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Inside the World of Bipolar Disorder

Updated on October 25, 2014

Therapy in combination with medication and other resources is a wonderful plan of treatment

The ups and downs of the disease can sometimes occur within a matter of hours. Some patients find themselves in a manic or depressive episode for weeks or months without relief.
The ups and downs of the disease can sometimes occur within a matter of hours. Some patients find themselves in a manic or depressive episode for weeks or months without relief. | Source
mania and depression are mixed states of emotion for those that suffer from bipolar disorder.
mania and depression are mixed states of emotion for those that suffer from bipolar disorder. | Source

From the point of view of manic depressive patients, families and professional providers

People suffering from this disease use a combination of medication and therapy to have a life as normal as possible.

The name of this disease is frightening and conjures up images of a crazed wild eyed individual that makes you cross the street to avoid them. Before judging anyone suffering from this illness you may want to know a few things about it. You don’t have to cross the street and your fear is unfounded in nearly all cases. Discovering what is inside the world of bipolar disorder or manic depression helps you understand important and relevant info about those patients living with the disease.

Lots of people with bipolar disorder, also known as manic depression, feel as if their life is literally destroyed trying to survive another day through the depression or the mania of it. There are ways for most patients to live a reasonably normal and productive life if they have identified their illness and get the correct treatment for it.

Whether you are a patient, caregiver, relative or spouse of a patient with the illness, educate yourself about this ailment. Going inside the world of someone you care about with this sickness is beneficial for both of you. Understand what is happening to make things better in your life. This is a lifetime sickness without a cure and must be treated accordingly.

Diagnosing the disorder

How a diagnoses is made

According to the World Health Organization approximately 1% of the total world population is affected by it. The disease is a chemical imbalance in the brain. There is no laboratory test to confirm you have it. Yet, health care professionals are capable of diagnosing and finding an individual treatment regime for every patient.

Physicians typically establish an individual has the disease based on psychological profiles, guidelines and evidence presented. Most of the substantial material used for identifying it is generally material shared by the patient, their physical appearance, behaviors and typically any past events and encounters. One of the most helpful pieces of information is how a patient behaved in particular circumstances and situations.

Although there is no lab test for validation, there is a physical image to corroborate a doctor's findings. A PET scan will show unequivocal proof of the syndrome. A PET scan or positron emission tomography is a nuclear medicine imaging technique that displays a three dimensional image or picture of the brain’s functioning. This particular test shows an imbalance inside of the brain which results in bipolar disorder.

The PET scan is enormously expensive and rarely used in treatment. Based on the data collected from the patient and other health care professional encounters and opinions, they are able to adequately diagnose and treat patients. Typically the behavior and data spans years and months. It can be handled effectively after a diagnosis is been made.

Why patients fail to be diagnosed

  1. The majority of patients fail to get professional help immediately. Many take years to finally succumb to professional help. A number of them come after major consequences have happened as a result of their behavior. They do not feel they are sick.

  2. The conditions driving them to find care symptomatically include financial ruin, professional catastrophes, relationship adversities or brushes with the law. Bankruptcy, foreclosure or divorce are all life changing events where conduct and actions from manic depression changed not only the patient's life, but others as well. They do not recognize they have a mental health condition. They right it off to bad life choices.

  3. Establishing a patient has the disorder is a voyage within itself. Scores of individuals suffer for years or even decades before discovering the right health care professional who recognizes and confirms the disorder and treats it accordingly. They think they have another disease.

Countless people are misdiagnosed with other mental health disorders like depression or schizophrenia. The management of these is very different from bipolar disorder and handling it as another disease only makes things worse.

For example, if you have breast cancer and receive treatment for lung cancer the results are catastrophic. In the case of cancer it turns deadly. Unfortunately for scores of people with manic depression receiving the wrong management makes the same outcome ring true.

Mania and depression episodes are incredibily upsetting for a patient's life. Imagine losing your husband or children through no fault of your own or winding up in jail. The consequences are generally devastating to say the least. The sooner you are diagnosed the faster treatment begins and these routinely unusual consequences stop.

Different types of bipolar disorder

There are different types of the disease which have an assortment of symptoms in common and some which are individualized to a specific diagnosis. Although they have minor differences, any variation affects personal treatment.

Bipolar diseases and their symptoms

· Bipolar 1-this episode is the most severe form of the illness. It includes extreme mood swings, usually with feelings of mania swinging to depression in short periods of time

· Bipolar 2-a milder type of the disorder. The patient experiences milder forms of hypo-mania that switch to feelings of depression with longer time periods in between

· Cyclothymic -basically milder mood changes and not as pronounced as Bipolar 1 and 2.

· Mixed bipolar-mixed bipolar disorder is characterized by periods of mania and depression that occur together or in a quick sequence, one following the other in waves. Frankly you feel joy then grief. Patients are generally irritable with racing thoughts. Anger and euphoria are all happening at the same time.

