Bipolar: What Is It?

 about bipolar mood
 

what is it?

Bipolar Mood Disorder (BMD, also known as Manic-Depression) is a chemical imbalance in the brain which causes unusual, extreme shifts in a person's mood and energy. It affects thought, behavior and ability to function.

It involves cyclical mood shifts between episodes of elevation [extreme elation / mania] and of depression [extreme sadness]. The mood shifts are different from the normal ups and downs that "normal" people experience; the symptoms are more severe.

It's called bipolar because of the tendency of energy and emotions to swing to either  extreme. "Bipolar" = meaning, "of two opposite poles".  Get it?

It is a biological disorder, NOT a psychological or mental disorder.It concerns a deficiency in the physical part of the brain- something like a birth defect.  Since it's involves the brain, it affects aspects of the mind, so it seems like a psychological / mental disorder and is often referred to as one. 

Though it is called a "mood disorder" it does not only affect emotions but also physical energy levels, performance and thought patterns.

It is NOT mental instability, retardation or insanity.
It is not technically an illness. 
It does not affect cognitive logic, intelligence or memory.

Contrary to popular notion, "bipolar" does NOT mean "crazy". 
It means "emotionally disturbed", not crazy. 
Bipolars are not idiots.  In fact, we tend to be highly intelligent individuals with multiple areas of interest. Bipolar Mood gives us the capacity for genius-level I.Q., sharp perception and great focus.  We are often immensely creative, brilliant and very intense.
... It's just that without the proper treatment, the monster mood swings can open the door to neuroses, psychoses and addictions, and those things can get in the way of success.

But the next time you think of a bipolar as an idiot, remember that "that idiot" is likely more intelligent than you are, b*tch.



What causes it?

The genes do.  This sort of chemical imbalance is hereditary, i.e., a person can be born with it if other members of the family have Bipolar Mood or some sort of chemical disorder.


Symptoms are visible from childhood, but it is often misdiagnosed as something else because it cannot be determined by a physical examination.  A psychological evaluation will reveal patterns throughout a person's life.In my case, I've been exhibiting symptoms as early as age 3.  But it was only a few years ago that I received a professional diagnosis on it.


Though the mood swings can be affected by external things such as circumstances, events or people [called "triggers"], the chemical imbalance isn’t caused by them.


what the condition is like
A DEFINITION OF RELATED TERMS

Cyclical Mood Swings
The mood swings are cyclical – meaning they happen repetitively, one after the other. These CANNOT be avoided or controlled, but they can be managed.

There are periods of normal / stable mood, but these don't count as “healing” or “victory” because there will always be a next episode.  Bipolar Mood will not go away.  Deal with it.

Episodes
Episodes are periods in which I show several symptoms of either elevation or depression, or both, PLUS anxiety and irritability for most of the day, going on for a few days. Symptoms are discussed in further detail below.

I am usually very agitated, anxious, emotional and volatile during episodes.

Episodes just happen, even for no reason.
You cannot talk me out of one. 
You can’t pray it away or cast it out.
You cannot fix me, and the more you try, the more it will upset me and worsen the symptoms. 

The only thing we bipolars could do about is take the meds, avoid the triggers and wait until it's over.What others around us should do is just be supportive.

MORE ABOUT EPISODES
Episodes (either depression or elevation) can come with the following:

- Anxiety
- Irritability
- Anger problems (expressed either outwardly or inwardly)
- Vile moods
- Distorted, selfish thoughts
- Dreadful behavior
- Poor or damaged relationships / few or no meaningful relationships
- Poor or inconsistent performance at work or school
- Addictions, unhealthy use of substances
- Overspending / poor money management
- Dependence, separation anxiety
- Persecution complex
- Shattered will to live
- Suicidal thoughts [common during shifts between episodes]
- Difficulties in focus or attention

Normal / Baseline / Stable Mood
This is the state where there are no episodes. 
When episodes occur, the day-to-day goal is to stick as close to baseline as possible, using coping techniques and treatments.
In my case, this happens around only 60 days a year, non-continuous.

Type 1 / Type 2
Type 1 Bipolar has longer periods of elevation, shorter periods of depression. Because of the prolonged elevations, people with this type are more outwardly destructive.
Type 2 Bipolar is the reverse - longer depressions, shorter elevations.  Those with type 2 turn their anger and destruction inward.
Read more about this here.

Rapid Cycling
I am a Type 2 bipolar with rapid cycling. In this case shifts can occur as frequently as several times in a month, sometimes a few times within a week. Depending on the mood and the triggers, ultra-rapid shifting can happen within the day.

Anxiety and irritability

Anxiety and irritability are sure to be present during an episode, so you shouldn't be wondering why I am agitated, antsy or angry over seemingly small things. It may be small to you, but it won't be to me.

