Whether you have a physical disease or a mental health condition like bipolar disorder, managing your symptoms, especially when your diagnosis is new or not well controlled, is likely to take a lot of your focus and energy. It can take so much of your focus that it can start to seem like it defines you. You’re much more than your condition, though, and you can live a full and joyful life defined by things you love.
There are four types of bipolar disorder, but they have in common that people with the conditions have dramatic shifts in mood and energy. Everyone experiences emotional highs and lows, but people with bipolar disorder experience them more intensely and often more frequently.
The four classifications are Bipolar I, Bipolar II, Cyclothymia, and Bipolar Disorder, unspecified.
The defining characteristic of Bipolar Disorder I is mania, which is an extremely elevated and generally euphoric mood. Sometimes mania is accompanied by delusions and health-threatening hyperactivity. Suppose a person has a manic episode that lasts at least seven days or is severe enough to require hospitalization. In that case, they meet the diagnosis for Bipolar I. Usually, people diagnosed with Bipolar I also experience periods of depression, but it isn’t a necessary condition for diagnosis.
People with Bipolar Disorder II don’t experience full mania, but they have periods of depression that alternate with periods of hypomania, which is a milder and shorter type of manic episode. The manic symptoms are less severe than for Bipolar I, but the depression may be significant and long-lasting.
If someone has at least two years of rapidly alternating periods of hypomania and mild depression, they may receive a diagnosis of cyclothymia (also called cyclothymic disorder). Periods of normal mood last less than eight weeks.
Bipolar disorder, unspecified:
When people experience bipolar symptoms but don’t fit one of the other categories, they may receive this diagnosis. Sometimes the symptoms accompany another medical condition.
Mania and Depression
No one enjoys depression, but some people enjoy the hypomania or mania that accompanies bipolar disorder, which complicates the desire to seek treatment. Although they can feel pleasant, at least initially, they can also severely impact life and relationships and cause people to make unwise decisions.
Hypomania is more manageable than full mania. You may feel very happy and excited when you’re hypomanic, but you may also feel agitated, irritable and be easily distracted. You’re likely to talk a lot and be very friendly and social. You’re also likely to sleep very little, which can lead to cognitive and physical challenges and worsen mental health symptoms. People in a hypomanic state tend to take risks and have lowered inhibitions. Spending money lavishly and engaging in unsafe sex are common.
Although people can sometimes keep up with their everyday lives and responsibilities when they’re hypomanic, it’s challenging to do that during a full manic episode. Mania involves hypomania symptoms, but you’re also likely to feel very sure of yourself and confident of your abilities. You may feel stronger and smarter than normal and believe that you see the world more clearly than others do. You may begin to feel invincible.
In addition to talking a lot, and often very quickly, you may speak in a way that others find hard to follow. You may act and speak in inappropriate ways that are out of character for you. It’s not uncommon for people experiencing mania to be aggressive or rude or abuse alcohol or drugs. They may take very extreme risks, which put them in physical danger.
Severe mania may also include hallucinations or delusions, including delusions of grandeur. Grandiosity is an exaggerated feeling of superiority and importance and is present in both hypomania and mania. Delusions of grandeur, which involve believing things that aren’t true, such as that you have a special relationship with a very famous or important person, are present only in mania. About two-thirds of people with bipolar I disorder will experience delusions of grandeur at some point.
The depression of bipolar disorder can be mild but is often quite severe and debilitating. It can involve feelings of hopelessness, helplessness, failure and guilt. People may feel suicidal.
Bipolar Disorder Needs to be Treated
How much bipolar disorder affects your everyday life depends on its severity. Even if your case is mild, however, it’s important not to delay mental health treatment. The National Alliance on Mental Illness states, “If left untreated, bipolar disorder usually worsens. However, with a good treatment plan including psychotherapy, medications, a healthy lifestyle, a regular schedule and early identification of symptoms, many people live well with the condition.”
Often people with bipolar disorder who are riding a wave of mania don’t recognize the risks they’re taking or the negative consequences of their behavior. However, after the mania or hypomania has subsided, they can often feel very distressed or ashamed.
If you made commitments during the episode, they might feel overwhelming or unmanageable later. You may have said or done things that affected your important relationships, and you may not know where to begin to repair them. You may have only fuzzy memories of what happened during the episode, or in some cases, have no memories of the time at all.
As one person with bipolar disorder put it, “Then comes the inevitable crash—waking up one morning after finally sleeping for about 12 hours for the first time in a week and realizing I’ve spent all my money, applied to study courses and for jobs I’m not even qualified for, and fallen out with everyone who tried to calm me down.”
Bipolar Disorder Doesn’t Define You
Something that affects much of our life can start to feel like it’s not just part of us but also our essence. It is especially true when our thoughts and behaviors are affected. It can be counterproductive to think that way, though, because it can lead to feelings of hopelessness.
An individual with a mental health disorder points out that your brain is just a part of your body like your arm is and that if you cut your arm, you wouldn’t tell yourself that you were now a cut. When a body part is injured or not functioning optimally, the wise response is to care for it, whether the challenge is with your arm or your brain.
Like all human beings, you are a beautifully unique and complex mixture of things you both did and didn’t choose. You didn’t choose your parents or siblings, but you chose your spouse if you’re married. Nor did you choose your height or the color of your eyes, but you can choose how you dress. Having bipolar disorder wasn’t a choice either, but you can choose how you manage it.
Healthy ways of coping with bipolar disorder include the following:
Educate yourself about the condition.
Education can help in both learning to manage it and in feeling less alone. Many people understand what you’re going through.
Find role models.
If you don’t know anyone personally, an internet search will yield a long list of celebrities and influential people living well with bipolar disorder. They are more than their condition, and so are you.
Follow your treatment plan.
Treatment generally involves both medications and psychotherapy. If you’re feeling stable, it’s easy to let your treatment slide, but this isn’t wise. Experts note that treatment for bipolar disorder is much more effective at controlling the condition when it’s continuous.
Learn to recognize early warning signs.
Even if you’re following your treatment plan, you can have mood swings. If you recognize them early, you and your treatment provider can adjust treatment to keep them from becoming full-blown manic or depressive episodes. In addition to mood changes, it’s wise to notice changes in your energy level, sleep patterns, and ability to concentrate.
Try to determine and avoid triggers.
Sometimes there don’t seem to be any patterns when mood episodes hit, but some people can determine things that set them off. They may come during periods of high stress or come more often during a certain time of year. Maybe traveling is a trigger, or drug or alcohol use is.
Think through what you’ll do when you see an episode coming on.
Who will you contact? Where will you go if you need help? When you’re in an episode, clear thinking becomes more challenging, so it’s wise to have a plan already in place. It’s also wise to have contingencies in mind. If you plan to call Person A but can’t get through, who will you call instead? If you know that you need help, advocate for it. You may seem fine to others, but you’re the expert in what’s going on inside your head.
Develop habits that contribute to physical and emotional health.
Habits can include exercising, eating well, keeping a regular bedtime, meditation, and journaling. It’s also helpful to find activities you enjoy and to cultivate them. These actions can help both with general emotional health and help you remember that you’re more than your bipolar illness.
Your mental health doesn’t define you. While it may be a challenge now, it doesn’t always have to be. At Promises Five Palms, we will work with you to educate you on your bipolar disorder, give you the tools to manage your mental health and provide thoughtful ways for you to navigate the world.
To find out more about how we can help you, call us today at 844.675.0962. Our admissions specialists are here to answer your questions and give you the best treatment options for your unique experience.
By Martha McLaughlin