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An Overview of Bipolar Disorder DISCLAIMER I’m not a psychiatrist (someone who diagnoses mental disorders and prescribes medication for them), so my understanding of this disorder is not complete. My education as a Certified Nursing Assistant is related more to recognizing the symptoms of the disorder and how to interact with and care for someone with the disorder. Do not use this information to try and diagnose or treat this disorder and anyone who believes they may be suffering from bipolar disorder should seek professional help. To anyone who suspects this might apply to them: remember that you have what you have, even if you are not diagnosed. A diagnosis is simply a description of your symptoms which allows you to get the help you already are needing. Onwards! What is Bipolar Disorder? Simply put, bipolar disorder means that a person has wildly unstable moods, struggle with having the energy to do things, and in general are plagued by troubling thoughts. Individuals with the disorder fluctuate between periods of mania and depression, and it is possible that these periods last several years if the individual is not receiving any kind of treatment. Bipolar disorder is known as being “common” among creative people (such as artists and musicians), as the periods of great sadness and mania are what give the person inspiration to create with such feeling. The severity of bipolar disorder varies from person to person. It can be thought of as a scale of 1 to 10, with 1 being the person has some problems and 10 being the person is completely handicapped by the disorder. Someone with severe bipolar disorder can actually develop a handicap, which means that they struggle to achieve living their daily lives as normal people. However, the flip side also applies. Some people can live with bipolar disorder for half or all of their lives with no one knowing about it. The person still exhibits all the signs, just not to a degree where it's blatantly obvious that there's something wrong and this person needs help. SIMILAR DISORDERS Because of the wide range of symptoms for bipolar disorder, it can sometimes look like other disorders. In the same family of affective disorders is depression, melancholy, dysthymia, and there are some personality disorders which can share similar symptoms as well, such as folks with extreme paranoia. PSYCHOSIS Rarely, it’s possible that someone in deep enough depression starts having hallucinations. This is brought on by prolonged and extreme stress. If the hallucinations last longer than 6 months then the person’s developed a type of schizophrenia. The more severe the hallucinations, the more sick the person is. (Hearing voices is actually more “non-serious” than seeing or smelling things, for example.) Symptoms of Bipolar Disorder A person with bipolar disorder can have any of the following symptoms: Sleeping problems. Specifically, problems with falling asleep and maintaining a regular sleep schedule. Poor self-confidence. Strong feelings of anxiety. Have no energy to do things. A decreased ability for critical thinking, fast-paced thoughts, thinking very far ahead. A person with bipolar disorder can think sixty steps ahead of someone else, but the line of thought their following is nonsensical because they’re unable to distinguish between what’s actually plausible and what is not likely to happen. Difficulties in making decisions. Aggression. Volatile and uneven emotions. Phases of mania. Generally where impulse control becomes a problem. A person can become hyper focused on something, or the opposite- be very flighty. People who know the individual might feel as though they are being used by the person. The problem with the moods, however, is a must in all cases. The moods can be thought of very much like a visualized heartbeat. It spikes up and down, with very brief interludes where things are stable. MANIA In a manic phase a person can behave in ways completely unlike themselves and can do a lot of things which are often detrimental to their health or relationships in some way. For example, they might gamble away all of their money or spend extreme amounts of it. A musician might stay awake for three days straight and produce an entire album. Someone might pick up a drug habit, or even kill someone. They are not always this bad, however, and it's possible to catch on to the fact that someone has bipolar disorder before things get this bad. In school, the child doing things they shouldn't can be indicators of a kind of mania- peeing on other kids, for example. Periods of mania can and do last as long as periods of depression. If the person is not diagnosed with bipolar disorder, these periods of mania can easily be mistaken for just a gambling addiction, for example. Causes of Bipolar Disorder Bipolar disorder (and mental disorders in general) can be caused by any one (or a combination of) the following: Genetics. Hormonal/chemical imbalances in the brain. Extreme amounts of stress, especially stress from crises or traumatic events which have not been worked through by the individual in question. Brain damage. Drug abuse. Another illness. Some disruptions in early childhood/poor upbringing which results in the child’s basic needs not being met (think