Exploring Bipolar Disorder

In “The Problem with How We Treat Bipolar Disorder,” a 2013 article in The New York Times, Linda Logan shared intimate details of her past, as well as her ongoing battle with bipolar disorder.

According to the National Institute of Mental Health, 5.7 million American adults, or roughly 2.6% of the U.S. population, are affected by bipolar disorder every year. The disorder can affect people of all ages, races, social classes and ethnicities, and neither men nor women have a greater chance of developing the disorder. The average age of those diagnosed is 25, although its onset is possible in early childhood or in a person’s 40s or 50s.

“The hormonal chaos of having three children in five years, the pressure of working on a PhD dissertation and a genetic predisposition for a mood disorder took me to a place of darkness I hadn’t experienced before.” – Linda Logan in The New York Times

Logan could not recall a particular point when depression took over her life. She remembered the disorder developing gradually and inexorably.

“I had a preview of depression in high school, when I spent a couple of years wearing all black, rimming my eyes in eyeliner and sliding against the walls in the hallways, hoping that no one would notice me,” Logan wrote.

At that point, she was unaware of how serious the problem could become – a common issue among many people treated for the disorder.

bipolar-disorder-causes-and-triggers_high-res_origWhat is Bipolar Disorder?

Bipolar disorder, also known as manic-depressive illness, causes extreme mood swings consisting of emotional highs in the form of mania and emotional lows in the form of depression. These mood swings often have an effect on a person’s thinking, behavior and energy.

Mood changes caused by bipolar disorder can be so intense they interfere with a person’s ability to perform normal daily functions, and can last days, weeks or months:

  • During an emotional high, more commonly known as a manic episode, a person demonstrates impulsive behavior. Manic episodes are typically characterized by a rise in energy.
  • The opposite occurs during an emotional low, known as a depressive episode. A person has very little energy and may be unable to get out of bed for days or weeks at a time. Depressed people may lose interest in any kind of pleasurable activity and remain consumed by feelings of sadness or hopelessness.

What causes of bipolar disorder remains unclear. Researchers say the disease often appears to be hereditary.

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Types of Disorders and Their Symptoms

There are three main types of bipolar disorder, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It is important to keep in mind that exact symptoms can vary from person to person.

  • Bipolar I Disorder – A person has experienced at least one manic episode, which can be preceded or followed by a depressive or hypomanic (not as severe or no psychotic features present episode.
  • Bipolar II Disorder – A person has experienced at least one major depressive episode lasting at least two weeks and one hypomanic episode lasting at least four days.
  • Cyclothymic Disorder – A person who has experienced many periods involving hypomania symptoms over a span of at least two years, which is less severe than hypomanic episodes.

In Logan’s case, she experienced her first hypomanic episode in 1989, confirming for her doctors that she was not just suffering from severe depression. Logan had Bipolar II disorder, the same type her father was diagnosed with when she was younger.

“With Bipolar II, unlike Bipolar I, the upward swing from depression stops at hypomania, not mania,” Logan said. “Mania is having five grand pianos delivered to your house; trying to buy the Sears company. Hypomania is mania with a tether, and while it might avert some of the financial and interpersonal disasters that unchecked mania may cause, it can still feel like a runaway train.”

Importance of an Appropriate Diagnosis for Bipolar Disorder

Most people experience their first bipolar-related episode during their teenage years like Logan did or during early adulthood, but usually the symptoms are subtle and confusing at first. Most times, people who are suffering from bipolar disorder are overlooked or misdiagnosed numerous times before they are able to receive proper treatment.

Early on in her battle with bipolar disorder, Logan went from doctor to doctor searching for a diagnosis that would explain her severe exhaustion and depression. She was tested for anemia, low blood sugar and hypothyroidism, but all of these tests came back negative. As time went on with no diagnosis and improper treatment, Logan’s condition worsened.

“Several nights a week, I drove to the reservoir near my home, sat under a tree and, as joggers and their dogs ran past, thought about ending it all,” she said. “There was a gun shop on the way to my poetry group; I knew exactly where to go when the time came.”

After a few weeks of being consumed by suicidal thoughts, Logan mentioned her worsening psychic pain to her husband. The next day she was checked into the hospital.

When doctors suspect a person has bipolar disorder, they usually start with conducting a number of tests and exams, which can help rule out other problems, check for any related complications and most importantly pinpoint a diagnosis.

Tests include a physical exam, a psychological evaluation, mood charting and a comparison of a person’s symptoms against existing criteria listed for bipolar disorder. All of these are an important part of diagnosis for proper treatment to be made available.

Bipolar disorder typically requires long-term treatment. Remaining symptom-free and preventing the occurrence of future episodes requires patients to continue treatment even if they feel better.

In almost all cases, medication alone is not sufficient enough to fully control the symptoms of bipolar disorder. A combination of medication, therapy, lifestyle changes and social support are the treatment strategies found to be the most effective. It also helps to work with a psychiatrist who specializes in monitoring those with bipolar disorder.

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