Understanding Bipolar Disorder

On March 30th each year is “World Bipolar Day” which is also the birthday of the world-famous artist Vincent Van Gogh. His birthday was chosen based on a “posthumously” (after his death) diagnosis that he “probably” suffered from bipolar disorder. That is no joke. This “diagnosis” was not based on any actual, verifiable, and direct interaction with Van Gogh, but second and third hand accounts of his behavior. And it sadly points out just one of the major problems with properly diagnosing this mental disorder. Make no mistake, bipolar disorder is quite real, yet it continues to be “overused” resulting in not only misdiagnosis by “mental health professionals” that causes harm to people both mentally and physically when the wrong treatments are “prescribed.” At one point bipolar disorder was referred to as a “manic-depressive illness,” but this was changed after several successful medical malpractice lawsuits where sufferers received treatment for a “depressive disorder” instead of bipolarism and visa vera that resulted in damages up to and including death of the patient. Hopefully the following information will help clarify what exactly is bipolar disorder and how it is different from those suffering from depression. First off, bipolar disorder is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). These mood swings can affect sleep, energy level, judgment, behavior, and the ability to think clearly. Here are some key points about bipolar disorder: 1. Types: There are several types of bipolar disorder, including: • Bipolar I Disorder: Involves manic episodes lasting at least seven days or requiring hospitalization. Depressive episodes typically also occur. • Bipolar II Disorder: Characterized by a pattern of depressive episodes and hypomanic episodes, which are less severe than manic episodes. • Cyclothymic Disorder (Cyclothymia): Involves numerous periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least two years (one year in children and adolescents). 2. Symptoms: • Mania: Elevated mood, increased energy, decreased need for sleep, racing thoughts, inflated self-esteem, impulsivity, reckless behavior. • Hypomania: Similar symptoms to mania but less severe and typically not resulting in significant impairment. • Depression: Persistent sadness, feelings of hopelessness, loss of interest or pleasure in activities, changes in appetite or weight, fatigue, difficulty concentrating, thoughts of death or suicide. 3. Causes: The exact cause of bipolar disorder is not known, but it is likely influenced by a combination of genetic, biological, and environmental factors. Stressful life events, substance abuse, and imbalances in neurotransmitters are also believed to play a role. 4. Treatment: Treatment usually involves a combination of medication and psychotherapy. Mood stabilizers such as lithium, anticonvulsants, and atypical antipsychotics are commonly prescribed to manage mood swings. Psychotherapy, particularly cognitive-behavioral therapy (CBT) and interpersonal therapy, can help individuals cope with symptoms, manage stress, and improve relationships. 5. Management: Along with medication and therapy, lifestyle changes such as maintaining a regular sleep schedule, exercising regularly, avoiding drugs and alcohol, and learning to recognize and manage early signs of mood swings can help manage bipolar disorder. 6. Prognosis: With proper treatment and support, many people with bipolar disorder can lead fulfilling lives. However, it is a chronic condition that requires ongoing management, and some individuals may experience recurrent episodes despite treatment. 7. Impact on Daily Life: Bipolar disorder can significantly impact various aspects of daily life, including relationships, work or school performance, and overall quality of life. It's important for individuals with bipolar disorder to seek help from mental health professionals and to build a strong support network. With that in mind, here are some of the suspected causes of bipolar disorder: 1. Genetics: Bipolar disorder tends to run in families, suggesting a genetic component. Studies have shown that individuals with a family history of bipolar disorder are at a higher risk of developing the condition themselves. However, having a family history does not guarantee that someone will develop bipolar disorder. 2. Biological Factors: Imbalances in neurotransmitters (chemical messengers in the brain), such as serotonin, dopamine, and norepinephrine, are believed to play a role in bipolar disorder. Structural and functional changes in certain brain regions involved in mood regulation, such as the prefrontal cortex and amygdala, have also been observed in individuals with bipolar disorder. 3. Neurobiological Factors: Research suggests that abnormalities in the functioning of certain brain circuits and neurotransmitter systems may contribute to the development of bipolar disorder. For example, disruptions in the hypothalamic-pituitary-adrenal (HPA) axis, which regulates stress response, have been implicated in bipolar disorder. 