What is Bi-Polar Disorder?

Bi-polar disorder, also known as manic-depression, is a brain disorder that causes people to experience unusual shifts in mood. People with bi-polar disorder may experience dramatic and recurrent highs and lows. These high and low periods are known as mania and depression, and often occur at levels and in cycles that are unique to each person.

Some people may experience periods of relief between the shifting cycles and may be able to return to their normal activities, while others may have little to no time between cycles.

Nearly 6 million Americans have this mental health issue. Typically, the first symptoms manifest in young adulthood, but initial symptoms have been seen in young children and older people as well.

The causes are not yet completely understood, but like other mental illnesses, it is believed to be a combination of genetic-predisposition and the person’s environment. Substance abuse may also play a role in the onset of symptoms. People with bi-polar disorder, especially young men, may be at greater risk of suicide.

Signs and Symptoms*

There are two phases of this illness; mania and depression. In each phase the symptoms may range from mild to severe.

Mania

This is the period of highly elevated mood. To be diagnosed with bi-polar disorder a person must experience at least 3 of the following symptoms most of the day, every day, for at least one week.

  1. Increased energy, activity, and restlessness
  2. Excessively “high,” overly good, euphoric mood
  3. Extreme irritability
  4. Racing thoughts and talking very fast, jumping from one idea to another
  5. Distractibility, can’t concentrate well
  6. Little sleep needed
  7. Unrealistic beliefs in one’s abilities and powers
  8. Poor judgment
  9. Spending sprees
  10. Increased sexual drive
  11. Abuse of drugs, particularly cocaine, alcohol, and sleeping medications

Depression

This is the period of low mood. To be diagnosed with bi-polar disorder the person must experience at least 5 of the following symptoms most of the day, every day, for at least two weeks.

  1. Lasting sad, anxious, or empty mood
  2. Feelings of hopelessness or pessimism
  3. Feelings of guilt, worthlessness, or helplessness
  4. Loss of interest or pleasure in activities once enjoyed, including sex
  5. Decreased energy, a feeling of fatigue or of being “slowed down”
  6. Difficulty concentrating, remembering, making decisions
  7. Restlessness or irritability
  8. Sleeping too much, or can’t sleep
  9. Change in appetite and/or unintended weight loss or gain
  10. Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
  11. Thoughts of death or suicide, or suicide attempts

* Information courtesy of The National Institute of Mental Health

Bi-polar disorder and Suicide

People with bi-polar disorder may become suicidal in either phase of their mood cycling. When people with bi-polar disorder become depressed they might feel hopeless about ever feeling better and think consider suicide. This may be especially true in the earlier stages of the illness when a person may not yet understand their illness.

In the manic phase, because people are apt to think that they have powers they do not really have. They may accidentally hurt of kill themselves by doing things so as trying to fly, jumping out of or in front of cars, or other dangerous behaviors. Because young people naturally tend to be more impulsive than older people they are at greater risk of suicide.

Not everyone with bi-polar disorder becomes suicidal, but in the event that someone one is displaying some of the warning signs of suicide (talking about death or dying, making plans for their belongings, saying good bye to friends and family), they should be seen by a mental health professional immediately. If someone is actively trying to hurt themselves 911 should be called immediately.

Types of Treatments

Because bi-polar disorder is a cyclic disorder that is likely to have several recurrences over the course of a person’s life, preventive treatments are recommended. A combination of medication therapy and psycho-social support has been found to provide the greatest amount of success.

Medication Therapy

There are several medications known as mood stabilizers that can be used to help control the symptoms of bi-polar disorder. The most common, and the one that has been used the longest is Lithium. There are other newer medications as well. Often mood stabilizers are used in conjunction with anti-depressant medications, but this will depend on an individual’s specific symptoms. Medications for bi-polar disorder are best prescribed by a psychiatrist.

Family Systems Therapy

This refers to a number of different therapy models that recognize that families influence who we are. The messages we learn from our families can help us to cope with stress later in life, or they can create unhealthy styles of coping. Family Systems Therapies help us to explore and use the role of family relationships, legacies, spoken and unspoken messages, and styles of communication to heal from issues that cause us distress in the present.

Cognitive Therapy

Cognitive therapy is a form of talk therapy that helps people to examine the thoughts influence their choices and behavior. Cognitive therapy challenges irrational thoughts and works to replace them with more rational ones.

Psychoeducation

This form of treatment can be helpful to both the person with bi-polar disorder and his/her family. It helps to increase understanding about the illness, it suggests healthy coping techniques, and helps identify the early signs of relapse so that intervention can take place quickly before the full illness returns. This form of treatment can be used in conjunction with all other forms of treatment.

Electroconvulsive Therapy (ECT)

In situations where medication, psychosocial treatment, and the combination of these interventions prove ineffective, or work too slowly to relieve severe symptoms such as psychosis or suicidality, electroconvulsive therapy (ECT) may be considered. ECT may also be considered to treat acute episodes when medical conditions, including pregnancy, make the use of medications too risky. ECT is a highly effective treatment for severe depressive, manic, and/or mixed episodes. The possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques. However, the potential benefits and risks of ECT, and of available alternative interventions, should be carefully reviewed and discussed with individuals considering this treatment and, where appropriate, with family or friends.*

Request Treatment

If you would like more information or an assessment by a mental health professional you can contact Catholic Charities Behavioral Health Services at 1-866-682-2166 or e-mail at counseling@camdendiocese.org.

*Information courtesy of The National Institute of Mental Health