BIPOLAR DISORDER

According to the American Psychiatric Association (APA), bipolar disorders are a group of mental illnesses triggering serious alterations to a person’s mood and energy levels.

People with bipolar disorders alternate periods of manic (or hypomanic) episodes with periods of depression.

The stigma around Bipolar Disorder

Most people living with bipolar disorder are not as unstable as the stigma let us believe. Some people are going to experience mixed episodes where they can go from manic to depressive symptoms, but this doesn’t mean most of the people are going to jump from being happy to sad every half hour.

A person with bipolar disorder will often be labelled as « crazy » in books and movies and might even be portrayed as murderers or people incapable to live their own lives. This image has a strong impact on the stigma and books like Another kind of madness from Stephen Hinshaw portrays it perfectly.

Another thing that might happen too often is people around will undermine the experience considering that everyone goes through mood swings. Let’s put it here once and for all, living with bipolar disorder is not just living strong « mood swings ». It is not an easy experience, it impacts every aspects of your life and often impacts your loved ones too. Even if possible, it can be very hard to take back the control to your life, to do so, you need to stick to a strict, healthy routine, always.

Before getting deeper into details, please remember that some people are living with a bipolar disorder or have a bipolar disorder diagnosis. They are not the disorder, they have the disorder, words are sometimes very important! So, please, next time you talk about someone with a bipolar disorder don’t say he/she is bipolar but has bipolar disorder.

Getting diagnosed with Bipolar Disorder

APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies different types of bipolar disorders, depending upon at which intensity the phase of depression alternates with the phase of mania (or hypomania).

There are three types of Bipolar Disorder Diagnosis:

Bipolar I Disorder – to be diagnosed with type I, a person needs to have experienced at least one episode of mania. Not everyone with this diagnosis has experienced a major depressive episode. The person will go from episodes of mania to euthymia (phase without symptoms) or to depression.
Bipolar II Disorder – to be diagnosed with type II, a person needs to go through one or more major depressive episodes that are usually longer than the ones in Bipolar I experiences. The person can also experience episodes of hypomania (less severe than manic episodes).
Cyclothymic disorder – to get this diagnosis, a person has to go through at least two years (one in childhood or adolescence) where hypomanic symptoms occur, but they do not lead to a hypomanic episode/diagnosis, and many periods with symptoms of depression, but notleading to a major depressive episode/diagnosis. This experience happens more often to children and adolescents and this, in turn, leads them to be 15 to 50% more likely to suffer from Bipolar I or II in adulthood.

People with bipolar disorders behave differently depending on whether they are experiencing a period of depression or they are struggling with manic tendencies.

In a manic phase, some of the symptoms are:

impulsive dangerous behaviors (e.g. compulsive spending, gambling, etc. …).
lack of inhibition;
aggressive attitudes;
decreased need for food and sleep;
hypersexuality.

In a depressive phase, some of the symptoms are:

very low mood;
feeling of fatigue;
weight gain or loss;
insomnia or oversleep;
suicidal tendencies (in extreme cases).

A misjudgment of bipolar disorder symptoms may have serious implications for the patient’s health. Some of bipolar disorder symptoms can indeed be found in other mental illnesses such as hyperactivity disorder, substance abuse, schizophrenia and eating disorders.

Too often, a person suffering with bipolar disorder will wait a couple of years before actually being diagnosed and instead of treating the problem at the root they will go through treatments of symptoms or being misdiagnosed with borderline personality disorder, schizophrenia or chronic depression.

People suffering from bipolar disorders do not always directly shift from one phase to another. They often go through a euthymic phase where they are “symptoms free” or experience them at a way lower intensity. This period of time can be days or years depending on the person’s experience. Taking the right treatment and having a healthy routine increase the chance to stay in this phase for a longer period of time and to only experience short relapse.

The causes of Bipolar Disorder

As to bipolar disorders’ potential causes, the National Institute of Mental Health (NIMH) reports “most researchers agree that there is no single cause […]”. Hence, people may struggle with bipolar disorders due to a variety of reasons:

Genetic heritage
Brain structure, where serotonin, dopamine and norepinephrine transmitters are involved. This occurs due to an imbalance of these neurotransmitters in the brain.
Although bipolar episodes can occur without cause, in many cases social factors can be a trigger. No specific event is proved to be a clear trigger, but studies show that the cortisol stress hormone is involved in this process. A trauma in the person’s life can also be the cause of the diagnosis.
Substance abuse can induce the diagnosis.