It’s not easy living with bipolar I, but here are some things I’ve learned throughout my struggle. If you also have bipolar I, you may want to consider sharing these points with your own friends and family to help them understand what you are dealing with.
Around 1% of us will develop bipolar disorder, formerly known as manic depression. People with bipolar experience both episodes of severe depression, and episodes of mania – overwhelming joy, excitement or happiness, huge energy, a reduced need for sleep, and reduced inhibitions.
The experience of bipolar is uniquely personal. No two people have exactly the same experience. Bipolar disorder has been associated with genius and with creativity. It is certainly true that a number of contemporary high achievers and creatives have spoken of their experiences, and throughout history it is possible to recognise bipolar type traits in the artistic, political and academic spheres. But what is it actually like?
Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels.
These moods range from periods of extremely “up,” elated, irritable, or energized behaviour (known as manic episodes) to very “down,” sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.
Bipolar disorder is typically diagnosed during late adolescence (teen years) or early adulthood. Occasionally, bipolar symptoms can appear in children. Bipolar disorder can also first appear during a woman’s pregnancy or following childbirth. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.
People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and uncharacteristic behaviours—often without recognizing their likely harmful or undesirable effects. These distinct periods are called “mood episodes.” Mood episodes are very different from the moods and behaviours that are typical for the person. During an episode, the symptoms last every day for most of the day. Episodes may also last for longer periods, such as several days or weeks.
Sometimes people experience both manic and depressive symptoms in the same episode. This kind of episode is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while, at the same, time feeling extremely energized. A person may have bipolar disorder even if their symptoms are less extreme. For example, some people with bipolar disorder (Bipolar II) experience hypomania, a less severe form of mania. During a hypomanic episode, a person may feel very good, be able to get things done, and keep up with day-to-day life. The person may not feel that anything is wrong, but family and friends may recognize the changes in mood or activity levels as possible bipolar disorder. Without proper treatment, people with hypomania can develop severe mania or depression.
Proper diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking with a doctor or other licensed health care provider is the first step. The health care provider can complete a physical exam and order necessary medical tests to rule out other conditions.
The health care provider may then conduct a mental health evaluation or provide a referral to a trained mental health care provider, such as a psychiatrist, psychologist, or clinical social worker who has experience in diagnosing and treating bipolar disorder. Mental health care providers usually diagnose bipolar disorder based on a person’s symptoms, lifetime history, experiences, and, in some cases, family history. Accurate diagnosis in youth is particularly important.
Researchers are studying the possible causes of bipolar disorder. Most agree that there is no single cause and it is likely that many factors contribute to a person’s chance of having the illness.
- Brain Structure and Functioning:Some studies indicate that the brains of people with bipolar disorder may differ from the brains of people who do not have bipolar disorder or any other mental disorder. Learning more about these differences may help scientists understand bipolar disorder and determine which treatments will work best. At this time, health care providers base the diagnosis and treatment plan on a person’s symptoms and history, rather than brain imaging or other diagnostic tests.
- Genetics:Some research suggests that people with certain genes are more likely to develop bipolar disorder. Research also shows that people who have a parent or sibling with bipolar disorder have an increased chance of having the disorder themselves. Many genes are involved, and no one gene can cause the disorder. Learning more about how genes play a role in bipolar disorder may help researchers develop new treatments.
Treatment can help many people, including those with the most severe forms of bipolar disorder. An effective treatment plan usually includes a combination of medication and psychotherapy, also called “talk therapy.” Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment can help people manage these symptoms.
Certain medications can help manage symptoms of bipolar disorder. Some people may need to try several different medications and work with their health care provider before finding medications that work best.
Medications generally used to treat bipolar disorder include mood stabilizers and second-generation (“atypical”) antipsychotics. Treatment plans may also include medications that target sleep or anxiety. Health care providers often prescribe antidepressant medication to treat depressive episodes in bipolar disorder, combining the antidepressant with a mood stabilizer to prevent triggering a manic episode.
People taking medication should:
- Talk with their health care provider to understand the risks and benefits of the medication.
- Tell their health care provider about any prescription drugs, over-the-counter medications, or supplements they are already taking.
- Report any concerns about side effects to a health care provider right away. The health care provider may need to change the dose or try a different medication.
- Remember that medication for bipolar disorder must be taken consistently, as prescribed, even when one is feeling well.
Avoid stopping a medication without talking to a health care provider first. Suddenly stopping a medication may lead to a “rebound” or worsening of bipolar disorder symptoms.
Beyond Treatment: Things You Can Do
- Regular Exercise: Regular aerobic exercise, such as jogging, brisk walking, swimming, or bicycling, helps with depression and anxiety, promotes better sleep, and is healthy for your heart and brain. There is also some evidence that anaerobic exercise such as weightlifting, yoga, and Pilates can be helpful. Check with your health care provider before you start a new exercise regimen.
- Keeping a Life Chart:Even with proper treatment, mood changes can occur. Treatment is more effective when a patient and health care provider work together and talk openly about concerns and choices. Keeping a life chart that records daily mood symptoms, treatments, sleep patterns, and life events can help patients and health care providers track and treat bipolar disorder over time. Patients can easily share data collected via smartphone apps – including self-reports, self- ratings, and activity data – with their health care providers and therapists.
If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn’t get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.