Bipolar Disorder
Bipolar Disorders, formerly known as Manic Depression, are characterized by the experience of mood extremes of mania and depression. Prolonged periods of frenzy and elation (Mania), often followed by a person’s return to a normal “baseline” mood are later followed by periods of listlessness (Depression). Mood swings in the direction of mania or depression may last for weeks or months, causing disruption for the individual as well as for significant others, family, friends and co-workers. The illness can cause great distress & damage, and is associated with a high rate of suicide. Nonetheless, highly effective psychiatric treatment is available, and people with Bipolar Disorders, who receive consistent treatment, enjoy lives as happy, productive & satisfying as anyone else.
Bipolar Disorders are not an easily classifiable, monolithic group of disorders, but a spectrum of illnesses, further classified as Bipolar I, Bipolar II and Cyclothymic Disorder. What is common amongst people with any of these disorders is that they have experienced at least one or more episodes of unusually elevated mood called Mania or a less severe mood elevation called Hypomania, nicknamed “Mania-Lite.” To understand the various forms of Bipolar illness, it is easiest to examine each in turn. However, even within these narrower categories, each person with a Bipolar Disorder experiences the highs of Mania and lows of Depression to varying, unique degrees. Thus a person with Bipolar illness must receive consistent, qualified psychiatric care to manage the illness and thrive.
Bipolar I Disorder
People with Bipolar I Disorder have experienced at least one episode of true Mania, a period of severely elevated, expansive or irritable mood generally lasting at least a week. During a manic episode, a person exhibits extreme shifts in mood, behavior and even physical appearance & dress. Generally their behavior seems troubling to anyone with whom they come in contact. Typical symptoms of mania are as follows:
- Inflated self-esteem or grandiosity (a special, even God-given mission or purpose)
- Decreased need for sleep (Feels rested after 3 hours of sleep)
- More talkative than usual, pressure to keep talking & difficult getting thoughts out
- Flight of ideas or sense that thoughts are “racing”
- Distractibility, attention & focus easily drawn to irrelevant or unimportant occurrences
- Sudden increase in work projects, social engagements
- Agitated restlessness
- Engaging in pleasure-seeking activities with high risk of painful consequences (buying sprees, high-risk sexual activity, impulsive business investments)
A manic person may also experience paranoia, delusions and hallucinations.
In addition to periods of mania, people with Bipolar I also generally experience episodes of Depression, lasting several weeks or even months. Common features of an episode of Depression include:
- Low, sad mood most of the day, everyday
- Loss of interest in social or job-related activities
- Significant weight loss or gain
- Either insomnia or sleeping most of the day
- Fatigue & lack of energy almost all day
- Sense of worthlessness
- Recurrent thoughts of death or suicidal thoughts
Frequency, duration and sequence of episodes vary with individuals. Some people with Bipolar I experience a Manic episode followed immediately by an episode of Depression. It’s almost as if the extreme high is followed by a correspondingly extreme low. However, others experience Mania but have rarely, if ever, experienced Depression. Most people with Bipolar I, however, experience periods of stable, “normal” mood for a substantial period of time in between episodes. While there are common trends, each persons experience is unique.
Bipolar II
People with Bipolar II experience at least one episode of true Depression. However, in contrast to those with Bipolar I, their elevated mood swing never reaches the extent of true Mania. Instead, they experience what is called Hypomania, also nicknamed “Mania-Lite” because of its less severe symptoms. Hypomania consists of the following features:
- Increased self-esteem
- Decreased need for sleep
- Racing thoughts
- Noticeable increase in work & social engagements
- Increased involvement in pleasure-seeking activities with some potential for negative consequences
Hypomanic symptoms mirror those of Mania. However, the difference is a question of degree. Hypomanic behavior will likely go unnoticed to those unfamiliar with the individual, but close friends, family or a significant other will generally notice some change in demeanor & behavior. In the case of Mania, most anyone will notice that an individual’s behavior is troubled or extraordinary.
Bipolar II is sometimes referred to as “less severe” than Bipolar I, as hypomania does not ever result in hospitalization. However, the depths of depression in both instances are potentially just as extreme. In addition, many individuals with Hypomania do not seek help because nothing seems obviously wrong. In addition, Hypomania can be challenging even for mental health professionals to diagnose accurately. As a result, Bipolar II often goes untreated, or misdiagnosed.
Cyclothymia
Cyclothymia is a disorder in which an individual’s mood swings to more moderate, and less severe extremes of highs and lows. People with Cyclothymia experience periods of Hypomania, or Mania-lite, as well as periods of Dysthymia, or “Depression-Lite.” As a milder form of depression, Dysthymia’s features are:
- Poor appetite or over-eating
- Insomnia or sleeping more than usual
- Fatigue or low energy
- Low self-esteem
- Poor concentration or decision-making ability
- Feelings of hopelessness
While the upside is that individuals with Cyclothymia never experience the severity of symptoms of full Mania or Depression, the downside is that people with Cyclothymia are never symptom-free of either an upswing (Hypomania) or downswing (Dysthymia) for more than a month at a time.