The Black Dog: An Overview of Bipolar Disorder
Churchill's Black Dog
How could the defining statesman of the 20th century, who boasted a –for the most part- highly successful political and military career, also win the Nobel Prize for literature, invent the now iconic abbreviation “O.M.G!", produce an estimated 500 pieces of artwork, as well as dabble in bricklaying and gardening? How could this same man be plagued by indecision, apathy, depression, insomnia, suicidal ideation, and impulsivity that, at times, cost uncountable human lives?
Perhaps periods of mania and depression, the latter referenced by Britain’s former Prime Minister, Winston Churchill, as his “black dog”, comprised this man’s life. The “black dog” was so extreme as to have caused him to keep his distance from the edge of balconies and train platforms so as to avoid, according to Churchill, “a second’s action [that] would end everything”. What seems evident as depression although fails to explain his times of undeniable productivity and successes. It seems, in any case, as though Churchill had cycles of creativity and gumption, as well as melancholia and dispassion.
Considering his extreme shifts in mood, thought, energy, and behavior, Churchill may have had a mental illness, which although wouldn’t be coined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) until the 1980, leaving him at the mercy of his symptoms. The mental illness? Bipolar Disorder
- According to Our World in Data, 40 million people globally were afflicted by Bipolar Disorder in 2016; according to the National Institute of Mental Health, approximately 2.6% of American adults have Bipolar Disorder.
- Nearly 30% of those diagnosed with Bipolar Disorder will attempt suicide at least once in their lives, making the suicide rate for these individuals twenty times that of the general populace.
- Doctors are uncertain as to the root cause of Bipolar Disorder, but there is a consensus on certain things that may contribute to the illness, including genetics, brain structure, trauma, and substance abuse.
- Individuals with Bipolar Disorder have an increased risk of thyroid disease, migraines, heart disease, diabetes, obesity, and other physical illnesses.
- Singer Mariah Carey, actress Carrie Fisher, actor Mel Gibson, singer/actress Demi Lovato, actor Russell Brand, musician Kurt Cobain, musician Jimi Hendrix, and singer Chris Brown are some of the celebrities known for having Bipolar Disorder.
Tell Me About Bipolar Disorder
"But It's All in Your Mind": A Fundamental Understanding of BD
Well, yeah. Bipolar Disorder is absolutely “all in your mind”. Often misdiagnosed as depression, Bipolar Disorder is a medical illness in which a person’s mood severely alternates between symptoms of mania and depression.
According to the Diagnostic Statistical Manual-5, adult bipolar disorder has five possible diagnoses:
- Bipolar I Disorder: one manic episode (with possible psychosis) that may be preceded or followed by hypomanic or major depressive episodes.
- Bipolar II Disorder: one major depressive episode and one major hypomanic episode.
- Cyclothymic Disorder: at least 24 months of hypomanic and depressive symptoms.
Substance-Induced Bipolar Disorder: mania, hypomania, or depressive episode immediately caused by substance abuse.
Bipolar Disorder Associated with Another Medical Condition
Bipolar Disorder Not Elsewhere Classified
These classification evidence on glaring fact: Bipolar Disorder can be quite varied and can depend on many factors including its type, frequency, and severity.
The Good, The Bad, and The Cycling
Persons with BD, an affective disorder, or mood disorder, experience symptoms ranging from mania/hypomania to depressive. When an individual experiences one episode of mania/hypomania and one episode of depression, this comprises a cycle. The frequency and duration of cycles varies and are, more or less, impossible to predict.A quick note on mania and hypomania: mania generally persists longer than hypomania. One of the main differences is that mania often requires hospitalization, whereas hypomania is something that can be addressed on an outpatient basis.
Each extreme has its own set of symptoms that make it identifiable both to the individual with Bipolar Disorder and those around him/her. The Depression and Bipolar Support Alliance offer a comprehensive list of manic/hypomanic and depressive symptoms, listed below. This information is taken directly from their website (listed under sources), which is also a phenomenal resource for patients and their loved ones.
