.

People in manic states have often taken huge irrational risks that could have serious consequences such as bankruptcy, car accidents, losing a job or unintentionally harming themselves or others.

Depressive states are equally dangerous and suicide rates are extremely high in this disorder. If you notice these symptoms in yourself or others, it is advisable to seek or encourage professional help.

Treatment Options for Bipolar Disorder

Drug Treatments

Prescription medication is often the first line of Bipolar disorder treatment once it is diagnosed. The most commonly prescribed drugs are:

• Lithium (Lithobid)
• Anti-seizure medications such as valproic acid (Depakene) or topiramate (Topamax)
• Mood stabilizers such as lamotrigine (Lamictal)
• Anti-psychotics such as rispiridone (Risperdal) or olanzapine (Zyprexa)
• Anti-depressants such as fluroxetine (Prozac) or quetiapine (Seroquel). However, there is some controversy regarding whether antidepressants should be prescribed for Bipolar disorder as they have the potential to trigger manic episodes.

All of these medications have various side-effects, some of which can be quite serious. For example, some anti-psychotic drugs increase the risk of high blood pressure, diabetes, and obesity. Ensure that you research all the options and are aware of all the side-effects and precautions of taking any prescribed medication before making a decision. Remember not to discontinue any prescription medication for Bipolar disorder without first consulting your doctor.

Psychotherapy

Another extremely useful Bipolar disorder treatment is Psychotherapy. This form of therapy can be extremely useful in helping you manage your Bipolar disorder. Your psychologist may help you uncover the triggers of your bipolar episodes such as high stress or too little sleep, or may assist you in changing certain behaviors during manic or depressive states.

Electroconvulsive Therapy (ECT)

Some doctors may recommend ECT as a part of Bipolar disorder treatment. This controversial treatment has been used with an 80% success rate in temporarily relieving the symptoms of bipolar and major depression. The procedure involves the administering of a muscle relaxant and short-acting anesthetic followed by a small shock of electricity sent to the brain which causes a generalized seizure that lasts for about 40 seconds.

ECT is often considered useful for those individuals that fail to respond to drug treatments or are unable to use the medication prescribed, such as pregnant woman, those that suffer adverse drug side-effects, or individuals that need immediate relief from symptoms. While the response rate to ECT is usually very fast, most studies show that it only has a short-term effect and should only be used for immediate relief from a severe bipolar episode. As with other treatment options, it is important to research all the precautions and possible side-effects of ECT. Memory loss has been implicated as a serious side-effect and has made ECT a controversial issue.  

Foods for Controlling & Hindering Bipolar Disorder

Many people suffering from Bipolar disorder find it helpful to cut out certain foods from their diet. Excluding alcohol should be number one for individuals with Bipolar disorder due to risks of combining a psychotropic drug and alcohol together, also, alcohol is a depressant and can cause mood swings to spike.

Another food that can spike a mood swing is sugar; simple sugars like those found in desserts have been known to aggravate mood swings. Since moods swings are so common in those with Bipolar disorder, it is important to steer clear of the caffeinated drinks and foods like coffee, soda and chocolate. These may temporarily boost mood and energy, but they can result in mental fatigue (crash) later. Any type of crash in mood may send someone easily into a bout of depression. Food is necessary for the body in order to get the right amount of nutrients daily.

Eating a well-balanced meal with fruits, vegetables, some dairy, poultry and fish products, can help someone with Bipolar disorder manage mood swings and maintain a positive outlook.

Tips for Coping with Bipolar Disorder

• Stick to your treatment plan! It is a common mistake for people suffering from Bipolar to stop their treatment when they begin to feel better. This often results in relapse.
• Avoid the use of alcohol and illicit or stimulant drugs. These sometimes trigger manic or depressive episodes. If you have a substance abuse problem, get immediate treatment - until that is dealt with, you will be less likely to stick to your treatment plan.
• Pay attention to your warning signs and patterns of mood changes. Keep a diary so that you begin to notice the patterns and triggers of your episodes. Involve family members and friends in watching out for these warning signs. If the signs suggest a pending episode, contact your doctor.
• Always consult a doctor before discontinuing or taking any new medications.
• Consider a support group or counseling with a licensed counselor. This may help you manage your disorder and deal with stress or other problems such as relationship difficulties.
• Get enough sleep! While most people can skip a few hours of sleep here and there with little consequence, loss of sleep has been shown to be a major trigger of bipolar episodes.
• Have an emergency plan! Ensure that you have details about your condition, important contact numbers such as doctor, employer, spouse and the names of any prescription medication you may be taking on you at all times. It may be important to appoint a back-up person that can handle all the necessary responsibilities such as fetching kids from school or feeding the pets in case of emergency.
• Have financial limits in place. Because spending-sprees are a common occurrence during manic states, you should set up precautionary measures. Do not keep a checkbook, and have strict limits put on any credit or debit cards. Have the bank notify a spouse or close family member if an excessive amount has been drawn or spent on any card.
• Get immediate help if you have any suicidal thoughts!
• People with Bipolar disorder often have excellent social skills, creative personalities, great reserves of energy and many other strengths. Speak to family members or your therapist to explore ways in which you can constructively use these qualities in a realistic and positive way without going overboard.

Coping Tips for Family and Friends

• Try not to tip toe around your loved one wondering how you can help. Rather sit down and talk during a calm moment to discuss constructive ways of helping without being too intrusive or over-bearing. Discuss in-case-of-emergency situations and get permission to notify relevant people should one arise.
• Take note of early warning signs and mood patterns so that you can learn to predict future episodes and help curb them.
• Learn all you can about Bipolar disorder. The more you understand the illness, the more prepared you’ll be to help and cope.
• Make a record of things that help and things that don’t.
• Plan ahead so that you know what to do in case of an emergency. Discuss limiting financial access or suggest that someone else be appointed ‘decision-maker’ over important matters during a manic or depressive episode. Agree beforehand on certain limits and boundaries to be set in place.
• Try not to blame your loved one for the illness. Be patient with the recovery process and offer unconditional love and support. While this does not make uncalled-for behavior acceptable, try not to take it personally.
• Set your limits. You need to take care of yourself and understand that sometimes your needs take priority. Do not become a slave to your loved one’s disorder.
• If someone close to you suffers from Bipolar disorder and this places great stress on you, seek supportive counseling for yourself and work out ways to take time out, relax and manage your stress effectively. It will not help your loved one if you wear yourself out to the point of collapse!