What You Should Know About Bipolar Disorder

What Is It?

Sometimes called manic depression, bipolar disorder causes extreme shifts in mood. People who have it may spend weeks feeling like they’re on top of the world before plunging into a deep depression. The length of each high and low varies greatly from person to person.

What the Depression Phase Is Like

Without treatment, a person with bipolar disorder may have intense episodes of depression. Symptoms include sadness, anxiety, loss of energy, hopelessness, and trouble concentrating. They may lose interest in activities that they used to enjoy. It’s also common to gain or lose weight, sleep too much or too little, and even think about suicide.

When Someone Is Manic

During this phase, people feel super-charged and think they can do anything. Their self-esteem soars out of control and it’s hard for them to sit still. They talk more, are easily distracted, their thoughts race, and they don’t sleep enough. It often leads to reckless behavior, such as spending sprees, cheating, fast driving, and substance abuse. Three or more of these symptoms nearly every day for a week accompanied by feelings of intense excitement may signal a manic episode.

Bipolar I vs. Bipolar II

People with bipolar I disorder have manic phases for at least a week. Many also have separate depression phases, too.

Those with bipolar ll have bouts of major depression, but instead of full manic episodes, they have low-grade hypomanic swings that are less intense and may  last less than a week. They may seem fine, even like the “life of the party,” though family and friends notice their mood changes.

What’s a “Mixed Episode”?

When people with bipolar disorder have  depression and mania symptoms at the same time, or very close together, this is called a manic or depressive episode with mixed features.  This can lead to unpredictable behavior,  such as taking dangerous risks when feeling hopeless and suicidal but energized and agitated.  Mood episodes involving mixed features may be somewhat more common in women and in people who develop bipolar disorder at a young age.

What Are the Causes?

Doctors don’t know exactly what causes bipolar disorder. Current theories hold that the disorder may result from a combination of genetic and other biological – as well as environmental- factors. Scientists think that brain circuits involve din the regulation of mood, energy, thinking, and biological rhythms may function abnormally in people with bipolar disorder, resulting in the mood and other changes associated with the illness.

Who Is at Risk?

Men and women both get bipolar disorder. In most cases, symptoms usually start in people who are 15-30 years old. More rarely,  it can begin in childhood. The condition can sometimes run in families, but not everyone in a family may have it.

How It Affects Daily Life

When it’s not under control, bipolar disorder can cause problems in many areas of life, including your job, relationships, sleep, health, and money. It can lead to risky behavior. It can be stressful for the people who care about you and aren’t sure how to help or may not understand what’s going on.

Risky Behavior

Many people with bipolar disorder have trouble with drugs or alcohol. They may drink or abuse drugs to ease the uncomfortable symptoms of their mood swings. Substance misuse also may be prone to occur as part of the recklessness and pleasure-seeking associated with mania.

Suicidal Thinking

People with bipolar disorder are 10-20 times more likely to commit suicide than others. Warning signs include talking about suicide, putting their affairs in order, and doing very risky things. If you know someone who may be at risk, call one of these hotlines: 800-SUICIDE (800-784-2433) and 800-273-TALK (800-273-8255). If the person has a plan to commit suicide, call 911 or help them get to an  emergency room immediately.

How Doctors Diagnose It

A key step is to rule out other possible causes of extreme mood swings, including other conditions or side effects of some medicines. Your doctor will give you a checkup and ask you questions. You may get lab tests, too. A psychiatrist usually makes the diagnosis after carefully considering all of these things. She may also talk to people who know you well to find out if your mood and behavior have had major changes.

Which Medicines Treat It?

There are several types of prescription drugs for bipolar disorder. They include mood stabilizers that prevent  episodes of ups and downs, as well as antidepressants and antipsychotic drugs. When they aren’t in a manic or depressive phase, people usually take maintenance medications to avoid a relapse.

Talk Therapy for Bipolar Disorder

Counseling can help people stay on medication and manage their lives. Cognitive behavioral therapy focuses on changing thoughts and behaviors that accompany mood swings. Interpersonal therapy aims to ease the strain bipolar disorder puts on personal relationships. Social rhythm therapy helps people develop and maintain daily routines.

What You Can Do

Everyday habits can’t cure bipolar disorder. But it helps to make sure you get enough sleep, eat regular meals, and exercise. Avoid alcohol and recreational drugs, since they can make symptoms worse. If you have bipolar disorder, you should learn what your “red flags” are — signs that the condition is active — and have a plan for what to do if that happens, so you get help ASAP.

Electroconvulsive Therapy (ECT)

This treatment, done while you are “asleep” under general anesthesia, can rapidly improve mood symptoms of  bipolar disorder. It uses an electric current to cause a seizure in the brain. It’s one of the fastest ways to ease severe symptoms. ECT is often a safe and effective treatment option for severe mood episodes when medications have not led to meaningful symptom improvement. It’s a safe and highly effective treatment.

Let People In

If you have bipolar disorder, you may want to consider telling the people you are closest to, like your partner or your immediate family, so they can help you manage the condition. Try to explain how it affects you and what you need. With their support, you may feel more connected and motivated to stick with your treatment plan.

Concerned About Someone?

Many people with bipolar disorder don’t realize they have a problem or avoid getting help. If you think a friend or family member may have it, you may want to encourage them to talk with a doctor or mental health expert who can look into what’s going on and start them toward treatment. Be sensitive to their feelings, and remember that it takes an expert to diagnose it. But if it is bipolar disorder, or another mental illness, treatment can help.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Bipolar Disorder and Your Job

A bipolar disorder diagnosis can have a big effect on your job and career. In a survey of people with depression and bipolar disorderconducted by the Depression and Bipolar Support Alliance, 88% said their condition affected their ability to work.

But don’t be alarmed. A diagnosis of bipolar disorder doesn’t necessarily mean that you can’t keep your job. Plenty of people withbipolar disorder work and live normal lives.

Should I Tell my Boss About my Bipolar Disorder?

You don’t have to talk to your boss or coworkers about your bipolar disorder. Your health is your business. But if your condition has been affecting your performance at work, being open may be a good idea. Your boss and coworkers may have noticed the changes in your behavior. If you explain what’s going on, they may be more sympathetic and helpful than you expect.

Making Changes in Your Job

Some people with bipolar disorder find their current job just isn’t a good fit. Maybe it’s too stressful or the schedule is too inflexible. Maybe it doesn’t let them get enough sleep, or involves shift work that could worsen their condition. If you think your job is hurting your health, it’s time to make some changes. Here are some things to consider:

  • Decide what you really need from your job. Do you need to reduce your responsibilities? Do you need extra breaks during the day toreduce stress? Would you rather work independently or in a group? Do you need to work shorter hours or take time off? Or do you need a different job altogether?
  • Make decisions carefully. People with bipolar disorder are prone to acting impulsively. Think through the effects of quitting your job — both for yourself and possibly for your family. Talk over your feelings with your family, therapist, or health care provider.
  • Look into financial assistance. If you do need to take time off because of your bipolar disorder, see if your employer has disabilityinsurance, or look into Social Security Disability Insurance, which will provide some income while you recover. You can also look into the Family and Medical Leave Act. Ask your doctor or therapist for advice.
  • Go slowly. Returning to work after you’ve taken time off can be stressful. Think about starting in a part-time position, at least until you’re confident that your bipolar disorder has stabilized. Some people find that volunteer work is a good way to get back into the swing of things.

Bipolar Disorder Stigma at Work

Unfortunately, you may still run into people at work who treat you unfairly because of your bipolar disorder. Often, their behavior stems from ignorance. They might see you as “crazy” or think your condition is “all in your head.” You might be able to head off problems by teaching people a little about bipolar disorder.

But that’s not always enough, and the stigma of mental illness can hold you back. Some people with bipolar disorder feel they’re treated unfairly at work; they might be passed over for promotions or raises, for instance.

If you think you’re being treated unfairly, there are things you can do. The Americans with Disabilities Act can protect some people who are discriminated against because of a health condition. But don’t do anything rash. Research the law, and talk your situation over with friends, family, your therapist, and your health care provider before taking action.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on October 27, 2014
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What to expect from therapy

You’ve decided you need psychotherapy, but the whole idea of it makes you nervous. You feel vulnerable at the thought of talking about your struggles, and you don’t know what to expect.

You’re not alone. Most people are at least a little nervous about starting therapy. But knowing what it entails can ease your anxiety and help you prepare for a successful experience. So with that in mind, here are a few things that might happen when you enter therapy:

It begins with an initial evaluation. At your first session, you will often be invited to share about what brought you into therapy. The therapist will likely follow up with more structured questions to give them a fuller understanding of the situation. The questions they’ll ask will differ depending upon that therapist’s approach and your particular problem. Generally speaking, they will ask you about your symptoms, current circumstances in all areas of your life, and personal history (because it may relate to your distress).

Therapy helps you take action. When you go to your doctor, you probably tell them your symptoms and then expect them to assess and cure the problem. Therapy is very different – it’s about helping you face particular struggles and relate differently to them.

You can more easily decide whether therapy is helping if you have goals for it. You may know there are certain feelings or experiences you’d like to get rid of, such as overwhelming sadness or recurring fears. This is a good start. The next step is to ask yourself how you’d like to feel in the long-run. Do you want to feel a sense of self-acceptance or inner peace, for example? If so, make those your goals. Otherwise, you might meet your short-term goal of no longer feeling sad, only to find yourself emotionally numb or constantly anxious. If you have trouble setting positive goals, ask your therapist for help.

You might feel worse before you feel better. Just as you might initially make a bigger mess when cleaning out a closet, therapy might stir up unpleasant feelings in the process of helping you feel better. Your distress should not be more than you can handle, though. So, tell your therapist if you are struggling with feeling upset by treatment.

You may learn new concrete coping skills. Your therapist might teach you more effective ways to manage your struggles.

Therapy is more than an intellectual exercise. Emotional healing happens, in part, by having new experiences as you learn to relate differently to familiar stressful circumstances.

