Bipolar disorder is a mood disorder that causes radical shifts in thinking, feeling, and behaving. Formerly known as manic depression, bipolar disorder involves the occurrence of extreme, polarized moods. Debilitating depression will rotate with euphoria, impulsivity, and agitation. The onset, frequency, and length of mood episodes vary from person to person, making the illness quite individualized across sufferers. This can make it difficult to diagnose, and many people go too long without a proper diagnosis.
Bipolar disorder is a serious mental illness. The National Comorbidity Survey that found 82.9% of individuals with bipolar disorder were classified as having “severe impairment” (Archives of General Psychiatry, 2005). With that said, any disease will lead to serious impairment if left untreated. It’s all about getting early, effective, and consistent treatment, the sin que non of managing any mental disorder.
In my experience working as a mental health counselor, most people diagnosed with bipolar disorder are able to experience fulfilling lives that meet their personal vision of happiness or success. They hold jobs, they raise children, and they give hope to the other 2.7 million bipolar sufferers in the US (National Alliance on Mental Illness, 2020).
Many people who suffer from bipolar disorder are first diagnosed with depression.
This is because most people will seek treatment during the depressive episodes, rather than manic/hypomanic episodes. Depression makes a significant contribution to global disability, suicide rates, and overall burden on the healthcare system due to highly correlated physical health problems.
One emotion commonly left out of the manic-depressive spectrum is anger.
Anger is a rather misunderstood part of mania. In “An Unquiet Mind”, Kay Redfield Jamison describes the difference between “white manias” and “black manias”. She talks about white mania being the classic euphoric mood with grandiose thinking and extreme fun, desire, and thrill seeking behaviors. The black mania, in contrast, includes anger, irritability, and extreme agitation.
The mood episodes in bipolar disorder do not always occur in rotating fashion.
Sometimes the highs and the lows will jumble together in a “mixed episode”. Manic and depressive symptoms are both present at the same time.
So Where Does the Mood End, and the Bipolar Begin?
Moods are something we all experience. Emotion is an essential part of the human experience. Many great thinkers have tried to understand the role mood and emotion plays in our lives.
In Emotion, Rationality and Human Potential, Caccioppo describes emotion as an “essential ingredient for and an overwhelming obstacle to optimizing human potential.”(2004).
In Psychology: The Science of Human Potential, Levy describes emotion as a biological drive, stating that “something has to make us want to eat, survive, and reproduce. Something must drive us to understand and transform our world and create things of beauty” (2009).
If Rene Descartes had bipolar, I imagine he would have said “I feel, therefore I am”, instead of I think.
I do believe there is a gift wrapped in this complicated bipolar paper. Feeling things deeply, passionately, and imaginatively is a rare gem in a world of duplicates.
Of course, we would never wish to betray our own experience of having feelings by telling them they are not true. And yet, the emotions felt by those with bipolar disorder can be irrational and extreme, quickly evolving into insidious traps for wrecked interpersonal relations and spiritual torment.
Insight is Key
While affective experience is paramount, insight, above all else, I would argue makes us the most human. It gives us the freedom to question ourselves and our experience. You are not rejecting your experience of emotion, as you are enlightening it with cross-examination and greater self-awareness.
Other symptoms that are often experienced with bipolar disorder include some levels of anxiety, panic, and insomnia. Additionally, many people who have bipolar disorder experience racing thoughts. This is when your thoughts cannot be controlled or turned off. Some experience thought-spiraling about one one topic, while others experience a rapid succession of thoughts, so that it feels like multiple thoughts are occurring all at once.
There are some medications that can help with racing thoughts. Practicing mindfulness is found by many to be an extremely helpful intervention as well. Mindfulness can be challenging if there are high levels of anxiety present. You’ll have to put up a good fight to calm your mind.
Psychosis can occur as part of bipolar disorder, especially during manic episodes. This can include delusional beliefs, visual hallucinations, auditory hallucinations (hearing voices), paranoia, and other impairment to thought or emotion that creates a disconnect with reality.
Without proper treatment, many sufferers will self-medicate with drugs and alcohol. In fact, the data reports that 60% of people who have bipolar disorder will also meet the criteria for a substance use disorder (NAMI, 2020). This rate is similar for other mental disorders (NAMI, 2020).
When it feels like there are no other options, it’s common to turn to substances or other self-defeating behaviors in an attempt to cope. Perhaps these behaviors, even for a moment, were helpful— until it very quickly turned into self-sabotage. Substance abuse usually has limited outcomes, including jail, institutions, or death. Treatment involves letting go of what does not serve you anymore, to make space for what does. It’s not easy, but it’s worth it. A therapist can help distinguish between adaptive and maladaptive coping skills. A mental health professional can empower you with the support, knowledge, and skills needed to effectively manage symptoms and live the life you want to live.
Watch Out for Stress
High levels of stress can induce psychotic symptoms or trigger mood episodes. It is important to prioritize self-care rituals and have fairly predictable routines in place to keep the stress at manageable levels. Create a home environment that can be your sanctuary, where you find comfort and safety when symptoms flare up.
Most importantly, keep practicing self-love. Working in the mental health field, I know how limited an understanding society at large has about mental illness. There is a lot of judgement resulting from prejudices and lack of education. Take some time to explore your local support groups, online social groups, and great organizations such as NAMI that offer understanding and acceptance. Remember, 1 in 5 people struggle with a mental health disorder. Someone you know probably struggles even if they don’t feel safe to talk about it. Or, they know someone who does.
You can find what you need when you look in the right places. You will also find that most of the acceptance, love, and understanding you are looking for comes from within.