Bipolar Disorder

Bipolar disorder, also known by its older name "manic depression" is a type of disorder that is characterized by serious mood swings. A person that is bipolar has "highs" (what can be called mania) and "lows" (also known as depression). The length of the periods of mania and depression are different with each person.

When a person is in a manic phase, they may feel extreme happiness, extreme irritability, hyperactivity, sleeplessness, racing thoughts, and rapid speech. When the person is in the depressive phase, they may be feeling extreme sadness, lack of energy or interest in things, feelings of hopelessness and helplessness.

Those with bipolar disorder often describe their experience as being on an emotional roller coaster. Cycling up and down between strong emotions can keep a person from having anything approaching a "normal" life. The emotions, thoughts and behavior of a person with bipolar disorder are often experienced as beyond one's control.

The emotional mood swings can make recovery extremely difficult for bipolar sufferers. The mood swings make it extremely difficult for sufferers to maintain any kind of recovery plan. When recovery cannot be maintained, feelings of hopelessness can overwhelm sufferers.

The ups and downs of bipolar disorder can be exhausting. The highly trained staff at Mirasol can offer the client an integrated approach to treatment and provide them with support to help them find stability.

Women and girls who have emotional mood swings may very well develop a co-occurring disorder as a way of helping them tolerate the mood swings. Every client needs to be assessed for all possibilities.

An important difference between bipolar disorder and normal emotions is that bipolar disorder results in an inability to handle daily activities. The person cannot work or communicate effectively and may have a distorted sense of reality (for example, unrealistically high or low opinion of one's skills).

Bipolar disorder often is not recognized by the patient, relatives, friends or even physicians. However, recognizing the mood states that occur is essential. Treatment can help a person with bipolar disorder avoid harmful consequences such as destruction of personal relationships, job loss and suicide.

How Is Bipolar Disorder Diagnosed?

Bipolar disorder is typically diagnosed by a trained mental health professional, such as one of our psychiatrists at Mirasol. Family physicians and general practitioners are generally not trained to make this type of psychological diagnosis. A bipolar diagnosis must be made very carefully as many of the symptoms are similar or identical those of ADD/ADHD.

The main method used to diagnose bipolar disorder is a thorough interview with a psychiatrist, psychologist or other mental health professional. An actual face-to-face interview with our psychiatrist at Mirasol happens during the first week of treatment. Then an accurate diagnosis can be made. The psychiatrist will very carefully make a determination whether clients' symptoms meet the criteria necessary for a bipolar disorder diagnosis.

Signs and Symptoms of Bipolar Disorder

The signs and symptoms of bipolar disorder are clear. During a manic phase, symptoms include:

• heightened sense of self-importance
• exaggerated positive outlook
• significantly decreased need for sleep
• poor appetite and weight loss
• racing speech, flight of ideas, impulsiveness
• ideas that move quickly from one subject to the next
• poor concentration, easy distractability
• increased activity level
• excessive involvement in pleasurable activities
• poor financial choices, rash spending sprees
• excessive irritability, aggressive behavior

During a depressed phase, symptoms include:

• feelings of sadness or hopelessness
• loss of interest in pleasurable or usual activities
• difficulty sleeping; early-morning awakening
• loss of energy and constant lethargy
• sense of guilt or low self-esteem
• difficulty concentrating
• negative thoughts about the future
• weight gain or weight loss
• talk of suicide or death

At Mirasol, a world-class treatment center, bipolar disorder is a manageable disease. Someone with bipolar disorder can live a successful, vital life. However, there are a number of factors that can get in the way of successful treatment. Mirasol's expert clinicians can help clients reduce many of the blocks standing in the way of complete recovery.

Connection Between Bipolar Disorder and Substance Abuse or an Eating Disorder

According to statistics presented by the American Journal of Managed Care:

• About 56 percent of individuals with bipolar who participated in a national study had experienced drug or alcohol addiction during their lifetime.
• Approximately 46 percent of that group had abused alcohol or were addicted to alcohol.
• About 41 percent had abused drugs or were addicted to drugs.

Alcohol is the most commonly abused substance among bipolar individuals.

In a study of 392 patients, rates of lifetime substance abuse were high for both alcohol (48.5%) and drugs (43.9%). Nearly 60% of the group had a history of some lifetime substance abuse.

According to the most recent literature on substance abuse and bipolar disorder, these two problems occur together so frequently that all young people with a bipolar diagnosis should also be assessed for drug and alcohol problems. Those who experience mixed states or rapid cycling have the highest rate of danger from substance abuse — the discomfort a person feels in these chaotic moods is so great that she may be willing to do or take almost anything to make it stop.

Some drugs, including marijuana, downers, alcohol, and opiates, seem to temporarily blunt the effects of mood swings, only to cause ill effects later. Others can actively exacerbate manic depression. Speed (methamphetamine, crank, crystal) and cocaine are two that have sent many abusers into mania, often followed quickly by deep depression and psychotic symptoms. Hallucinogens, including LSD and PCP, can set off psychotic symptoms as well. These drugs are not a good idea for any child or teenager, but their effects on young people with bipolar disorders can be even worse.

Many people with bipolar disorder can be successfully treated with a combination medication and psychotherapy. However, due to the challenging nature of this disorder it is not uncommon for bipolar individuals to attempt to alleviate symptoms by self-medicating. They may self-medicate either in place of or in spite of traditional treatment. The frequency with which individuals who have bipolar disorder also suffer from substance abuse is very high. It is estimated that approximately 60% of all individuals with bipolar disorder also abuse substances.

Treatment Planning for Bi-Polar Disorder Residents with Co-Occurring Conditions

The types of treatment that are commonly prescribed for bipolar disorder include:

• Mood stabilizers: Older medications, such as lithium, which are reliable and well-tolerated by most. Once the first-line treatment for bipolar disorder, they have largely been supplanted by atypical antipsychotics.
• Atypical antipsychotics: Newer, more expensive medications for bipolar disorder that may provide greater symptom relief, but also have greater side effects.
• Other treatment strategies: Other treatments for bipolar disorder may include prescribing a combination of medications for bipolar, including antidepressants for bipolar.
• Psychotherapy: In addition to medication, according to NIMH, psychotherapy, or "talk" therapy, can be an effective treatment for bipolar disorder. It can provide support, education, and guidance to people with bipolar disorder and their families. Some psychotherapy treatments used to treat bipolar disorder include:
  1. Family-focused therapy includes family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their loved one. This therapy also improves communication and problem solving.
  2. Interpersonal therapy and skill building helps people with bipolar disorder improve their relationships with others and manage their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.
• Psychoeducation teaches people with bipolar disorder about the illness and its treatment. This treatment helps people recognize signs of relapse so they can seek treatment early, before a full-blown episode occurs. Usually done in a group, psychoeducation may also be helpful for family members and caregivers.