7 things you need to know about Bipolar

Each year World Bipolar Day takes place on 30th March and this year members of the public across the globe are being encouraged to use social media to help disseminate information and get the event’s hashtags trending on social media.

World Bipolar Day is designed to raise awareness worldwide of bipolar conditions and to work to eliminate social stigma whilst providing information to educate and help people understand the condition. Hence this post.

1. What is Bipolar

Recognising the signs of Bipolar
Disorder — Apa.org/helpcenter

It’s normal to experience a wide range of feelings and moods. At some point we might feel incredibly excited or happy, then another time we feel low, anxious, tearful or downright flipping miserable.

Bipolar disorder (known previously as manic depression) is a mental health condition where people experience extreme highs, called mania, and intense periods of sadness or depression. These phases of mania and depression are called episodes, and can shift rapidly.

Bipolar disorder is a serious mental illness and can affect a person’s thoughts, feelings, mood, energy, behaviour and overall functioning but it can be treated.

There are three types of Bipolar Disorder

  • Bipolar I — a person will experience at least one episode of mania lasting longer than a week. They might also have experienced depressive episodes, although not everyone does.
  • Bipolar II — a person would experience both episodes of severe depression and symptoms of hypomania.
  • Cyclothymia is where a person who has experienced both hypomanic and depressive mood states over the course of two years or more and their symptoms aren’t severe enough to meet the criteria for a diagnosis of Bipolar I or Bipolar II.

2. What is hypomania and mania

Recognising the symptoms of Bipolar
Marcio Jose Bastos Silva/shutterstock
  • Hypomania is a milder version of mania that lasts for a short period (usually a few days)
  • Mania — overactive and excited behaviour — is a more severe form that lasts for a longer period (a week or more)

Someone might have hypomania and/or mania on their own or as part of another mental health problem –including bipolar disorder, postpartum psychosis (after childbirth) seasonal affective disorder (where mood is affected, most commonly in winter), or schizoaffective disorder.

3. Symptoms during manic phases of Bipolar

The symptoms of mania typically include several of the following:

  • Racing thoughts — are typically one of the first symptoms during a manic phase. Racing thoughts may be the inability to concentrate and include rapidly changing ideas.
  • Feeling overly exhilarated — an overly euphoric or elevated mood is one of the most common bipolar mania symptoms. However, in some cases, instead of an exhilarated mood, individuals experiencing mania might be extremely agitated.
  • Higher energy — increases to abnormal levels. For example, someone with mania moves quickly from one activity to the next, not finishing them but have lots of amazing fanciful ideas
  • Sleep difficulties — People with mania generally feel that they need less sleep and it wouldn’t be uncommon for someone with mania to stay awake for more than one night, cooking or cleaning, or only sleep a couple hours a night, but report they’ve slept well.
  • Pressured speech — the tendency to talk quickly and loudly and often accompanies racing thoughts. They rarely stop to let anyone else talk. The person might want to share their whimsical ideas urgently, without making sense and saying inappropriate things.
  • Inflated self-esteem — is more than just being self-assured and overly confident. Rather, it’s an unrealistic and exaggerated sense of being superior or of self-importance. Someone might think that they have supernatural abilities or can achieve impossible things, such as writing Michael Jackson’s hits.
  • Engaging in risky behaviors — behaving impulsively, spending money they can’t afford or take part in dangerous or risky behaviours like misusing alcohol or drugs, reckless driving or having unprotected sex.

Some people find their mania entertaining, pleasurable and engage in risky sexual relationships or behaviours. Or they might find them distressing, unpleasant or uncomfortable and some dread the onset, perhaps knowing what’s coming next.

4. Professional experience of Bipolar Disorder

Shopping spree — image by
Standard.co.uk

In my job, as Mental Health Nurse and Ward Manager, I only ever met one female patient who didn’t enjoy the mania. At the Day Hospital (DH) we had a group of women who’d all had many episodes of mania over the years. They got together regularly, regaling everyone with their tales of shopping sprees on credit cards they wouldn’t have to pay.

They loved including me in their “Nutter’s Group” because of my previous mental illness and they’d curl up in hysterics with each new adventure; like Sharon who spoke very well and would apply for all sorts of high flying jobs — and get them, when she was manic. Words just flowed effortlessly for her and she’d often be out shopping in Kensington (a posh part of London), collecting store cards along the way, and arrive back at the DH laden with bags of goodies, only to give them all away.

The one lady who dreaded any impending mania was terrified she’d go back and stalk a married man that she’d worked with, but was dismissed because of her behaviours. Whenever she became manic she stalked him; persistently phoning, emailing, and writing to his family, believing that he loved her, not his wife. It was quite a big case in the media some years ago — the last straw was after she’s sent him and his wife a package holding a used sanitary towel as proof of his love for her.

