What is Bipolar?

Question:

I’ve just been told I have bipolar affective disorder. Just what does this mean?
 

Answer:

I’ll very briefly summarize some important points about bipolar disorder, years ago called manic-depressive illness. First, it is important to differentiate it from unipolar depression for one primary reason: the treatments are different. For example, the mood-stabilizing medications (one being lithium) are the first-choice option much more often than are the antidepressants.  If you have something of an “under the radar” form of bipolar and go on an antidepressant, it can at times bring about a full-blown manic episode. Another difference is that there is more of a congenital predisposition to bipolar disorder. That is, to a large degree it is something you are born with, whereas other forms of depression a less predetermined. Features of mania may include symptoms such as rapid, pressured speech, racing thoughts, grandiosity or inflated self-esteem, poor judgment, reckless behavior, high distractibility, agitation, a general spike in eccentric behavior and, at times, psychotic features such as delusions or hallucinations. These and other symptoms would be prominent enough to cause notable consequences.

There are various types of bipolar, such cyclothymia, kind of a low-grade version. There is a mixed state, where elements of mania and depression occur together, and bipolar II, where depression seems to be the primary problem and the up-swings are “hypo-manic”, shorter-lasting and less extreme.

Unlike with “basic” depression (if only there was such a thing), those with bipolar need to keep a wary eye on early warning signs for upward as well as downward swings. You may need to be extra careful to keep your life routine and filled with other stabilizing influences such as good social connections and solid self-care practices. Medications may well be a necessity for a long time, whether you like it or not, and the prescriber may need to be a psychiatrist or otherwise have specialized knowledge.

For more information, a good place to start is http://dbsallianc.org/.

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Tom Linde M.S.W.
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