Understanding bipolar disorder
When faced with stressful life events, we might go through a range of emotions such as feeling irritable, angry or even sad. These noticeably large and rapid mood swings are common and it’s okay to experience them. However, at times these shifts in mood can become too intense and persistent, significantly affecting our daily routines.
In such cases, it may be a sign that we are experiencing bipolar disorder. By identifying these signs early and seeking help, we can better manage the extreme emotions we may experience. After all, we're in this together, and reaching out for support can help us cope.
Read on to learn more about bipolar disorder and how we can better manage it.
What is bipolar disorder?
Bipolar disorder is a mental health condition that causes us to have recurring and
extreme mood episodes.
These can be either:
Depressive
When we’re noticeably
and
persistently sad
Manic/Hypomanic
When we’re noticeably and
persistently happy or irritable
These mood episodes, unlike our typical responses to everyday situations and stresses, can be quite unpredictable, sometimes stretching on for days, weeks, or even longer. They can create significant challenges in our lives, often affecting our personal and professional relationships.
How does it affect us?
Depending on the type of episode we experience, we may find ourselves dealing with different types of intense and extreme emotions.
- Euphoric (immense joy)
- Unusually energetic
- Agitated
- An inflated sense self-esteem
- Sad
- Hopeless
- A loss of interest in most activities
Younger individuals are more likely to experience manic/hypomanic episodes, or a mixture of manic
and depressive episodes.
Since these states can have a major impact on our quality of sleep, energy, judgment, and behaviour;
professional or social situations may become challenging for us. In severe cases, they may even lead to
serious consequences such as thoughts about self-harm or suicide, or other risk-taking behaviours.
However, even in the most challenging times, we can find healthier ways to deal with our struggles
with the right support and mindset.
Common misconceptions:
Causes
While we still don’t know the exact cause of bipolar disorder, it is usually a combination of genetic, psychological, and environmental factors that leads to someone developing it.
Biological factors Family History
- Having a family history of bipolar disorder increases one’s likelihood of developing it
- While it may run in families, it’s important to know that even when a family member is living with bipolar disorder, chances are most people in the family will not develop it
Biological factors Chemical imbalances in brain
- Having an excess or lack of certain chemicals in the brain, such as serotonin and dopamine can lead to bipolar disorder
- It may also occur as a side effect of medication or alcohol, resulting in mood disturbances
Psychological and social factors Certain personality traits
Personality traits such as neuroticism, or the tendency to experience negative emotions like worry, anxiety, aggressiveness, and impulsivity are associated with bipolar disorder.
Psychological and social factors Traumatic or stressful life events
- Traumatic childhood experiences can increase the tendencies of developing bipolar disorder
- Triggers from stressful life events such as the death of a loved one, problems with friends or academic pressures, can also contribute to one developing bipolar disorder
- The lack of a good support system can further worsen the effects of these stressful events
Signs and symptoms
Manic episodes
During a manic episode, one may feel a mixture of:
- Distinct, abnormal and persistent periods of elevated or irritable mood
- An unusual increase in goal-directed activities or energy focused working on a project all night until the point of sacrificing sleep)
- An inflated self-esteem
- A reduced need for sleep
- Talking excessively on a variety of topics
- Racing thoughts
- Short attention span
- Risky or reckless behaviours with negative consequences (e.g. excessive spending, risky sexual behaviours and alcohol/drug abuse)
These symptoms can last for 1 week or longer, and become severe enough to affect daily activities (e.g. one’s ability to go to school), and in some cases, even require hospitalisation.
Depressive episodes
During a depressive episode, one may struggle with a mixture of:
- Persistent sadness
- Loss of interest in activities previously enjoyed
- Restlessness or agitation
- An increase or decrease in appetite or weight
- Physical discomfort (e.g. stomachaches or headaches)
- Insomnia or excessive sleep
- Fatigue
- Difficulties concentrating
- Feelings of worthlessness or guilt
- Sensitivity to rejection
- Recurring thoughts of death
These symptoms can last 2 weeks or longer, and become severe enough to affect daily activities.