Feelings for mixed bipolar episodes are at odds with one another, but occur simultaneously. This makes it difficult to do anything. Handle business, work a job, raise a child or even keep a marriage.

All of these sensations and feelings are inside of you battling to get out and are ill timed in most cases. You try to hang on for the ride and hope that no one noticed the struggle. They always do because actions and reactions to circumstances and situations are normally out of place or do not fit correctly. Laughing at somber occasions or crying for no reason at all. Anger and anxiety are felt lots of time for no reason at all.

A patient will attempt to hide it, but it is extremely difficult. It gets worse and eventually comes out no matter what you do. It could be displayed in a grocery store, a child's school or other inappropriate location which is frightening and accounts for more anxiety and the cycle continues.

· Rapidly cycling of mania and depression-this is typically a roller coaster of the world of manic depression. This is defined by any patient with four episodes or more of mania during a 12 month time period. Some people experience several episodes in as little as a 7 day period or even within 24 hours.

What is mania and depression?

Symptoms of mania-

1. Overwhelming optimism about everything regardless of the evidence of the opposite

2. A frame of mind of being on the very top of the world, but feeling irritable at the same time

3. The emotion state of grandiose or capable of doing anything. Even superhuman actions are not out of reach

4. Hardly any sleep is needed and lots of excess energy exists. Insomnia is not recognized. Patients attribute the lack of sleep to their superhuman ability

5. Unable to focus on one task for any length of time

6. Rapid speech to the point no one is able to keep up in a conversation. Most people are unable to engage in a conversation with you because you talk without waiting for a response. In most cases you feel you do not need them or really want them to. They are simply there as an audience to receive your thoughts and ideas. Many of these are scattered and incomplete.

7. Racing thoughts, unable to center mentally on one idea or thought for very long

8. Impulsiveness in a variety of areas. Spending money, quitting a job, starting a business and other life changing decisions without thought to consequences

9. Impaired judgment. Going against many moral and ethical rules inherent to person beliefs is not unheard of. Actions are done without thinking about after-effects or penalties

10. Appetite changes and alterations. Eating too much or eating too little. Some will change to vegan lifestyles or other major alterations.

11. Patients will experience delusions and hallucinations in extreme cases

This is a typical manic episode for a manic depressive

Mania begins with feelings of euphoria. Being all powerful and all-knowing is the overall sensation in your mind. The mental state is the possibility of being the president of the United States if you wanted to. You have a sense of being totally invincible. If you wanted, you could fly. Sex, sex and more sex is your mantra. You want to shop and spend money you don’t have, who cares? Sleep is elusive or not needed. You will dress and redress several times a day.

Manic episodes will sometimes mean a patient doesn't sleep for days at a time. You talk too fast and too loud. You blame others for not keeping up with you. You act on impulse and don’t consider any of the consequences of your actions and work outside of your personal morals and ethics without hesitation.

Some will direct their mania to other areas such as working hours on end or even house cleaning to the highest point possible. The impression is being always right and a sentiment of being the center of the world right now.

Symptoms of depression-

1. Feels of hopelessness and unable to see a future

2. Sad. Bouts of crying. Typically they cry every day or for hours on end. Tears will start for the simplest things or at inappropriate times. Unable to control this response

3. Irritable for no reason. Cranky and touchy with conversations they have with anyone. They prefer no interactions with others at all

4. Sleep disturbances. Anxiety causes insomnia or major depression will make them sleep for hours on end.

5. Appetite or changes in weight either up or down. Always hungry or nothing is good. Even favorites are not attractive or appetizing.

6. Mental and physical sluggishness. Mentally they forget or are unable to remember. Conversation and responses are difficult and wear them down physically.

7. Unable to function with daily upkeep. It is a chore to dress, bathe, clean, cook or even eat. Making a bed or doing laundry requires a mental push and is exhausting. Most of these are avoided whenever possible.

8. Suicidal thoughts or feelings are often and prevalent

9. Unable to concentrate. Even small tasks are difficult.

10. They seek isolation and usually avoid interacting with others whenever possible

Description of a typical depression episode for a manic depressive

During feelings of depression for sufferers they generally experience suicidal thoughts multiple times per day for days on end. They are unable to get out of bed for days or maintain personal hygiene such as showering, brushing their teeth or attending to other personal needs like a change of clothes.

They have a mantra racing through their thoughts that no one cares about them. Isolation is sought out and if found they feel safe and less anxious. No answering the phone or the door because the thought of interacting on any level with anyone is too much. Sex, you never heard of it. You don’t care if you eat or not.


The correct medication, therapy and health care provider is the winning combination patients are looking for


A lot of people get treatment as a combination of methods. They are usually treated with a variety of prescription medication, such as mood stabilizing drugs and anti-depressants when necessary, anti-psychotic medications along with psychotherapy.

