One of the most misunderstood and clinically complicated disorders is Bipolar Disorder. It has two types and up to 16 subtypes for diagnostic criteria. It is difficult to diagnose and also very difficult to treat.
Causes
The causes of Bipolar Disorder are not fully known but there is a high correlation of a genetic component. Families that have at least one parent with Bipolar Disorder have a high likelihood of bearing children with Bipolar Disorder, a form of depression, or Attention Deficit/Hyperactivity Disorder (ADHD). There is evidence that people with Bipolar Disorder have an imbalance in neurotransmitters and an abnormal alignment of neurons in the brain. Children raised in a home with a parent that is Bipolar will usually be exposed to the dysfunction that accompanies this diagnosis. Children will sometimes have to endure mood swings, violence, substance abuse, depression, and manic episodes. This, along with genetics, will also increase the chance a child will be diagnosed with Bipolar Disorder of the same type as the parent.
Symptoms
Symptoms of Bipolar Disorder are very specific but there is one main difference between Bipolar I and Bipolar II disorder. Bipolar I disorder includes manic episodes while Bipolar II includes hypomanic episodes. Manic episodes may include psychosis whereas hypomanic episodes are less severe and do not include psychotic episodes. Someone with Bipolar II disorder may have hallucinations or psychosis but only during depressive episodes. The main symptoms to look for in someone you suspect has Bipolar Disorder are very high happy times and very low depressive times. The mood swings may occur in the same day or over the course of a week but the differences in mood will be notable. Some experience mood swings very quickly and can change in personality from one moment to another. One moment they may be happy, energetic, and engaging but something may trigger them to become intensely angry, sad, or violent without warning. A manic episode includes rapid speech that may be confused or tangential, no need for sleep and staying awake for days, impulsive behavior that may include financial or sexual risk taking but could also mean the person changes the furniture around multiple times in a day. Mania is often appreciated by someone with Bipolar because it is a time when they feel free and uninhibited and may also be highly productive during this time. It is also a dangerous time due to risk taking behavior but it is also the time when suicidal thoughts originating during the depressive episode might be carried out. Signs that a person with Bipolar is suicidal include communication with people about their feelings as though they are saying goodbye, giving away all valuables to people or charity, hoarding medication or purchasing of a weapon, and evidence of previous attempts or ideation.
Treatment
Treatment for Bipolar Disorders is not short term. Due to the severity of disruption in the life of a person with Bipolar the treatment must change to meet the client where they are in that time frame. It is likely that someone with Bipolar will be prescribed medication to even out the chemical imbalance of the brain and help deal with hallucinations or psychosis. It is difficult to prescribe medication because often when the client feels great during a manic episode they will discontinue medications and then experience a crash in emotions that becomes a depressive episode. Lifestyle changes to make dealing with Bipolar manageable include having a set daily schedule to follow regardless of current episode type, cessation of drugs and alcohol that may interfere with prescriptions and also increase mood swings, and have regular sessions with a therapist. A therapist can help by teaching life management skills and by helping the client be aware of their mood changes and use techniques to get through them successfully. If the person is a danger to themselves or others or is having vivid, intrusive, hallucinations or psychosis it may be required that they receive inpatient treatment in the safety of a hospital setting until stabilized.