Triggers
The mood swings can be worsened by things called triggers – basically, they are things that are upsetting.
Triggers intensify episodes.  i.e., when I am in an elevated episode, triggers will heighten the mania; if I am in a depressive period, anything upsetting can make me more depressed.
One trigger after another can throw me into a severe episode, and that could be extremely difficult not just for me but for the people around me as well.

Triggers are different for every bipolar.  These need to be identified and avoided during episodes in order not to worsen the elevation / depression.

treatment
BMD has no cure, so I am [we are] pretty much stuck with it. It's a long-term condition that has to be carefully managed for the rest of my life.

It can be treated though:

Lithium Carbonate (a.k.a. Lithium)
Lithium is not the only medication for BMD, but it is the primary one. It is probably not the best either, but it's the one that is available locally.
It doesn’t really eliminate the mood swings but it sort of muffles emotions. I reiterate: with Lithium, the mood swings are still detectable, but it removes passion and enjoyment of life.

It has a lot of side effects such as numbness, dizziness, headaches, tiredness, feeling "detached". It is toxic in large doses.



Coping Methods
Though the mood swings can't really be eliminated, there are certain methods of coping that can be applied. These don't really get rid of the episode, but can help minimize the symptoms.

The basic goal for me [with the help of those around me] is to each day reach a mood that is closest to the BASELINE [normal / stable] as much as possible.

recognizing the symptoms

elevation / mania

4 or more of the following symptoms, plus anxiety and irritability, for most of the day nearly every day lasting a week or longer.

• High energy, increased work ability, busy-ness
• Decreased need for sleep [few hours a night, sometimes no sleep at all for days]
• Excessive or irrational happiness; impulse to laugh at things not normally considered funny
• Excessive anger or irritability, even over trivial things
• Rapid shifts from joy to anger; experiencing joy and anger at the same time
• Extreme optimism and faith
• Heightened self-esteem; feelings of importance or invulnerability [in extreme: messiah complex]
• Excitability
• Multiple interests; desire to do a lot of things; going from one activity to another, possibly dropping previous involvements to pursue new ones
• Distractability, lack of focus
• Talkativness, quick, loud, and / or elaborate speech
• Racing thoughts, restless mind
• Impatience, being demanding or imposing
• Increased creativity and productivity; exciting ideas
• Excessive cleverness, many quick mental associations after another [word play and amusing irrelevancies
• Increased sexual desire
• Indiscriminate behavior
• Compulsiveness, carelessness
• Uncharacteristic / inappropriate behavior
• Offensive behavior - hostility, argumentativeness, tactlessness, lashing out
• Overreacting, exaggerating
• Heightened senses
• Overspending, giving away money
• Change in appetite
• Hyperactive imagination, extreme creativity [in extremes: delusions]

depression 

4 or more of the following symptoms, plus anxiety and irritability, for most of the day nearly every day lasting a week or longer.

• Low energy, lethargy, laziness
• Loss of sleep / insomnia
• Increased need for sleep, oversleeping
• Excessive sadness , negative emotion
• Crying easily; desire to cry for no apparent reason
• Pessimism
• Feelings of worthlessness, inadequacy
• Remorse, guilt feelings, self-blame; preoccupation with perceived failures
• Numbness; excessive boredom
• Loss of interest in things formerly enjoyed; inability to experience pleasure or have fun
• Difficulty in concentrating, distractability, forgetfulness, disorientation
• Indecisiveness
• Slow thinking, talking and / or moving
• Restlessness, agitation
• Anxiety, worry , paranoia [in extreme: hallucinations, hearing voices, delusions]
• Low desire for sexual activity
• Withdrawal from social contact
• Anger turned inward
• Change in appetite or weight
• Thoughts of death [suicide, murder]; lack of desire to live
• Bodily complaints - headaches, muscle pains, blurred vision, indigestion
• Oversensitivity

mixed episodes / dysphoria
Several symptoms of both in the same day.
Dysphoric mania has more symptoms of elevation than mania.
Dysphoric depression has more symptoms of depression than elevation.


the scale

• Severe Mania - Significant impairment to work and interactions; delusions, hallucinations.  People will want me in the hospital.
• High-Moderate Mania - Behavior affects work and interactions; overly intrusive or odd actions; extreme busy-ness; poor judgment.  
• Low-Moderate Mania - Increased ability to work; tendency to be overly happy, optimistic, but very irritable.  Still more ore less safe.
• Mild Mania - Lots of energy, busier or more disorganized than normal; still able to function normally.  Still safe.
• NORMAL - Stable, content, relaxed; normal functions and interactions. 
• Mild Depression - Low mood, lethargy; able to function normally.  Very sad but still OK.
• Low-Moderate Depression -Requires some effort for usual activities but can function normally; disinterest for life.
• High-Moderate Depression - Behavior affects work and interactions; needs a lot of effort to carry out normal roles and routines; suicidal thoughts. 
• Severe Depression - Significant impairment, inability to work or function; hallucinations; I should be in the hospital.