Bipolarism is a psychiatric disorder that affects 1 to 4.3% of the population in the United States alone. Typically, it manifests itself with phases of pathological elevation of mood, which fall under the broader definition of "mania". Manic episodes alternate with depressive ones. This disease often has an early onset; in fact, research shows that 1.8% of children and adolescents receive a diagnosis of bipolar disorder. However, it is usually diagnosed in your late 20s and early 30s. This article will help you figure out if you have this disorder or if someone you love has it.
Steps
Part 1 of 3: Identifying the Symptoms
Step 1. Recognize the signs of the manic phase
It is characterized by feelings of euphoria, creativity and strong self-esteem. These are episodes that can last only a few hours, but also days or weeks. The Mayo Clinic (a US non-profit organization for medical practice and research) describes the symptoms of the manic phase as follows.
- Pathological elevation of mood so intense that the patient feels invincible, is often accompanied by the belief that he has special powers or is divine.
- Increase in the speed of thought: thoughts follow one another in the mind so fast that it is difficult to follow them or concentrate on anything.
- Logorrhea: the subject expresses himself with such irrepressible verbiage that others cannot find meaning in his speeches; this symptom is accompanied by agitation and restlessness.
- Insomnia: A tendency to stay up all night or sleep only a few hours at a time, but never feel tired the next day.
- Irresponsible Behavior: During a manic episode, the subject may have sexual intercourse with several people without protecting themselves. It could also wager large amounts of money or invest it in risky assets. In some cases, they may even spend money on important or expensive items, quit their jobs, and so on.
- Extreme irritability and impatience towards others: this attitude can escalate into arguments and quarrels with people who have opposite opinions.
- Rarely delusions, hallucinations and visions (for example, believing you are hearing the voice of God or an angel).
Step 2. Learn to recognize the symptoms of the depressive phase
In people with bipolar disorder, periods of depression are longer and more frequent than in manic periods. Look for the following symptoms.
- Inability to feel pleasure, joy, or even happiness.
- Sense of hopelessness and inadequacy; the feeling of guilt and uselessness is also frequent.
- Hypersomnia: sleeping more than normal and always feeling tired and sluggish.
- Weight gain and changes in appetite mechanisms.
- Thoughts of death or suicidal behavior.
- Understand that depression caused by bipolar disorder is very similar to major depressive disorder (MDD). In any case, a mental health professional is able to distinguish the two problems by looking at the previous manic phases and their severity.
- Drugs prescribed to treat major depressive disorder do not relieve the depressive symptoms caused by bipolarism, often accompanied by irritability and mood swings absent in MDD.
Step 3. Look for signs of the hypomanic phase
It is characterized by an excessively positive and persistent mood, which can last up to 4 days. People may also be irritable and have other symptoms. Hypomania is different in severity from mania: it is a less extreme form of it. Pay attention to the following symptoms:
- Euphoria;
- Irritability;
- Increased self-esteem or idea of grandeur
- Reduction of the need for sleep;
- Logorrhea (rapid and heartfelt speeches);
- Rapid changes in the flow of thought (thoughts seem to follow each other rapidly)
- Tendency to get distracted
- Psychomotor agitation, such as swaying a leg, tapping with the fingers, or inability to sit still
- In case of hypomanic episodes, there are no problems in social life or at work. In principle, this disorder does not involve hospitalization. The patient may feel euphoric, experience an increase in appetite or libido, but is usually able to work and manage daily life normally without suffering many or any negative consequences at all.
- During a hypomanic episode, the subject is able to carry out and carry out his work obligations. Furthermore, he manages to relate adequately with colleagues (even if perhaps in a somewhat intense way). However, in the case of a real mania, he finds it difficult to do his job without making judgmental errors. Equally, it may display such inappropriate behavior among people that it has unpleasant consequences. Delusions and hallucinations do not occur during hypomanic episodes.
Step 4. Understand the episode with specific mixed characteristics
Sometimes, manic and depressive states can occur at the same time. In these circumstances, the subject experiences a feeling of depression mixed with irritability, racing thoughts, anxiety and insomnia, all simultaneously.
- Hypomania and mania are defined as mixed if they occur simultaneously with at least three depressive symptoms.
- For example, imagine someone exhibiting dangerous behavior, but at the same time exhibiting insomnia, hyperactivity, and pressing thoughts. These characteristics fully meet the criteria for manic episodes. However, if the subject also presents at least three depressive symptoms, it is a manic episode with mixed characteristics. In the depressive symptom kit, he considers the sense of worthlessness, the loss of interest in one's passions or daily activities and the recurring thoughts of death.
Part 2 of 3: Understanding the Different Forms of Bipolar Disorder
Step 1. Learn about the characteristics of bipolar I disorder
It is the most widespread and known manic-depressive form of the disease. A patient diagnosed with bipolar I disorder must experience at least one manic or mixed episode, but also one depressive.
- People affected by this type of bipolarity tend to have a rather elevated mood which favors risky behaviors.
- Often this pathological form destroys professional life and social relationships.
- People with bipolar I disorder tend to meditate and try to commit suicide, with a success rate of 10-15%.
- They also run a higher risk of having or developing substance abuse.