Diagnosis
Healthcare professionals may conduct several different assessments to check if one has bipolar disorder.
Individuals may also be asked to record their daily mood, sleep, or other behaviours that may help reach a diagnosis in the form of a mood diary.
Treatment
Although the effects of bipolar disorder can be overwhelming, it can be effectively
treated with medication, counselling, and brain stimulation therapies. This will depend
on the symptoms, age, general health, and severity of the condition.
During the treatment, a team of dedicated healthcare professionals can be counted on
for support. This may include a:
Medical doctor specialising in mental health conditions (i.e. a psychiatrist)
Psychologist
Social worker
Occupational therapist
Case manager
Pharmacist
Nurse
Healthcare professionals may prescribe certain medications to help treat bipolar disorder. One may incorrectly assume that they do not need to take their medication when experiencing mania, especially in hopes of prolonging their elevated moods. However, it is important that individuals follow their full medication plan prescribed by their healthcare professionals. This helps one to properly treat and manage their symptoms.
Medications
- 1 or more medications may be used to help balance extreme emotions
- These may include mood stabilisers, antipsychotic medications, antidepressants, or anti-anxiety medications
- Prescribed medications can be taken without worry as they are not known to be addictive
Duration
- Medications may be prescribed for 6 months or longer, depending on the pattern and severity of the disorder
- While it may take 1-2 weeks or longer for changes in mood to occur, one may notice improvements in sleep earlier
- Even after feeling better, long-term medication therapy may be required to prevent more episodes from recurring
- Based on one’s needs, healthcare professionals will adjust medications accordingly
Side effects
- Just as with other medications, it is normal to experience some mild side effects
- These may include nausea, stomach discomfort, dizziness, drowsiness, dry mouth, and constipation
- Normally, the effects will go away on its own over time, and there is no need to worry
Other points to note
- The healthcare professionals will advise on any diet adjustments (though there is usually no need for it)
It’s okay and normal to be nervous or overwhelmed by the medications or its side effects. It is important to follow the treatment plan even when not manic or depressed. If one has any concerns, they can reach out to healthcare professionals for support. If for any reason they would like to stop their medications, they should discuss and make the decision together with the healthcare professionals so that they can advise them on the best course of action.
In addition to medications, healthcare professionals may recommend counselling, psychological therapy, family therapy, or working with the individual’s school. This can provide support, information and guidance to them and their families. It can also help one manage their emotions and daily activities as well as reduce the recurrence of mood episodes.
During therapy sessions one may learn how to:
- Identify triggers for episodes
- Develop healthy coping strategies
- Take medications as prescribed
- Solve interpersonal problems
- Maintain regular daily routines
- Enhance communication skills
- Manage negative emotions effectively
Therapy sessions may be conducted individually (one-on-one) or in groups.
In individual therapy, one can acquire valuable skills for effectively managing the symptoms of bipolar disorder. For example, they could learn helpful ways of dealing with stressful scenarios such as relaxation techniques.
Family therapy on the other hand, can equip parents or caregivers with the tools to provide support and assist in managing the individual’s symptoms. For instance, parents can play a crucial role in ensuring medications are taken as prescribed by checking in regularly.
Through both types of therapies, one will learn how to better manage their symptoms, and build a good support network of trusted loved ones who understand what they need.
If one’s bipolar disorder does not respond well to medications, or they are unable to tolerate their prescribed medications due to side effects, healthcare professionals may recommend a course of brain stimulation therapy. This may come in the form of electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS).
In ECT, the brain is treated with small controlled electrical currents over a brief period, a safe and effective treatment for both manic and depressive episodes.
On the other hand, in TMS, the neural circuits in the brain are stimulated using magnetic fields to help regulate mood during depressive episodes. TMS is only used for youth aged 18 years old and above.
Managing bipolar disorder
Although bipolar disorder may affect the way someone thinks or acts, it does not have to define them. To complement their treatment and manage their symptoms, one can try these strategies:
