Understanding Bipolar Disorder: Beyond the Stigma

Bipolar disorder causes extreme mood swings between mania and depression that disrupt daily functioning, but evidence-based therapeutic interventions help individuals develop effective coping strategies, recognize early warning signs, and maintain stability through professional counseling support.

Vous est-il déjà arrivé de vous sentir jugé pour vos sautes d'humeur intenses ou de craindre de "perdre la boule" ? Bipolar disorder affects millions of Americans, but it doesn't define your worth or make you 'crazy' — here's what you need to know about this manageable condition.

Having Bipolar Disorder Does Not Make You Crazy

The National Institute of Mental Health defines bipolar disorder as “a mental illness that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks”.

Having bipolar disorder does not make you crazy

It’s normal to experience mood swings. However, if these mood swings tend to affect you in other areas of your life (like work, school, relationships, etc.), then you may wonder if you are one of the many people experiencing bipolar disorder.

Do you sometimes find yourself experiencing intense moments of joy and happiness followed by a sense of debilitating despair or depression? Do you ever grapple with a myriad of emotions and find yourself wondering if there’s something wrong with you or fear that you’re going crazy? Are you full of energy one day and can hardly get out of bed the next? If you’ve answered yes to these questions, you might have bipolar disorder. Fortunately, telehealth therapy through services like ReachLink can help you manage this condition.

Most people have heard of Bipolar disorder and it is commonly known as the illness where you’re happy one minute and sad the next. It’s not an inaccurate definition. Bipolar disorder, also referred to as Manic-Depressive illness is a mental health disorder that causes extreme mood swings. The moods are usually polar opposites, for instance, going from extreme joy to intense sadness, hence the name ‘Bipolar’. These mood episodes are referred to as mania, hypomania, and depression. Depending on the type of bipolar, each episode can last anywhere from a few weeks to a few months and even years! These episodes are interspersed with stable periods where the person experiences no symptoms and is normal.

Mania and hypomania refer to the episodes where the person is on a ‘high’ when they are full of energy and feel they can conquer the world. This is when many people with bipolar disorder exhibit the most symptoms that make them seem crazy. The depression episode brings the person crashing down from the high into the deepest despair. Severe depression or mania can lead to a psychotic episode, during which an individual may experience delusions, hallucinations, or disorganized thinking.

This might all sound confusing but being bipolar does not mean you’re crazy. It simply means you have an illness that needs to be treated. Unfortunately, it is not a curable illness, it is a serious condition and needs proper medical treatment as soon as possible. But it is also an illness that can be managed well by seeking treatment and using the appropriate therapeutic approaches, and you can go on to lead a completely normal life. Labeling yourself or anyone else with this condition as “crazy” can be stigmatizing and prevent those people from seeking help or engaging in self-care.

Symptoms of a manic or depressive episode

Even though mania and hypomania are categorized as two separate kinds of episodes, they have very similar characteristics and the symptoms are largely the same.

Like depression, mania can lead to psychosis and hospitalization. In order to be diagnosed with a hypomanic or manic episode, at least three or more of the following symptoms have to be present:

• Very high energy levels, overly active and agitated
• Unusually upbeat, too happy, too cheerful
• Extremely talkative, fast-paced
• Feeling as though you are going crazy
• Being distracted
• Sense of euphoria, of being invincible
• Problems sleeping i.e. needing less sleep
• Thoughts are racing and jumping from one idea to the next
• Reckless, irresponsible behavior i.e. spending a lot of money, going on a shopping spree, or abusing drugs and alcohol
• Very high sex drive, engaging in promiscuous behavior

The episodes of ‘high’ characterized by the symptoms above are often followed by moments of major depression. Bipolar depression is defined as periods of time where five or more of the depressive symptoms below are present:

• Feeling depressed, sad, lonely, and hopeless
• Crying for no reason
• Lack of interest or joy in activities and things that usually brought pleasure i.e. listening to music or playing sports
• Irregularity with sleep patterns, either sleeping too much or not enough
• Fluctuating weight and appetite, gaining or losing weight without trying to
• Loss of energy
• Difficulty concentrating
• Slow, lethargic movements
• Lack of self-confidence, feeling worthless or guilty
• Suicidal thoughts or attempts

Categories and types

Bipolar disorder is broken down into four distinct categories and types, which include episodes of hypomania, depression, and mania.

Bipolar I disorder

This means the individual experiences full-blown manic episodes, which last for at least 7 days. Hypomanic or depressive episodes might occur before or right after a manic episode and may last up to two weeks. Sometimes the manic episodes can be so severe the individual needs to be hospitalized immediately. With Bipolar I Disorder, it is also possible to experience depression and manic symptoms at once, which can be frightening and make the person believe that they are going crazy.

Bipolar II disorder

Means the individual has experienced one or more major depressive episodes and at least a hypomanic episode at some point but never a manic episode. It’s a common misconception that Bipolar II is a less severe form of bipolar compared to Bipolar I. However, this is not the case. Bipolar II has a separate diagnosis and can be just as detrimental to the individual’s well-being because the depressive episodes last for much longer and can have episodes of mixed features – when the opposite mood (manic, hypomanic, or depression) symptoms are experienced simultaneously. For instance, the individual may be extremely active and energetic while dealing with bouts of hopelessness and despair.

Cyclothymic disorder

The individual experiences periods of depression that alternate with periods of hypomania.

Rapid-cycling

Experiencing multiple mood disorders (four or more) during a period of 1 year. This type of disorder increases the risk of going through severe depression as well as suicide.

Other bipolar disorders

When an individual experiences symptoms of bipolar disorder that don’t match any of the criteria of any of the types discussed above. The symptoms can arise as a result of taking certain kinds of drugs, alcohol, or because the person is suffering from an illness such as multiple sclerosis.

Some people with bipolar disorder enjoy the high moments. How can they not? The feelings of euphoria, invincibility, of being full of energy can all be very intoxicating and leave the individual feeling empowered and strong. They may not even realize their behavior is abnormal, which may make people around them think they are crazy. The burden thus often falls on the family or other people such as friends, co-workers, or educators, to point out there’s a problem and urge the patient to seek help. However, if their loved ones do not sympathize with this condition and also view the person as crazy, it can make it much harder for the person to get the treatment they need.

What causes this mental illness?

Medical science has yet to determine exactly what causes someone to develop a bipolar disorder. It affects both men and women, although women are more prone to ‘rapid cycling’ than men. People with bipolar disorder are most commonly diagnosed in their late teens or during the early 20s since that’s when symptoms begin to appear, in some very rare cases, a diagnosis may be made in childhood.

Research has shown that biology and genetics also play a significant role in developing bipolar disorder.

Biology

Studies have shown irregularities in how neurotransmitters (brain chemicals) function in people with bipolar disorder.

Genetics

The disorder is usually more common in people who have relatives with the condition, and it is an illness which tends to ‘run in the family.’ While scientists have determined genes have something to do with getting the illness, they have yet to determine which genes and how.

Abusing drugs and alcohol can also put someone at a higher risk of developing the illness. An individual’s environment and lifestyle, being the victim of abuse, or going through a traumatic, stressful event can also worsen bipolar symptoms when the disorder is already present.

Often, the hardest hurdle to overcome is accepting the illness. This is true for both the individual and their loved ones. Someone with bipolar disorder may feel crazy or broken when initially diagnosed. But remember, there is no shame in being ill- this is an illness that is entirely beyond your control, and the best thing you can do for yourself and your family is to get help right away.

Diagnosing this disorder

Unfortunately, there is no one sure-fire blood test or exam that points to bipolar disorder. Instead, several different types of evaluations are conducted by various health professionals in order to render the diagnosis. These evaluations include:

• Physical Examination
• Psychological Examination
• Mood Charting

While these are all useful, the best way of diagnosing the illness is, to be frank and open with your doctor. The diagnosis may not be completely straightforward and might take some time because some illnesses such as substance abuse problems, borderline personality disorder, or schizophrenia have similar symptoms so it’s important to detail your symptoms, the number of episodes, their severity, etc. The more information you can provide, the quicker the doctor can eliminate other illnesses and disorders.

The doctor will also ask you questions about any history of mental illness in the family and may ask you to complete a mood questionnaire. It might be a good idea to track your symptoms in a journal and write down everything you’ve been feeling and going through. They will use the information you provided and use criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine whether you are suffering from bipolar disorder and if so what type of bipolar disorder.

Once the illness has been determined, the doctor will start working on a treatment plan with you. Like most illnesses, the sooner you diagnose and treat the disorder, the better it is.

Treatment options

The most effective way of managing bipolar disorder is through a combination of medication and therapy. Hypomania and depression are treated using different approaches. For medication management, clients would need to work with a psychiatrist or primary care physician, as ReachLink’s licensed clinical social workers do not prescribe medications.

However, therapeutic counseling plays a crucial role in bipolar disorder management. Through ReachLink’s telehealth platform, licensed clinical social workers can provide evidence-based therapeutic approaches to help clients:

• Develop coping strategies for mood episodes
• Identify early warning signs of mood changes
• Establish healthy routines and stress management techniques
• Address relationship challenges that may arise from the condition
• Build a support system and communication strategies with loved ones

It’s important to understand that bipolar disorder is a lifelong condition that requires ongoing care. When working with both a prescribing physician and a therapist, clients often achieve the best outcomes. ReachLink’s therapists can coordinate care with your medical providers to ensure a comprehensive treatment approach.

Some people with bipolar disorder may also be dealing with other mental health conditions. ReachLink’s clinical social workers can help address these co-occurring issues through personalized treatment plans. No two people have the exact same symptoms, therefore every therapeutic approach is customized to suit the client’s specific needs.

Most people who seek and get appropriate treatment go on to live healthy, successful lives. Bipolar does not have to define who you are. But for some people, the illness becomes too hard to manage and they may become depressed, be consumed with thoughts of suicide or self-harm, they may be obsessed with the idea of death, and may distance themselves completely from friends and family.

If you notice these warning signs in a loved one or feel overwhelmed with these emotions yourself, seek help immediately. Call 911 or go to the nearest hospital and speak to someone as soon as possible. Hotlines are also available 24 hours a day to talk you through your problems.

Telehealth therapy can help

If you receive a diagnosis of bipolar disorder and are having trouble coming to terms with it, a therapist may be able to help. Telehealth therapy through ReachLink offers an effective, convenient way to meet with a licensed clinical social worker from the comfort of your own home, and research suggests that it can be as effective as in-person sessions for certain situations.

While ReachLink’s licensed clinical social workers cannot prescribe the medication a person with bipolar disorder may need, they can provide a safe space for an individual to process their feelings about their mental health status, build self-esteem, and otherwise receive support as they adjust to life with the disorder. ReachLink can also provide appropriate referrals to psychiatrists or other medical professionals for medication management when needed.

Takeaway

Bipolar Disorder is not something you can leave untreated forever without severe consequences either for yourself or your family. Over time, the symptoms will continue to get worse and may eventually lead to serious outcomes. People with bipolar disorder are at greater risk for worse mental health conditions and even some physical health conditions such as heart disease. So, if you suspect you may have the illness or suspect a loved one may have it, please get help.

This is an illness that affects close to 3% of the population in North America, you are not alone. Your life means something to someone, so get the help you need today through ReachLink’s comprehensive telehealth therapy services.