Symptoms of Mania/Hypomania
Heightened mood, exaggerated optimism and self-confidence
Decreased need for sleep (less than three hours) without fatigue
Grandiose delusions, inflated sense of self-importance
Excessive irritability, aggressive behavior
Increased physical, mental activity
Racing speech or flight of ideas, impulsiveness
Poor judgement, easily distracted, difficulty concentrating
Reckless behavior without concern for consequences, such as spending sprees, rash business decisions, erratic driving, sexual indiscretions
In severe cases, auditory hallucinations (hearing voices) or delusions (strong convictions about things that aren't true)
Symptoms of Depression
An individual who experiences five or more of the following symptoms each day during a two-week period or if these symptoms interfere with work or family activities, criteria for a major depressive episode are met:
- Prolonged sadness or unexplained crying spells
Significant changes in appetite, sleep patterns
Irritability, anger, worry, agitation, anxiety
Loss of energy, persistent tiredness
Feelings of guilt, worthlessness
Inability to concentrate, indecisiveness
Inability to take pleasure in former interests, social withdraw
Unexplained aches and pains
Recurring thoughts of death and suicide
Moderating Mayhem: Methods to Lessen the Severity of Episodes
It is impossible for the individual with Bipolar Disorder to prevent an episode from occurring, but steps can be taken to diminish the severity of symptoms.
Firstly, it is essential for someone with a Bipolar Diagnosis to seek treatment. Therapy, such as narrative, cognitive behavioral, or social rhythm, is an integral part of managing Bipolar episodes. Treatment usually always involves medication as well, such as the mood stabilizer lithium. Combined, therapy and medication offer a solid foundation upon which an individual with BD can attempt to live a more stable life.
Secondly, it is important to understand what triggers precede an episode. If these can be identified, further steps can be taken to mitigate symptoms. Triggers can include, but are not limited to, drug and alcohol use, stress, lack of sleep, negative life events, positive events, and seasonal changes.
Some Additional Points Worth Noting...
- According to the Depression and Bipolar Support Alliance,women are far more likely to be misdiagnosed with depression and men are far more likely to be misdiagnosed with schizophrenia than Bipolar DIsorder.
Bipolar disorder is NOT multiple personality (dissociative identity) disorder. People who are bipolar have mood-based episodes, while people with multiple personality disorder (MPD) believe they are more than one person, with distinctly different personalities, traits, and memories.
- Individuals with BD are at greater risk for further health issues, such as thyroid problems, migraines, diabetes, heart disease, and obesity.
- People with Bipolar Disorder are more likely to abuse substances as a method of self-medication.
- Instagram features an excellent, accepting, and encouraging Bipolar community. Here are some great people to seek out: @bipolar_2_life, @bpmagforbipolar, @bipolarinfo, @bipolarparents, and @realitybipolardisorder. Another great idea: search #bipolar for more.
- Bipolar Triggers: https://www.webmd.com/bipolar-disorder/guide/mood-swings#1
- Bipolar Triggers: https://www.bridgestorecovery.com/blog/understanding-bipolar-disorder-triggers-and-how-to-prevent-them/
- Causes of Bipolar Disorder: https://psychcentral.com/disorders/bipolar/bipolar-disorder-fact-sheet/
- Depression and Bipolar Support Alliance: https://secure2.convio.net/dabsa/site/SPageServer/?pagename=home
- Physical Illness: http://www.adamhscc.org/en-US/facts-bipolar.aspx
- Statistics: https://www.google.de/search?q=how+many+people+globally+have+bipolar+disorder&rlz=1CAHPZS_enDE826&oq=how+many+people+globally+have+bipolar+disorder&aqs=chrome..69i57j69i64.10989j0j7&sourceid=chrome&ie=UTF-8
- Statistics: https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml
- Suicide Rate: https://www.verywellmind.com/red-flags-warning-signs-of-suicide-379034
- Winston Churchill: https://www.bipolar-lives.com/winston-churchill-and-manic-depression.html
- Winston Churchill: https://www.warhistoryonline.com/history/10-strange-facts-sir-winston-churchill.html/2
- Winston Churchill’s Depression:http://www.howibeatdepression.com/how-winston-churchill-beat-depression/
- Winston Churchill’s Mental Illness: http://www.ibpf.org/blog/winston-churchill-and-mental-illness
© 2018 Lilith Eden