Bipolar Disorder, Manic Depression: Understanding the Disease

What is Bipolar Disorder?

Bipolar is a disease state where the client moves back and forth from depression to mania. Depression is characterized by loss of interest in things that they used to find pleasure in, loss or gain of appetite, typically not wanting to get out of bed for prolonged periods of time, and sometimes suicidal thoughts or actions. Mania is characterized by racing thoughts, pressured speech, decreased need for sleep, spending sprees, road rage, driving fast, promiscuous sex, risk taking behaviors, drug abuse, alcohol abuse. There is also something called dysphonic mania which is angry, irritable or agitated – a state often missed by doctors. Mania is excessive happiness – the client rarely sees it as a problem but they are generally causing distress to those around them. People rarely go to the doctor for manic characteristics, but no one likes being depressed.

Going to the Doctor with depression?

So someone goes to the doctor and says they are depressed – so the doctor gives them an antidepressant. If they are just depressed in about 4 to 6 weeks they will usually level out and feel good again.

What if the antidepressant makes me too happy?
If they start to exhibit the symptoms of mania or dysphonic mania above they need to go back to the doctor because they are not just depressed but very likely bipolar and they need a mood stabilizer like Lithium or Depacote.

Medications for Bipolar

There are many new medications for this disease state but the two baseline medications should be Lithium or Depacote. Bipolar is treated with a family of medications that do three things – they prevent seizures (anticonvulsant), reduce psychotic behavior (antipsychotics), and stabilize mood (mood stabilizers). They can be prescribed for any of those conditions but just because one has been prescribed for you does not mean you have all three conditions. Bipolar can have psychotic features such as hallucinations seeing or hearing things that are not there.

Common advice from well meaning but misinformed people Bipolar or manic depression – should you just be able to cheer up, get over it or buck up? Can’t you slow down, why are you acting so hyper, why are you acting so crazy? Calm Down! Can someone with a broken leg just walk on it without support? Yes, but if they do it leaves them crippled and deformed – not to mention that it hurts – a lot!

So many people have an opinion without anything to back it up but their own experience – I hate to be the bearer of bad news but people are different – they do things for their own reasons not yours. They think their own thoughts not yours. It is a simple truth that everyone knows but most of us ignore every day. There is nothing wrong with experience based advice except that just because it worked for one person a certain way does not mean it will work for everyone. As a result people are shamed by their parents, family and friends because they must not be trying hard enough, they must be weak. Who would tell their child to go out and run on a broken leg (bone sticking out through the skin) – No one!

Bipolar is a disease like Cancer – Doctors & Medication

It requires treatment by professionals. Usually an MD/Psychiatrist because medication is almost always a requirement to get better and a therapist to both monitors the medication and gives feedback to the MD and the Client as well as coaching the client through trials and tribulations into a satisfying and rewarding life. Unlike a broken leg or cancer you may feel better but you cannot stop the medication – it is just not that kind of disease. This is a stumbling block for people with bipolar. They have either been told or just think on their own that they should just be able to be stronger or they just think that since they feel better they must be better and not need that medication anymore. That is one of the biggest reasons that people struggle with this disease for ten to twenty years before they accept that medication is what makes them normal and that they are only crazy when they don’t take their medicine. People who are bipolar are often in a life and death situation – it needs to be treated that way – they kill themselves when they are depressed and they kill themselves when they are manic usually as a result of risk taking behaviors. People who are bipolar need medication and they need it long term. People die of depression!

Patience is required and close communication with the Doc. Another big problem with bipolar is that it can take quite a while to get the medication right for any given client. Remember every one is different. However using a therapist in conjunction with the MD or Psychiatrist – someone who can help monitor and manage the medication and who has much more frequent contact with the client than the MD greatly shortens the zeroing in process.

Why I know this

You may be saying, “how do you know this?” Well, first I have relatives who are bipolar, so I have firsthand knowledge. I also went back to school in my late thirties and became a marriage & family therapist – but having a rather severe case of obsessive learning disorder, I dug in deep trying to understand the brain, then neurotransmitters, medications, therapy, research, brain imaging and function mapping – I am a nerd and proud of it. I learned psychopharmacology from Dr. Stubblefield, a psychiatrist, and then really dug in with Dr. Lyles, another psychiatrist. I have counseled hundreds of people with a variety of issues always trying to get to the bottom of their issues and help them get their life back. I have both learned from my mentors and from direct client contact that bipolar is very often missed even by psychiatrists because for most people being manic is not a problem for them – it feels way better than being depressed. In addition there is something called dysphonic mania where the person is not hyperactive but angry, agitated, and argumentative. That may not seem like a big problem to the client either, however mania and anger is a big problem to the people around them.

How I can help you or someone you love with Bipolar

I help the client put the puzzle pieces together and understand what happened and how to move forward. I help with what to say to the doctor so that they have the information that they need for a proper diagnosis and proper medication as well as working directly with the doctor when necessary. I work every angle to help the client have a satisfying life – to get their life back – sometimes for the very first time.

Helping people to get their life back

That is what I offer to you or anyone that you know. I help people get their life back from bipolar (Manic Depression), from depression, from drugs, from AD/HD, from psychosis, from traumatic events and from traumatic lives. I have worked with enough people to know that I can make a difference in even the most hopeless of situations. Let me help you or someone that you care about – maybe even someone you hate – get their life back!

List of resources:

Change Your Brain, Change Your Life: The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Anger, and Impulsiveness, Dr. Daniel G. Amen, Three Rivers Press, 1999