Questions About Bipolar Disorder
Q. WHAT IS BIPOLAR DISORDER?
Bipolar disorder is a brain disorder that affects the chemicals in my brain and causes changes in mood and behavior that are often not my normal responses. The emotions I experience can be inappropriate or exaggerated responses to a situation, can feel very real to me. More technically, bipolar disorder is a genetically transmitted medical illness that affects brain chemistry. It results in abnormal regulation of nerve cells that are responsible for controlling strong emotions and causes intense episodes of either mania or depression as well as wide variety of others symptoms. It is combination of biochemical, genetic and environmental factors that may trigger the chemical imbalances in the brain that causes severe shifts in my mood and energy, making it difficult for me to function normally. It’s fundamentally a biological medical illness involving an impaired ability to stabilize certain aspects of my brain chemistry.
Q. WHAT ARE THE SYMPTOMS OF BIPOLAR DISORDER?
Bipolar disorder causes repeated severe mood swings, or episodes, that make me feel very high (mania) or very low (depressive) with wide range of symptoms in between. I use my own body to create a natural high in place of drugs. It's called adrenaline, and my body naturally make it, but just like drugs, alcohol, and other things, I can become addicted to it that’s why I always crave to be manic. The excess adrenaline always keep me up at night because my brain have so much energy, I can’t sleep.
Mania Episode Signs and Symptoms:
- Increased energy from excess adrenaline
- Increased involvement in goal-directed activities
- Euphoric mood, don’t feel sick, won’t take medication
- Racing thoughts, oversharing
- Rapidly talking, texting, writing, and jumping between ideas that others have difficult time getting a word into the conversation.
- Starting projects I am confident will change the world
- Lack of concern for how family members and friends feel about my behavior.
- No sleep for 1-3 days or longer
- Heightened sense of self-importance
- Spending sprees
- Being my own doctor to find a cure for illness
- Religious psychosis/Hyper-religiosity
- Loss of appetite, unintended weight loss
- Denial that anything is wrong
- Believe to be fully-functioning person
- Psychotic symptoms (more severe psychotic symptoms are only seen in full-blown mania)
- With full-blown mania, I eventually can’t function on my own and must go to the hospital or be quarantine at home under strict care from family.
- Loss of all contact with reality.
Depressive Episode Signs and Symptoms:
- Sad, anxious or empty-feeling mood
- Feelings of hopelessness and pessimism
- Feelings of guilt and worthlessness
- Loss of interest or pleasure in activities
- Lack of energy, fatigue
- Difficulty concentrating
- Can’t make a decision, when I do, it never feels right
- Restlessness and irritability
- Sleeping too much for 1-3 days
- Binge eating, unintended weight gain
- Psychotic symptoms: delusional and hallucinations
- Unable to function doing daily tasks
- Isolate from everyone
- Difficulty expressing feelings/thoughts
- Neediness, anxiety, distorted thoughts
- Paranoid ideas: People are talking about me.
- Feeling easily overwhelmed
- Oversensitivity
- Over analyzing everything
- Brain racing and looping — one thought keeps going through my mind over and over again.
- Thoughts of death or suicide
Q. HOW IS BIPOLAR DISORDER DIAGNOSED?
Bipolar disorder cannot yet be diagnosed physiologically by blood tests or brain scans. Currently, diagnosis is based on symptoms, course of illness, and family history. Mental illnesses run in my family. The different types of bipolar disorder are diagnosed based on the pattern and severity of manic and depressive episodes.
- Bipolar I Disorder is mainly defined by manic or mixed episodes with symptoms that can be so severe that needs immediate hospital care. The symptoms of mania or depression must be a major change from normal behavior. I got diagnosed having this type of bipolar. My episodes and symptoms are mostly manic that can be manifested into full-blown mania then I always crash into a depressive episodes with symptoms that can get so severe I cannot function at all. My manic highs often just look like enthusiasm. My lows I keep hidden from most people.
- Bipolar II Disorder is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes, but no full-blown manic or mixed episodes.
- Bipolar III Disorder is with numerous major depressive episodes, often with only brief periods of wellness yet no manic or hypomanic episodes. The manic is dormant and may never be unlocked unless certain drugs ignite it as there is a strong tendency for severe manias to erupt when the person takes prescribed antidepressants, stimulants, or steroids, or if there is substance abuse.