- A link has also been found between bipolar I disorder and hyperthyroidism which makes the need to see a doctor even more important.
Step 2. Recognize the symptoms of bipolar II disorder
This pathological variant involves less intense manic episodes unlike depressive ones, which are very strong and evident. Sometimes, the subject experiences a more subdued version of hypomania, even if the underlying mood retains the depressive traits.
- Bipolar II disorder is often mistaken for depression. To recognize the difference, it is necessary to identify the distinctive features of bipolar depression.
- The latter is different from major depressive disorder because it is accompanied by manic symptoms. Since confusion is sometimes created, it is necessary to consult a qualified professional to distinguish the two ailments.
- In people with bipolar II disorder, the manic phase can manifest itself in the form of anxiety, irritability, or racing thoughts. Outbursts of creativity and hyperactivity are less common.
- As with type I patients, the risk of suicide, hyperthyroidism and drug abuse is quite high among those with bipolar type II.
- Type II tends to be more common among women than men.
Step 3. Identify the symptoms of cyclothymia
It is a milder form of bipolar disorder that involves mood swings with less severe manic and depressive episodes. Mood swings tend to occur in cyclical phases, appearing and disappearing between a depressive and manic episode. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM):
- Cyclothymia occurs early in life and usually begins during adolescence and early adulthood;
- It affects men and women alike;
- As with bipolar I and II disorder, people with cyclothymia are also at greater risk of substance abuse;
- Often cyclothymia is accompanied by sleep disturbances.
Part 3 of 3: Learning to Recognize Bipolar Disorder
Step 1. Notice seasonal mood swings
It is quite common for people with this disease to suffer from mood swings with the change of season. In some cases, a manic or depressive episode can last for a whole season, while in others the transition triggers a phase that includes both manic and depressive manifestations.
Manic episodes are more frequent in summer, while depressive episodes occur more often in autumn, winter and spring, although this is not a fixed rule. In some subjects, depression appears in the summer, while mania appears in the winter
Step 2. Understand that bipolar disorder does not always compromise individual performance
Some patients have difficulty at work and school, while others are able to carry out their duties calmly.
Often people with bipolar II disorder and cyclothymia do not have difficulty at work or school, while in type I cases more problems can occur in these areas of life
Step 3. Don't underestimate substance abuse
About 50% of people with bipolar disorder face this problem. Generally, alcohol or tranquilizers are used to stop the continuous flow of thoughts during manic episodes. Sometimes, psychiatric drugs are also taken to try to lift the mood during a depressive episode.
- For example, alcohol affects mood and behavior so much that it makes it difficult to identify symptoms of bipolar disorder.
- People who abuse drugs and alcohol are at greater risk of committing suicide because excessive consumption of these substances can aggravate both phases, both manic and depressive.
- Additionally, substance abuse can trigger a manic depression cycle.
Step 4. Beware of derealization
Most of the time, people with bipolar disorder lose touch with the world around them. This symptom occurs both during extreme manic phases and during periods of severe depression.
- Dissociation from reality can take the guise of excessive self-esteem or a sense of guilt that is disproportionate to real events. In some cases, psychotic episodes and hallucinations also occur.
- Derealization occurs most often during manic and mixed episodes of bipolar I disorder, while it is less common in type II and almost absent in cyclothymia.
Step 5. Consult a specialist
Self-diagnosis is useful if it leads to the next step which is to seek help. Many patients live with bipolar disorder without receiving proper treatment, but the disease is better managed if the right medications are taken. Psychotherapy with a trained professional can also provide excellent support.
- Medicines used to treat bipolar disorder include mood stabilizers, antidepressants, antipsychotics, and anxiolytics. They work by blocking and / or regulating the production of certain chemicals in the brain, such as dopamine, serotonin, and acetylcholine.
- Mood stabilizers help regulate the patient's mood. They prevent him from reaching the peaks and troughs typical of manic and depressive episodes. These include lithium, valproate, gabapentin, lamotrigine and topiramate.
- Antipsychotics help relieve psychotic symptoms, including hallucinations and delusions, during a manic episode. These include olanzapine, risperidone, aripiprazole and asenapine.
- The antidepressants used to treat bipolar depression are escitalopram, sertraline, fluoxetine and others. Finally, to treat the symptoms of anxiety, the psychiatrist may prescribe alprazolam, clonazepam, or lorazepam.
- Medicines must always be prescribed by the psychiatrist or attending physician and must be taken following the instructions given in the package leaflet or provided by the doctor himself to avoid complications.
- If you are concerned that you have this disease (or you suspect that it has affected a person you love), consult a psychotherapist or psychiatrist for a certain diagnosis.
- If you have thoughts of suicide, contact a friend or family member immediately. Call a Suicide Emergency Telephone Center (such as Telefono Amico on 199 284 284) for help and advice.
Advice
- Keep a calendar. Mark the beginning and end of "manic" and "depressive" episodes so that you have a tool to help you estimate the arrival of relapses. Realize that no one can perfectly predict when they start.
- If you tend to drink alcohol or use drugs, consider that these substances can promote mood swings with the onset of bipolar disorder. Therefore, it is better for you to abstain.
