Recording available. Dr Adrian Hayes, psychiatrist and psychotherapist, introduced the broad categories of psychiatric medication…
Bipolar is also known as manic-depression or manic-depressive illness. This may be diagnosed by a psychiatrist if a person experiences extreme mood swings over a period of time, which in turn affects their ability to function in their everyday life. The illness, if untreated, can often be destructive to the person’s job, marriage and family life. These changes of mood are much more extreme than the normal ups and downs we all experience and which are part of normal life. The change in mood can happen within seconds, or over months, or a person can experience both simultaneously.
A person with bipolar will usually experience several of the following symptoms during a manic phase:
- a confidence, exhilaration and energy in the early phases but which can lead to a desperate restlessness, irritability and turbulence in the later phases
- a tendency to spend money they haven’t got, leading to serious debts
- sleep disturbance, and early waking which offers the person the opportunity to become excessively productive
- a feeling of “grandiosity” – feeling at the centre of the world, and as if nothing is impossible
- loss of any regularity in normal everyday activities
- disinhibition to the extreme
- rapid thinking and talking; a flight of ideas (one thought leading to another at a pace that is hard to keep up with); the need to communicate your ideas; dominating the conversation
- speech feels incredibly easy; sense of absolute vitality turbo charges speech
- imposing oneself on others, visiting and phoning to the point of exhausting the other
- a tendency to begin grand projects or ventures, often taking big risks
- a powerful feeling of connectedness between things
- the future holds much promise, with certainties of success, wealth and achievement
- senses are heightened, colours more vivid and contours better defined
- an unwavering belief in the goodness of the world
- behaving impulsively with activities such as drink, drugs or sex
- in the final stages of mania, a person may become suspicious of others, paranoid, and unwilling to be helped or treated as they are fixated on their own delusions of greatness
A depressive phase can be experienced as:
- an emptiness that is totally devastating
- unbearable loneliness, mental pain, terror or rage
- a sense of paralysis that makes simple everyday decisions, (such as what clothes to wear once you get out of bed, what direction to walk in, how to respond when someone greets them) seem impossible
- feelings of worthlessness and self-reproach, but also thoughts of how others have wronged them
- a feeling that human endeavour and achievement are meaningless
- suicidal thoughts
For further information about depression on its own, please see our other blogs.
Causes of Bipolar
Exact causes are not fully known although there is a strong family link. This is not just genetic inheritance, but perhaps more importantly it can also be caused by the experience of interacting with a parent who is bipolar. For example, a child can be frightened and confused by a parent’s unexpected and inconsistent mood changes. The child may learn that attachments are unstable and precarious. A parent who is bipolar may seek relationships which require dependency as a way of guaranteeing closeness; as a way of coping with an internal fragile sense of connection with others, and the fear of abandonment. This would then become problematic for the child as s/he becomes independent and the parent’s love collapses. Bipolar sufferers can often be children who have been earmarked to raise the family’s social status; the child may be burdened by these ideals, but conforms.
Mania can be triggered after a stressful or traumatic experience, such as a loss, a physical illness, or when something is too bad to think about. Such a trauma or loss may have happened many years previously. It is thought by psychotherapists that apparently arbitrary cycles of mania and depression are not accidental, but often the connection is not made in the conscious mind.
If you are worried, visit your GP in the first instance. He or she may then refer you to a psychiatrist. Getting help early is very important. Subsequently, if you do receive a diagnosis of bipolar you will be prescribed medication and also possibly offered some form of talking therapy. For those people who suffer debilitating depressive episodes, a manic phase can be a welcome relief! This is why it is very tempting for sufferers to either resist getting help in the first place, or to deny the need for medication.
It is helpful to:
- accept that you have a problem and receive help
- educate yourself about the condition, and where appropriate involve family or friends
- recognise the early warning signs around your symptoms, such as restlessness, changes in sleep patterns, etc. Gather support from family to help recognise these.
- share your experiences with others suffering from the same condition
- once your moods are more stable, seek a psychological therapy to talk through your feelings, the details of your highs and lows, to manage stress, and to explore your past in relation to your current difficulties.
- try to lead a healthy lifestyle and improve well-being, by incorporating exercise, sleep and good nutrition etc.
Wendy Bramham September 2013, for BBC Wiltshire series on mental health
- UCH Book of Psychiatry
- Strictly Bipolar, Darian Leader (2013)