Therapy can help you gain clarity and a new perspective on things that bother you. As a result, you may feel greater self-acceptance and comfort.

Your close relationships may change. You tend to relate in set ways with friends and loved ones. So, if you change, it may disrupt those old ways of interacting, forcing a change in your relationships.

While this list can help you understand what to expect from therapy, trying to describe therapy is a bit like trying to describe a song to someone. The only way to truly appreciate what it will be like is to experience it.

 

Entries for the Relationships blog are for general educational purposes only. They may or may not be relevant for your particular situation; and they should not be relied upon as a substitute for individual professional advice, diagnosis, or treatment. If you need help for an emotional or behavioral problem, please seek the assistance of a psychologist or other qualified mental health professional.

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Mental Health: More Than A Military Issue

Depression should be talked about with the same candor as say, diabetes. But we have quite a ways to go in recognizing what it looks like – and stripping away the shame attached to mental health conditions, says Rory Brosius.

Brosius is deputy director of Joining Forces, an initiative launched in 2011 by first lady Michelle Obama and Jill Biden, wife of Vice President Joe Biden, to help military personnel transition to civilian life. Brosius’ mission is to promote wellness in that population and beyond — service members, veterans and civilians.

She’s broadening that conversation through Campaign to Change Direction, an initiative begun last spring that hopes to change the culture of mental health in the U.S. The campaign helps raise awareness of five key signs of emotional suffering.

“We’ve treated mental health somehow different than our physical health, but it’s part of our holistic wellness,” says Brosius, a social worker by training and the wife of Matthew Brosius, a Marine who is re-entering civilian life.

WebMD talked to Brosius, 33, about the campaign and the work she’s doing to promote psychological wellness, both among service personnel and their families and the general public.

Q. What are the 5 signs that someone may be suffering from a mental health issue?

A. The key part is educating people on these five signs: personality change, withdrawal, agitation, poor self-care, and hopelessness. They’re signs somebody may be suffering. If you see them, you can reach out and help them. Because there is support that is available.

Q: What are some misperceptions people have about mental illness?

Rory Brosius

Rory Brosius

A: There are quite a few, like, people with mental illness are violent or somehow unpredictable, when the reality is that people with mental illness are 10 times likelier to be victims of a violent crime. We have stereotypical ideas of what it means to live with a mental health issue. Another one is that people assume they don’t know anyone with mental illness, but 1 in 5 American adults has dealt with a mental health issue in their life. You look around a room, someone’s dealing with it, someone’s in recovery. You may not notice it.

Q: If the signs of mental illness are subtle, how do you make ordinary people aware of them?

A: It’s not so easy to detect because it’s something we don’t talk about. [But] there are things you notice that indicate that somebody’s in pain. Forty years ago people didn’t know how to recognize a heart attack; through education we learned how to read the signs. This is a sticky and hard issue for people to talk about …it will take time, but we’ve seen the same thing with heart disease and stroke and breast cancer — it’s a matter of education.

Q: What is the best way to support someone with mental health issues?

A: There are great ways to support somebody suffering, just by being empathetic, being a good friend, listening, you can learn a lot about mental health. There are great resources –mentalhealth.gov, National Alliance for Mental Health – their whole mission is to teach people what to look for. In the age of the internet and Google, we have the ability to access that information at our fingertips. But really, just being there. Maybe the person would like you to go to an appointment with them or spend time with you.

Q: Is there a different approach we might take with a service member than with a civilian?

A: In the same way you’d listen to a civilian, you would do with a service member. One benefit in that population is we have specialized resources geared to service members and their families. There is support for military personnel and their families, peer-to-peer services, warm handoff programs to service members transitioning to civilian life. There are distinct benefits to being a service member.

Q: You have written that mental health is a human issue, not a military issue. Can you elaborate?

One in 5 American adults has experienced a mental health issue. In the military, people are suffering from mental health issues just like across the population. PTSD [post traumatic stress disorder] is a signature illness, but that shouldn’t be the only issue we’re discussing. By focusing too much on specific populations we could pigeonhole people. We should be talking about this as a broader cultural perspective, about Americans going through this.

Q: What is a signature wound?

A: The signature wounds of Iraq and Afghanistan are traumatic brain injury (TBI) and post- traumatic stress disorder. There’s been a lot of focused research and work in these areas because this is what we’ve seen in our service people.

You do see TBI in other places – in our professional sporting teams you see severe concussions, and the NFL, DoD (Department of Defense) and the VA (Department of Veterans Affairs) have worked together and shared research. We see PTSD in children who’ve survived child abuse, crime victims, people who’ve been in car accidents. PTSD has made its name in the news because of the military population, but it happens in the civilian population, too.

Q: What can average people do to support the mission?

A: The reason we love Campaign to Change Direction is that it’s so simple: People can take the pledge. Go to changedirection.org. Help us spread the message through social media. It’s my goal that people see shame fall away from mental health and think about it like when you go to the dentist.  How’s your brain doing today?

 

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Emotional Health VideO

http://www.webmd.com/balance/video/laughter-heals

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