Maslow’s Hierarchy of Needs). INHERITED VULNERABILITY A person’s “vulnerability” for mental disorders is something which is inherited. Some people have a high “tolerance” for these sorts of things, but others do not. Basically, if other family members are very sensitive then it is highly likely that their offspring will be born sensitive as well, and therefore be more vulnerable to developing a mental disorder if the above factors are experienced. Debut It is fairly uncommon for someone to be diagnosed with bipolar disorder before reaching their teens. It usually develops and “appears” sometime between the early teens to twenties. People who develop bipolar disorder early on can sometimes grow out of it by their late twenties, depending on how the disorder is handled. It is possible for a person to meet all of the above criteria which might cause the disorder without them exhibiting any outward symptoms. In these cases, a traumatic event can trigger the onset of the disorder. This can be as simple as someone important to the person dying. Diagnosing Bipolar Disorder In order for someone to have bipolar disorder they must have their symptoms for at least two weeks and have gone into at least two manic phases. The exact way in which it can happen can vary depending on the age of the individual in question: usually with kids, things take longer to figure out because you need to observe them a bit since they’re not usually very good at talking about feelings and experiences and things. It’s probable that someone with more severe bipolar disorder was involved in some incidences in school which lead them to being checked out for the disorder. Treating the Disorder How the disorder is treated varies depending on the severity of the disorder, as well as other factors (such as country, financial situation, etc.). Someone with severe bipolar disorder may be institutionalized. This can also happen if someone has committed a crime and been diagnosed with bipolar disorder, or who was simply apprehended while in a violent or otherwise dangerous manic phase. In emergency situations, the person can be given benzodiazepines (to put the person to sleep) and anti-anxiety medications (to calm the person). Benzodiazepines are highly addictive and so they are given out only temporarily in cases of bipolar disorder. Otherwise, lithium is the prescribed medical treatment for bipolar disorder. Examples of lithium medication include Abilify and Zyprexa. GETTING ON LITHIUM Because lithium is a natural element and is a salt, it is no simple thing to just start taking it. The electric impulses in our hearts and brains need salt to work, but having too much salt in the body can cause disruptions in them which may even lead to heart failure. Before a person gets on lithium, their kidney function gets tested and there are a series of blood tests done to make sure that the person is receiving an amount that will be effective without killing them. Other information about lithium medication: The dosage ranges between 0.8 - 1.2 mmol/l (millimoles per liter). The person can’t just start taking the full dose of the medication, they have to gradually increase the dose. It is fast acting insofar as psychiatric medications are concerned, taking effect as soon as three days after treatment begins. Someone taking lithium might have to control how much liquid they drink, as too much/too little can change the concentration of the lithium in the bloodstream (thus causing aforementioned issues). It’s possible to get lithium poisoning if too much is taken. Symptoms of Lithium Poisoning Tremors. Confusion, dizziness. Extreme thirst. Headache. Stomach pains, diarrhea. Troubles seeing (things look dim). Irregular heartbeat. Side Effects of Lithium Drowsiness. Reduced libido. Reduced reaction time (it can be dangerous for someone on lithium to drive, for example). Constipation. After longterm use, the person can develop uncontrollable tremors (and potentially other issues related to lithium poisoning). OTHER TREATMENTS Simply taking medicine as treatment is effective about only 50% of the time. Therefore, other methods are often needed. Most common is talk therapy, and educating the individual on bipolar disorder. Cognitive Behavioral Training (CBT) is also an effective treatment for bipolar disorder. In a nutshell, the goal is to get the person to recognize troublesome thoughts and change the way the person thinks, which in turn changes how they react. Electric Shock Therapy can be used in periods of deep depression or mania as well. This works by resetting the chemical balances in the brain with electricity, essentially. Side effects of this can be temporary or permanent memory loss (if the person receives this type of treatment often). Electric Shock Therapy usually happens around 8 times over the course of as many weeks. Afterwards, the person can be very drowsy and not quite "there," and should not operate a vehicle or heavy machinery and should have someone come pick them up from the hospital. If you have any questions or would like clarification, please feel free to reply to this guide. Is there something you would like to see a guide for? Reply to this topic with your request! Have something you need advice on? Contact me privately and I'll respond to it in my blog!