5. Mood swings in Bipolar Disorder

Mania might sound exciting and moreish but what follows is soul destroying and heartbreaking to watch. Take a look at the chart below and see the midline — that’s classed as normal mood and the short squiggly line shows that, like in most of us, moods go slightly up and down, depending on the circumstances i.e. we get excited when we’re going to a wedding or we feel down if we’re going to a funeral perhaps.

Schematic mood swings in Bipolar – Researchgate.net

But in Bipolar, the person’s moods swing violently – see how high the squiggle goes — then how low it drops — possibly way down beyond anything most people might experience in their lifetime.

Unfortunately, during my fifteen years, several patients made attempts to die by suicide because they couldn’t bear the devastating drop in mood. The lady who stalked her colleague was always devastated and so embarrassed by her behaviour during the manic phase, she would feel suicidal as her mood dropped.

6. Symptoms during a depressive phase of Bipolar

During the depression phase of bipolar disorder, someone might:

Sad and tearful — Image
by Leandro De
Carvalho from Pixabay 
  • Feel empty, sad, worried
  • Have trouble concentrating or remembering things
  • Have a hard time making even minor decisions
  • Have little to no energy to do normal things
  • Feel like you don’t enjoy anything, even things they used to enjoy
  • Eat too little or too much
  • Sleep too little or too much
  • Have a hard time getting out of bed
  • Think about suicide or death

A person could have all of these symptoms or some of them. Someone with bipolar disorder can sometimes feel very sad but also full of energy. The surest sign of a phase of depression is that you feel down for a long time — usually at least for 2 weeks. You might have these episodes rarely or several times a year, Webmd.com.

Most people who have a diagnosis of Bipolar will have been prescribed mood-stabilisers medication and, while it’s important to adhere to their medication regime throughout the various phases, they must also maintain contact with their Mental Health Team who will be able to monitor their moods and adapt their medication as appropriate.

7. Self-help strategies for bipolar disorder

Monitor your mood — Image by
Bohemimama.com
  • Monitor your mood — daily, including factors such as medication, sleep and anything that might be impacting on your mood. You may be able to download a chart or and app to help you do this.
  • Stick to routine — important in keeping your mood stable. In order to maintain stability, organise a schedule and try to stick to it regardless of your mood.
  • Build a good support network — friends, carers and family can be there if you’re struggling or just need someone to listen. They might also be able to offer another perspective on your mood and help you cope day-to-day.
  • Limit stress — where possible and try not to take on too many other commitments.
  • Sleep hygiene — disturbed sleep can have a negative impact on mood. Try to get into a sleep routine.
  • Take your time in making decisions — or ask a trusted friend to help you make decisions if you’re feeling impulsive and want to go on a shopping spree
  • Join a support group — it might be reassuring to hear from people who are experiencing similar symptoms or circumstances. Support groups can offer great advice and comfort.
  • Exercise. Regular exercise is helpful as a way to help manage mood and mental state.
  • Relaxation is effective in reducing stress.
  • Avoid or reduce alcohol and drug intake — which can make our mood worse. If you’re on medication, alcohol and drugs can be particularly dangerous. Talk to your psychiatrist, your Mental Health Team or GP.
  • Only take prescribed medication — and don’t make changes to medication without talking to your Doctor or psychiatrist.
  • Make a wellbeing plan — Perhaps you’ve made one of these with your care team and given a copy to close family or friends? You can record your plans for how you’ll manage your routine, how to manage any highs or lows, and contact details if you need help.
  • Ensure you have a suicide safety plan. Prepare how to manage low moods and suicidal thoughts. Keep your contact details list close to hand for emergencies.

If you or someone you know is experiencing the above symptoms, please contact your GP, Doctor, your local Mental Health Team immediately. You might like to read the useful Mental Health Contacts List here for various UK agencies and organisations who are able to offer advice and support.

In the meantime, look after yourselves and each other. As always, I’d be delighted to answer any questions and read your comments or suggestions. I certainly need something to keep my mind off the dreaded V word ‘cos although I know it’s important to keep up to date, I’m finding it all really worrying and quite depressing.

Acknowlegements:

Author: mentalhealth360.uk

Mum to two amazing sons. Following recovery from a lengthy psychotic episode, depression, anxiety and anorexia, I decided to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager. I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor. Just started my mental health from the other side blog.