4. Environmental Triggers: While genetics play a significant role, environmental factors can also trigger the onset of bipolar disorder or exacerbate symptoms in susceptible individuals. Stressful life events, such as trauma, loss, or major life changes, can trigger mood episodes in some people with bipolar disorder. Substance abuse, particularly stimulants like cocaine or amphetamines, can also precipitate manic episodes. 5. Psychological Factors: Certain psychological factors, such as personality traits (e.g., high levels of neuroticism) or coping styles, may influence the course and severity of bipolar disorder. Additionally, early childhood experiences, including adverse childhood experiences (ACEs) such as abuse or neglect, may contribute to the development of bipolar disorder later in life. It's important to note that bipolar disorder is a complex and multifaceted condition, and individual experiences may vary. While these factors are thought to contribute to the development of bipolar disorder, not everyone with these risk factors will develop the condition, and the interplay between genetic, biological, and environmental factors is still being studied. Now, at this point you may be thinking that this sounds a lot like what you hear about depression and depressive disorders. You are correct. There are obvious similarities. BUT, there are several key differences that you need to be aware of: 1. Nature of Mood Episodes: • Bipolar Disorder: In bipolar disorder, mood episodes alternate between manic or hypomanic episodes and depressive episodes. Manic episodes involve elevated or irritable mood, while depressive episodes involve persistent sadness or loss of interest. • Depression: In depression (also known as major depressive disorder), individuals primarily experience depressive episodes characterized by persistent sadness, hopelessness, and loss of interest or pleasure in activities. 2. Manic/Hypomanic Symptoms: • Bipolar Disorder: Manic episodes involve symptoms such as increased energy, racing thoughts, inflated self-esteem, impulsivity, and reckless behavior. Hypomanic episodes are similar but less severe and typically do not result in significant impairment. • Depression: Depressive episodes involve symptoms such as persistent sadness, changes in appetite or weight, sleep disturbances, fatigue, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of death or suicide. 3. Duration and Frequency of Mood Episodes: • Bipolar Disorder: Mood episodes in bipolar disorder can last for days to weeks or even months, and there are distinct periods of mania/hypomania and depression. The frequency of episodes varies among individuals. • Depression: Depressive episodes in depression typically last for at least two weeks but can persist for months or even years if left untreated. The frequency of depressive episodes can also vary. 4. Treatment Approach: • Bipolar Disorder: Treatment for bipolar disorder often involves mood stabilizers (such as lithium), anticonvulsants, and atypical antipsychotics to manage mood swings. Psychotherapy, particularly cognitive-behavioral therapy (CBT) and interpersonal therapy, can also be helpful. • Depression: Treatment for depression usually involves antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), along with psychotherapy. However, antidepressants alone may trigger manic episodes in individuals with bipolar disorder, so careful evaluation and monitoring are necessary. 5. Risk of Mania/Hypomania: • Bipolar Disorder: Individuals with bipolar disorder are at risk of experiencing manic or hypomanic episodes, which can lead to impulsive or risky behavior. • Depression: While individuals with depression do not experience manic or hypomanic episodes, they may be at risk of developing bipolar disorder if they have a family history of the condition or experience certain life stressors. As you can see, while both bipolar disorder and depression involve significant mood disturbances, bipolar disorder is characterized by alternating periods of mania/hypomania and depression, whereas depression involves persistent depressive episodes without mania/hypomania. Unfortunately, the health services field appears to be trying to link bipolar disorder and depression again. You can plainly see these recent posts by ABSCBN News on Instagram on “World Bipolar Day”: It is vitally important that if you know anyone suffering from the symptoms of bipolar disorder listed above or showing signs of chronic depression you try and assist them in getting help from a qualified mental health professional. Too many people who are suffering from these conditions and do not receive appropriate help are lost every day. Hopefully this information has been helpful and provided more clarity for you regarding bipolar disorder. Disclaimer: This blog post is for informational purposes only and should not be considered medical advice. If you or someone you know is experiencing symptoms of bipolar disorder or depression, it is important to consult a healthcare professional for evaluation and treatment.