The Extremes of Bipolar Disorder: Manic vs. Depressive
Bipolar disorder is a mental illness characterized by emotion shifts that are large, rapid, unexpected, or somehow unusual. For people with bipolar disorder, emotions seem to overwhelm them unexpectedly, and they may feel very little control over how they feel in any given day, or how they react to the circumstances that infuse their everyday life.
Experts are not quite sure how bipolar disorder develops, but they suspect that genetics might play a role. As the National Institute of Mental Health points out, children with a parent or sibling who has bipolar disorder are more likely to develop the illness than children who do not have a relative with the disorder. Genetics are likely to play a role.
When people do develop bipolar disorder, they may lean on substances of abuse in order to handle the emotional shifts. They may lean on alcohol to lower an up mood, cocaine to raise a low mood, or benzodiazepines to make a mood shift less disturbing. To these people, drugs seem like a good solution to an overwhelming problem. But in reality, drugs can do a great deal of damage to a person with bipolar disorder. Often, the substances can become addictive. Addiction is so common in people with bipolar disorder, in fact, that experts writing in Psych Central suggest that everyone with bipolar disorder should be screened for addiction.
While people with bipolar disorder might feel betrayed by genes and buffeted by addiction, there are solutions. Finding them means learning more about how bipolar works and what it can do. A good place to start is to understand what separates bipolar mania from bipolar depression.
A manic episode can be described as a period of time in which the person has an increased sense of power, energy, and self-worth. During mania, people may:
- Sleep less
- Talk more
- Talk quickly
- Become distracted
- Set impossible goals
- Engage in dangerous behaviors
- Express delusions of grandiosity
- Take risks
A manic episode must last for at least a week in order to be clinically significant, according to Psych Central. People can do a great deal of damage during that time. They might run up credit card debt, engage in sex with strangers, get in fights, hurt their bodies, take too many drugs, or otherwise ruin their lives. The entire time that the mania lasts, these people may feel really good about the way things are going.
In BP Hope magazine, an author writes longingly of the manic symptoms she no longer has. She describes feeling like a rock star in a crowded stadium full of fans during her mania. She felt invincible and totally powerful. She thought she could do anything and be anything. These are not sensations the average person feels on the average day. Mania brought them about. Many people with bipolar disorder actually like mania, and they want it to last.
Mania has also been associated with creativity and increased productivity. People who need little sleep and who have a great deal of energy can get a lot of amazing things done. They might be able to paint, sculpt, or even write during a manic episode, and they won’t be plagued by a sense of doubt or low self-worth. They will feel like everything they do is magical. That can be pretty wonderful.
On the opposite side of the bipolar spectrum is depression. It is here that people with bipolar feel low, sad, and sluggish. They may feel as though they are worthless, hopeless, or helpless. All of the confidence and happiness that comes with mania drains away with depression. This is a season of loss.
During bipolar depression episodes, people might:
- Sleep almost all the time
- Seem tired
- Cry for no reason
- Express feelings of guilt or loss
- Stop going to work
- Talk little
- Gain weight
- Move slowly
- Complain of physical pain
Depression like this can last for a very long time. According to BP Magazine, people with one form of bipolar disorder can spend 40 times more days in depression than they in mania. They may feel low and sad almost all the time.
During a depressive episode, people might lose their jobs and social connections, simply because they do not have the energy to attend to these important details. People in depression may also think about and/or commit suicide just to make the feelings stop.
People with bipolar disorder rarely look forward to the depression. They want to feel better, but they simply do not know how to make it happen. They may feel as though the time they spend during their depressive episodes is time in which they are dead or somehow not really alive, as they cannot achieve their goals or participate in life. No one wants to live like that, but people with bipolar disorder might live like that often.
Unfortunately, when many people with bipolar disorder head to their doctors for help, they are given forms of assistance that do not really help. The Depression and Bipolar Support Alliance says that 10-25 percent of people diagnosed with conventional depression actually have a form of bipolar disorder. These people do not need the same therapies as people with straightforward depression. But those are the therapies they will get with this inaccurate diagnosis.
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People with bipolar disorder often benefit from a therapy that involves both medication and talk therapy. The medications help to soothe unbalanced chemical signals in the brain, and that could help to reduce the number of emotional shifts that happen and/or reduce the severity of the shift symptoms people feel.
Those people who have an addiction as well as bipolar disorder need a slightly different form of treatment. They have two disorders at the same time, and those disorders need different types of care. A program that addresses co-occurring disorders can handle those demands.
In such a program, therapists work to deal with both the addiction and the bipolar disorder at the same time. The entire team knows what the two conditions are and how they work, and every therapy is designed to provide people with tools they can use to treat both of these very different types of issues.
For example, in a traditional addiction program, therapists help their clients to understand drug abuse relapse risks. Those might include people, situations, or places. For people with bipolar disorder, those relapse risks could be signs of mania or signs of depression. With that awareness, people can learn the importance of keeping bipolar symptoms under control, so they will not be tempted to lean on drugs for self-medication.
In addition, in a therapy program, clinicians can help people to develop healthy behaviors that might work to head off a bipolar shift. Those might involve:
- Getting the right amount of sleep each night
- Eating on a set schedule
- Exercising regularly
- Setting aside time for meditation
- Finding nurturing hobbies
All of these commonsense, reasonable steps can lead to better overall mental health. That could make bipolar symptoms less likely to appear.
While the connection between bipolar disorder and addiction has been identified, not all treatment programs offer this kind of support for dual diagnoses. As a result, families must do their homework and ask about these issues. Only then will they be able to find and utilize the right program for the person they love. During therapy, that family should stay involved, too, and make sure that the treatment is progressing as it should.
With the help of a loving family and the right program, people with bipolar disorder can get better. People do it every day.