Right combination of medication, therapy serves to best treat bipolar disorder

“You’re bipolar.” That phrase has come to be the name you call someone unstable or moody. The fact is bipolar disorder (BD) is far different from being “moody” or being a crazy person. It has gotten into the mainstream news fairly recently with some celebrities admitting to their diagnosis of it. Many psychologists believe Beethoven and Winston Churchill both suffered from it. Bipolar disorder was first discovered by French psychiatrist Jean-Pierre Falret in 1851 when he observed a “circular insanity” where patients would cycle between severe depression and hyper elevated or manic moods.

Mental illness, as I have mentioned before, is still surrounded by much stigma. Many still feel uneasy about admitting their struggles. BD is one of the most stigmatized mental illnesses because of its symptoms that get exaggerated portrayals in some media. I want to dispel the stigma and provide correct information and hope to those who are affected by this difficult illness.

According to the National Alliance on Mental Illness, BD is a mental illness that causes dramatic shifts in a person’s mood, energy and ability to think clearly. People with BD experience alternating high and low moods known as mania and depression, which differ from the typical ups-and-downs most people experience. Also according to NAMI, BD occurs equally in men and women, with 2.6 percent of adults in the United States diagnosed with the condition.

Mania is the elevated mood you see in people with BD. When in this phase, people may act recklessly, have poor judgment, are very irritable and have delusionary thinking. They may think they are invincible and display extreme bursts of energy. This phase of BD is considered to be the most dangerous because of the risk-taking behaviors people display. Individuals in a manic phase might make terrible financial choices or engage in risky sexual conduct.

Depression is the flipside. It is marked by hopelessness, fatigue, loss of interest and withdrawal. This phase carries its own dangers as well. The hopelessness and extreme sadness can be accompanied with thoughts of suicide, with 15 percent of those with BD dying from suicide each year in the United States.

The cycle of mania and depression depends on the types of BD one has. The types are the following:

• Bipolar I Disorder is an illness in which people have experienced one or more episodes of mania. Most people diagnosed with BD will have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. To be diagnosed with Bipolar I, a person’s manic episodes must last at least seven days or be so severe that hospitalization is required.

• Bipolar II is a subset of BD in which people experience depressive episodes shifting back and forth with hypomanic episodes, but never a “full” manic episode.

• Cyclothymic Disorder or Cyclothymia is a chronically unstable mood state in which people experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood, but these periods last less than eight weeks.

• Bipolar Disorder, “other specified” and “unspecified” is when a person does not meet the criteria for Bipolar I, II or Cyclothymia but has still experienced periods of clinically significant abnormal mood elevation.

BD has several potential causes which include genetics, stress levels and brain structure. Your doctor can order tests to rule out other conditions that can affect mood and refer you to a psychiatric specialist for diagnosis. BD is diagnosed with a psychological assessment. There is no cure for BD. However, treatment is available. Medications including antidepressants, mood stabilizers, anti-psychotics or a combination have been shown to effectively treat BD. Cognitive behavior therapy has also shown to be significant in treating BD. The most effective plans typically involve a combination of therapy and medication. Your psychiatric care professional can work with you to help decide the best course.

I want to highlight that you have to be your biggest advocate. It starts with admitting you have the illness and it is not going anywhere and will not improve if you ignore it. Denial only leads to deterioration. Get connected to a supportive network of care professionals and others in the mental health community to draw strength from. Maintaining a healthy lifestyle including a balanced diet, regular exercise and a routine sleep schedule pay dividends in keeping BD managed properly. You may start to feel better and think you do not need to stay on medication or keep going to therapy. That is one of the biggest mistakes people with BD make and it is costly. Stay with the prescribed treatment plan as not doing so can lead to a recurrence or worsening of prior symptoms. While the road to treating BD is lifelong and requires constant effort, the good quality of life that can be enjoyed is well worth it.

For more information on where to find available treatment for BD and other mental illnesses, visit www.findtreatment.samhsa.gov.