Bipolar Disorder, also known as Manic Depressive Illness, is a disorder that affects the moods. Swinging from one polarity to the other, manic (the highs) and depression (the lows). Bipolar affects not only moods, but thoughts, and behavior. This disorder afflicts about six million Americans every year and is no respecter of persons. It runs in men and women equally. It is found in all races and ethnic groups, and while most people start manifesting symptoms in their teens or young adulthood, it can also surface in children, or later in adulthood. Bipolar Disorder tends to run in families.
Three Types of Bipolar Disorder
There are three types of Bipolar Disorder. Bipolar I, Bipolar II, and Cyclothymia. Bipolar I is the most severe form of Bipolar. The mood swings are more extreme with the emphasis is more on the mania. Bipolar II is a milder form in which the mania is less intense (referred to as hypomania) and the depressions are more frequent and severe. Cyclothymia is milder yet, with frequent hypomania and less intense depression.
Mania and Hypomania
Mania is the high mood. Each person's mania has its own characteristics in varying intensities. Let's start with Bipolar I mania.
- Highly elevated mood
- Feelings of grandiosity, invincibility, overly self-confident
- Rapid flight of ideas
- Excessive irritability and/or aggressive behavior
- Risky behaviors (gambling, shopping sprees, risky business deals, risky sexual behavior)
- Poor judgment
- Impulsivity
- Racing thoughts
- Racing speech
- In extreme cases, psychosis (paranoia, delusions and/or hallucinations)
Bipolar II mania is actually called hypomania. It is less severe than that of full blown mania of Bipolar I. According the Depression Bipolar Support Alliance, sometimes hypomanic symptoms are not noticed and a misdiagnosis of unipolar depression can occur. Here are some symptoms of hypomania
- heightened self-confidence
- More energetic and less need for sleep
- Irritability which can turn quickly to anger
- Mildly racing thoughts or speech
- More productivity at work
- More active and heightened pleasure in activities
- Trouble concentrating and/or distractibility
- Increased physical activity
- Agitation
Cyclothymia is much the same as bipolar II with hypomania being more frequent.
Depression
The opposite mood from mania in bipolar disorder is depression. Here are the symptoms of bipolar depression:
- Prolonged sadness and bouts of crying (often times for no obvious reason)
- Sleeplessness, or too much sleep
- Loss of appetite or increased appetite
- Anxiety
- Hopelessness
- Loss of interest in things that usually give you pleasure
- Fatigue
- Suicidal thoughts
- Decreased sex drive
- Excessive guilt
- Inability to concentrate
- Self-loathing
- Low energy
Suicidality During Depressive Stage
Depending on which type of Bipolar you have, the symptoms of depression will be more or less severe. There is a higher rate of suicide for bipolar II, however, bipolar I also has a high rate of suicide. The National Institute of Mental Health reports that as many as 1 in 5 bipolar patient's attempts and/or succeeds at suicide. This is an alarming statistic.
Rapid Cycling
Rapid cycling can be a very difficult and problem to treat. Rapid cycling is when there are 4 or more episodes of mania, hypomania or depression in a year. Cycles can swing from high to low as often as months, weeks, days, and even hours. According to the Journal of Clinical Psychiatry, 58, 1995 [Suppl.15], women are 3 times more likely to suffer from rapid cycling. Experts say that antidepressants or alcohol and drug abuse can trigger rapid cycling. However, NEVER stop taking any of your prescribed medications suddenly. Work with your doctor so he can monitor you closely. Abruptly stopping medication can be very dangerous.
Mixed Mood or Mixed State
Mixed moods are when someone is experiencing mania and depression at the same time. During a mixed state one can be in the deepest despair and hopelessness, and at the same time experience the rapid thoughts and high energy of mania. There is feeling of being completely out of control. It can be a very scary and dangerous situation. People in the throes of a mixed mood are at high risk for suicide, aggression, and other self-destructive behaviors.
Hope for Bipolar
There is hope for those suffering from any type of Bipolar disorder. Treatments vary and you will have to work very closely with your Dr. to find the right medication combinations and dosages. Medication and talk therapy go hand in hand, and a strong support system of friends and family can add tremendously to the quality of life.
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