31 thoughts on “7 things you need to know about Bipolar”

  1. Looking in from the other side of the stained glass……..early dx of manic depression @ 13…..A huge challenge I don’t believe is talked about enough is the awareness that “knowing” you are “crazy” –by obvious behavior & history– as reference is a very vulnerable position to count on others to help one recollect time even…….and to hold yourself accountable regardless….knowing is a curse in the blessing itself….ty for sharing this…

    1. Wow, you were ever so young ‘Willow’ to be faced with such a huge challenging illness. I get that ‘knowing’ but unable to stop it or change the course of the phase and having to rely on others help recollect what happened. I hope you’ve been able manage it more successfully now?

      1. ugly setback that has me spinning still & no anchors….but …..idk….always to be looking up

        My sis I watched [a few years] suffer from paranoid schizophrenia…that’s where my sympathies..but yes…i think abuse has more play than actual biological ‘err’….’eh. Ty for hearing me…

      2. I’m always here for you ‘willow’ if you need to chat. That must have been awful watching your sister as I feel for my sister with BPD and my brother with Bipolar – seeing him so low, curled up in the foetal position for days, even weeks on end.

        It sound like it also runs in your family and \i feel for you. x

  2. Great blog post!!
    I’m bipolar (as per having schizoaffective disorder, bipolar type), but in my case, the bipolar issues are readily treated with a modicum of 25 mg Seroquel. (I generally take 200 mg a day for sound sleep, so I’m well protected.) It was through trial and error that I learned that the Seroquel’s getting it done. I’d gone off it a few times, thinking it was just a sleep aid, and that I could surely learn to get through the night without it; and my doctor had me on mood stabilizers, which turned out to not be all that effective for me; so I no longer take them. But when I’d go off the Seroquel, hello mania! I finally put two and two together and realized how much Seroquel was helping me.
    I was manic for around six months from 2004 to 2005, and I didn’t know it, nor had I been diagnosed, or anything like that. But oh Lordy. I might have slept with a guy who I’d never go for normally, but I don’t even know because I blocked the whole night out the next day! 😀 It’s a mystery. Speaking broadly, I was in a great mood, but there weren’t too many horrible things happening (aside from that incident). However, then I went off of my antidepressant, because I thought, “I sure don’t need this any longer, now, do I?” Cue manic Crash into depression, only I hit paranoia and stayed there. (I.e., I’m always paranoid now, even when my mood is fine, which it usually is.) I’ve learned to fear and respect the Crash, so I have no desire or need to ever be manic again, beyond the thrill of spring fever, or whatever.
    Sometimes I still get mildly manic, but I’m able to control it by going to bed and not letting myself work on creative projects at, say, 2:00 in the morning (unless it’s at the computer, like writing). I know my limits. But honestly, it’d be impossible without the Seroquel.
    I feel lucky, because I know a lot of bipolar people are treatment-resistant, and/or they crave the high, so they’ll go off their drugs and seek it out. So I don’t even identify with being bipolar (even though it’s there). I primarily identify with the schizophrenia/paranoia.

    1. I know it’s very difficult to get meds right for many mental illnesses, particularly more severe disorders like bipolar, schizophrenia and if that’s not bad enough, there’s schizoaffective to contend with too.

      That’s the thing with any medication, we all think when we feel better, we stop taking the meds. This spells disaster for lots of people Meg and it sounds like you went through it all too.
      It’s good that you choose not to have the mania. I’ve obviously read and been privy to working with patients and seeing my brother – it’s said that the mania reduces as people get older but the depression gets worse. What’s your thoughts?
      I’m glad to read that you can self-manage your illness too by getting sleep and not doing too much creative work in the early hours lol
      I still have mild paranoia but it’s only around certaqin things – does that sound odd? 😉 Thank you so much, as always Meg, I love your comments and input.

      1. Yeah, HA HA! Choosing mania is almost always the wrong choice. It’s tough to live with it after the fact. I feel bad for the person you wrote about who stalks someone and then hates herself! Ouch!! And then I read the other stories, and I’m like, “How are these people avoiding the credit card debt?” 😀 No clue. Oh, but I don’t think I went off my meds thinking I was better. (Just run if I ever do that.) I was mad at my psychiatrist. It made sense at the time! This was back in 2007. It was a slow process of realizing, huh, maybe the drugs are making a difference. And yeah, it took forever to figure out which drugs to take!! Fortunately, we’re at a point of minor adjustments now. That’s an interesting question about mania improving but depression getting worse, and I have no idea! If I were more in touch with my bipolar side (okay, that just caused me to laugh out loud), then I’d probably have some insight. But I sure hope your brother is doing well!! You should ask me sometime about a woman I used to know… I could tell stories about her. Oh, I understand about paranoia! I think it’s normal to feel paranoid about certain things or people. With me, I experience it as energetic pollution whenever I get too close to someone (in close proximity). The essence of whoever they are oozes over me and makes me feel polluted. I can’t meet the eyes of cashiers, because then their energy would overtake me. I have to angle my body away, too, and speak as little as possible. I had issues visiting my best friend in Prague, because there’s less personal space. This all goes back to how my mom spewed negativity all over me as a child, and I couldn’t escape it, ya know? I never learned how to block others’ energy, especially when their energy is “bad”. Oh, hey, I love the new web site name and logo! Rock on!!

