Bipolar disorder a complex issue

Bipolar disorder is a complex mental illness. Bipolar disorder (manic depressive) is characterized by serious and significant mood swings. According to NAMI (National Alliance on Mental Illness) approximately 2.6% (6.1 million) American adults live with Bipolar disorder. The individuals affected by bipolar disorder can experience alternating highs (mania) and lows (depression). These mood swings can be brief (hours to a few days), or longer (several weeks or months). This cycling differs from person to person.

A bipolar manic episode is characterized by: extreme happiness; hyperactivity; little need for sleep; racing thoughts; and rapid speech. A bipolar depressive episode is characterized by: extreme sadness; lack of energy; interest in things; an inability to enjoy normally pleasurable activities; feelings of helplessness; and feelings of hopelessness.

The DSM5 (Diagnostics and Statistics Manual 5th Edition) is used by mental health professionals to diagnose mental illnesses. Some of the symptoms of mania listed in the DSM5 are: a sense of self importance; an exaggerated positive outlook; significantly decreased need for sleep; impulsiveness; inability to concentrate; and excessive irritability. Some symptoms of a depressive episode include: feelings of sadness or hopelessness; loss of energy and constantly tired; a sense of guilt or low self esteem; talk of death or suicide. The full list of symptoms can be found in the DSM5 in your local library. You can also find this information at www.psychcentral.com. Please note that it takes a trained mental health professional to accurately diagnose this or any other mental illness.

There are two primary types of bipolar illness they are, Bipolar I, and Bipolar II. Both forms of the disease feature both manic and depressive cycles. The main difference is in the severity of the manic phase. A manic episode is a mood characterized by a period of at least one week where an elevated, expansive, or unusually irritable mood exist. An individual with Bipolar II experiences hypomanic episodes that are characterized by a distinct period of at least 4 days of elevated, expansive, or irritated mood. Some of the symptoms include those listed above as well as: inflated self esteem; grandiosity; distractibility; excessive or irresponsible spending. The individual with Bipolar I experiences the same symptoms but to a noticeably greater degree. While an individual with Bipolar II’s behavior may be moderately outside norm for them selves, someone with Bipolar I’s behavior is wildly outside the norm for anyone. Additionally someone with Bipolar I may experience psychotic symptoms such as delusions or hallucinations. Hypomania does not have psychotic symptoms.

Mental health professionals use specifiers to add more detail to a person’s diagnoses. “With mixed features” is one such specifier. It applies when a person experiences both symptoms of a depressed mood and mania (though one would be considered predominant) within the same episode.

The complexity of bipolar disorder makes both diagnosis and treatment difficult. Once diagnosed the individual must work closely with their mental health provider to reach an effective treatment plan. Once the plan is in place recovery is possible.

Melissa Nicholas is the community consultant to the Washington Count Behavioral Health Board’s Public Information and Education Committee.