- Bipolar Disorder Not Otherwise Specified (BP-NOS) is diagnosed when a person has symptoms of the illness that do not meet diagnostic criteria for either bipolar I or II. The symptoms may not last long enough, or the person may have too few symptoms, to be diagnosed with bipolar I or II. However, the symptoms are clearly out of the person's normal range of behavior.
- Rapid-cycling bipolar disorder is when a person have four or more episodes of major depression, mania, hypomania, or mixed symptoms within a year. This type of bipolar is me, too.
- Cyclothymic Disorder, or Cyclothymia, is a mild form of bipolar disorder. People who have cyclothymia have episodes of hypomania that shift back and forth with mild depression for at least two years. However, the symptoms do not meet the diagnostic requirements for any other type of bipolar disorder.
- Hyperthymia is described long-term, continuous hypomanic behavior. This may seen as a temperamental or personality style characterized by gregariousness, high energy, a decreased need for sleep, enthusiasm, irritability, and rapid speech.
Q. HOW IS BIPOLAR DISORDER TREATED?
While no cure exists for bipolar disorder, it is treatable and manageable with psychotherapy and medications. Mood stabilizers, like lithium, or anticonvulsant drugs are commonly prescribed to help manage the symptoms of bipolar disorder. Your doctor may also recommend other types of medication, such as antidepressants and antianxiety and antipsychotic drugs.
It took me a long time to really come to terms with bipolar disorder. I kept hoping it would just go away. I know I was super hard on myself for years because I couldn't seem to get my act together. It was a loss to realize that this is my life. It's not going to go away. I learn to manage it. I would tell myself nothing will ever get better. But it does get better. Year after year and month after month I manage my symptoms more successfully, and each time is better than the last. My depressions are much shorter now and as long as I stay on my medications and watch my lifestyle I don't get too manic. I still become hypomania once or twice a week but the episode is not severe. This is something my psychiatrist and I are currently working on. My medication continue to get adjusted because we haven't find the correct combination of medications that will regulate me to sleep consistently every night. I am currently on Lithium and Zyprexa injectable, this medication is given to me by injection every four weeks. The injection help to lessen the stress having to remember to take a pill every day and I will have the correct dosage in my system. Mood changes and having symptoms can still occur even when I am being treated but full-blown episodes is averted by adjusting my treatment.
Q. DO I NEED MEDICATION, OR CAN I BE TREATED EFFECTIVELY WITHOUT IT?
Learning to live with a serious lifelong illness takes so much adjustment. I have to look at my life differently than I expected. The brain I thought would be there when I need it often malfunctions and wrecks my life. The body I thought would take care of me gets sick easily. Talking about the feelings I have surrounding my diagnosis is a positive first step in learning to live with bipolar disorder without it taking over my life. I have the ability to take charge of bipolar disorder. I can't do it with medications only, and I can't do it alone. I believe with the combination of science and spiritual intervention helped a lot. I will never forget that I am the one who lives with the illness. It’s not my fault I have this illness but it’s my responsibility to stay well. I will keep myself well enough to have a clear enough brain to make my own decisions. I have a system in place to take care of me when my brain isn't well enough to take care of me. I find that the more I live in the reality of the fact that I have a mental illness, the more proud I am of my considerable accomplishment of staying alive and creating a really good life. It really is about the choices I make when I am well. The more prevention I can do during the stable times, the more able I will be to recognize, treat, and end the mood swings before they go too far.
At the end of the day, I am the core. The person God made me. My healing and recovery are mostly from God. He wants to heal my whole person. Through love and support from Father God, my wonderful husband, and close friends, I wouldn't of made it. Even in the midst of turmoil, God sticks with me and uses challenges to shape me. When I understand that, my perspective completely flips. No longer do I see my illness as a failure, I see it as moments when God, my loving Father, works on me. That is exactly why I can trust in the Lord with all my hearts. The more I know about God the more I am awaken by his love to heal me from the inside out. I can only continue to pray for more healing. I have faith to believe in God and eventually I will not need to take psychiatric medications.
Q. WHAT IS THE DIFFERENCE BETWEEN DEPRESSION AND BIPOLAR DISORDER?
The main difference between bipolar disorder and major depression is the presence of manic episodes. This is why depression alone is not enough to diagnose an individual with bipolar. However, one manic episode is sufficient to make a bipolar diagnosis.