      2. The credit companies got letters from their psychiatrists saying that the patient was manic or psychotic when they were using the cards lol. Oh, some tooks pals to restaurants and put on their psychiatrists account 🙂 got taxi’s and used the NHS account – they could be cunning and find out things lol. That’s another post tho’. Glad you laughed out loud at your own comment – that’s brilliant 🙂
        I get paranoid around police cars and crowds of police – takes me back to my psychosis and paranoia. Yes, you must tell me about your pal – why not write a post 🙂 Aaawww, that awful experience with your mum has now created all this 🙁 People tell me I recognise others ‘energy’ immediately and I’m able to respond effectively. Thankfully. But it’s obviously very different to your experiences of feeling polluted.
        We all have our own ‘oddities’ don’t we. I think there actually an element of ‘madness’ in all of us 😉

      3. Oh, oops, separate incidents! yeah, in 2005, I went off my antidepressant thinking I didn’t need it! MAJOR oops moment! 😀

  3. It’s nice to get the details about different types of bipolar and how the symptoms really work. Bipolar is one of those conditions that get batted about in the media a lot but are often presented in an extremely surface way that helps breed all sort of misconceptions. We need better information out there so that we can support bipolar individuals in managing their symptoms. Thank you for being part of the effort to promote awareness!

    1. Aaww, thank you. Yes the Bipolar gets bandied around too often, celebreties professing they have bipolar, wearing it like a badge of honour. Yes, we need more people to promote awareness about the various mental health disorders, giving more accurate and eviden-based descriptions,

  4. Thank you so much for writing this post! There’s also postpartum bipolar disorder, a perinatal mood & anxiety disorder which is different than postpartum psychosis.

    If you’d like a free PDF copy of my book “Birth of a New Brain–Healing from Postpartum Bipolar Disorder,” you’re welcome to email me at: dyane@baymoon.com

    For more info., here’s my “PsychByte” webinar about postpartum bipolar for the International Bipolar Foundation:

    Take good care!

    Sincerely,

    Dyane Harwood

  5. Thanks for sharing your knowledge. I think a lot of people will find this useful.
    I especially like the strategies you listed. I have bipolar I and I have found that routine is my best friend. Any whackiness in my routine and I have mood instability. That, adequate sleep and exercise have been key for me in dealing with it.
    As for mania and depression, I was diagnosed with the disorder after a mixed episode. Since then I’ve only had brief hypomania, but primarily treatment-resistant, chronic depression. It can be a debilitating condition.

    1. That’s rotten that you’ve got treatment resistant end of it 🙁 That must be really tough. I’ve seen both my brother and many patients ‘stuck’ in that phase for months and it’s painful to see. My heart goes out to you. I’m glad you think this information will be helpful, I appreciate that. x

  6. I prefer the old term manic depression as it was easier for people to grasp. Bipolar sounds confusing whereas most people can define manic and depressive and comprehend at least the concept.

      1. I agree with you 100%. It starts with us talking about it. What have I said? ‘Dealing with mental health issues. Step 1 talk about it.’ I have been part of another poetry website for the last 2 years. Whenever I wrote about mental health issues I would always put myself as the subject. Guess age helps and I don’t care what anyone thinks anymore. i was an educator before retiring and know how important this is. There is still the stigma which holds many back from talking about their own problems on a world stage to an unknown audience. I can appreciate this. It’s people like us who have been through the pain who are able to continue educating the community.

        After all, the only difference between you and me is the degree of our mood swings..

        Oh, is that all?

      2. Lol – you’re right! Age/maturity/wisdom all help. Like you, I don’t care what anyone thinks, I spent too many of my former years being a people pleaser and look where that got me. No more. I say, no more 😉

        Of course, the stigma holds people back from talking about their own mental illness but there appears to be more openness these days. What, with all the ‘celebrities, footballers coming out to talk about mental illness.

        So yes, again like you, I’ll continue beating my drum, shouting out about mental illness and getting rid of the attached stigma 🙂 Thank you for your input, Caz

  7. Caz

    Don’t beat yourself for wanting to be a people-pleaser. It is an inborn urge for humans to want to be accepted by others and agree with them. Age/maturity/wisdom eventually brings you to your senses. Often after the damage is done.

    Don

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