Mental health professionals

A variety of mental health professionals provide services. There are psychologists, psychiatrist, mental health nurses, counselors and mental health therapists. Your family physician is not equipped to handle the complexity of bipolar symptoms and treatment. Many family doctors are the first stop in diagnosing, but will refer suffers to professionals with expertise in the disorder for more effective actions to handle manic depression.


Scores of people try several different medications before finding the right combination, dosage and least amount of side effects they can tolerate. As a last resort some patients undergo electroconvulsive shock therapy (ECT). The most frequently used mood stabilizing medications for the disorder are Lactimal, Abilify, Deparkote and Tegretol. All of these are major medications with horrible side effects for many people.

Mental health medication has a significant drawback when experimenting to find the right one. Each one will be taken for no less than 6-8 weeks before deciding its effectiveness. Additionally, doctors will stick with a medication and change the dosage which means another 6-8 weeks of looking for a remedy. It still may not work at a higher or lower dosage. Therefore, another one is tried and another one until a medicine is discovered which works best for the patient.

Medication and therapy combined

Sufferers have an opportunity to manage the disease with proper medications and mental health therapy along with recognizing triggers that cause acerbation of the condition. Patients avoiding stressors that cause intense episodes of depression or mania and avoid anything that extends depression or mania are able to manage their disease better.

Patients should keep their scheduled medical appointments and therapy schedules to have a maintenance approach to their illness. Being proactive is better than a reactive approach. Less consequences and negative effects have a chance to happen. This permits them to stay on top of episodes and stay ahead of them.

They are managed better with the smallest amount of symptoms emerging and help them to lead more normal lives. Medication should never be discontinued or changed without a physician’s permission. This is a lifetime condition which will never go away.

With proper medication, therapy, support groups, encouragement of family and friends bipolar patients manage their disease. There is no cure. Any family members or friends living with a bipolar patient in their lives will hopefully find all of this information helpful in understanding them and providing some support.

Shortcomings to treatment

Along with finding the right medicine there is an even bigger hurdle to managing the disease. Numerous people refuse to get treatment after being diagnosed because of the stigma attached to it. Many understand something is wrong, but will make up obstacles to avoid getting any help.

Scores of these people live with the disease and ruin relationships or jobs or other beneficial life events because of their actions or inactions during a manic or depressive phase. Patients will even find themselves in trouble with the law since during mania they don’t recognize the consequences of some of their actions.

All of this negativity is avoided and they live a better life with the right management of the disorder. Getting rid of the stigma and directing them to a health care professional to help is extremely difficult.

In conclusion

Bipolar disorder is an extremely powerful and life changing disease. At times it can be debilitating for anyone suffering from it. Though, on the bright side there are countless people diagnosed and living productive lives with a combination of the right medications and therapy. Managing this disease will continue for a lifetime. Even with this mind, it is not an impossible task with the right information and education at your fingertips.

A wonderful video outlining what medications do for the disorder

© 2011 smcopywrite


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    • irenemaria profile image

      irenemaria 6 years ago from Sweden

      The mental disorders are individual and not so easy for an outstander to understand. Thanks for all this information.

    • smcopywrite profile image

      smcopywrite 6 years ago from all over the web

      thank you for your comments. there are some natural remedies that can help with the problem. however, some sort of prescription medication intervention is needed. taking your prescriptions in conjunction with natural products may help you take less prescription medications depending upon your individual situation.

    • profile image

      Sueswan 6 years ago

      It is sad that those who need help may not get it because of the stigma attached to mental illness.

      There is no cure but I wonder if the drug companies even want to find a cure.

      I know sometimes drugs may be the only choice but I believe that there are natural alternatives out there.

      Voted up and interesting.

    • Dee aka Nonna profile image

      Dee aka Nonna 6 years ago

      This is a great hub. I have a relative, my niece, that suffer bipolar with intermitant bouts of depression. For years we tried to help her get help which of course she refused because she didn't think anything was wrong with her. We "just didn't understand", etc. etc. Then one day she almost hurt one of her children. It scared her so badly that she finally went for the help she needed. Voted up and useful. Great job!

    • Seeker7 profile image

      Helen Murphy Howell 6 years ago from Fife, Scotland

      An excellent hub on this devastating illness. I think there are many, many people out there who have had to cope with bipolar disorder for many reasons - the main one being as you said, mis-diganosis.

      Here's hoping that one day they will find an effective cure.

      Great hub + voted up!

    • Gypsy Willow profile image

      Gypsy Willow 6 years ago from Lake Tahoe Nevada USA , Wales UK and Taupo New Zealand

      Thanks for explaining this sad affliction. How many people go undiagnosed? Quite a few I think.