Patterns Of Depression And Mania
If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa.
Between episodes of depression and mania, you may sometimes have periods where you have a “normal” mood.
The patterns are not always the same and some people may experience:
- rapid cycling where a person with bipolar disorder repeatedly swings from a high to a low phase quickly without having a “normal” period in between
- mixed state where a person with bipolar disorder experiences symptoms of depression and mania together; for example, overactivity with a depressed mood
If your mood swings last a long time but are not severe enough to be classed as bipolar disorder, you may be diagnosed with a mild form of bipolar disorder called cyclothymia.
Types Of Bipolar Disorder
There are three basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely up, elated, and energized behavior or increased activity levels to very sad, down, hopeless, or low activity-level periods . People with bipolar disorder also may have a normal mood alternating with depression. Four or more episodes of mania or depression in a year are termed rapid cycling.
- Bipolar I Disorder is defined by manic episodes that last at least seven days or when manic symptoms are so severe that hospital care is needed. Usually, separate depressive episodes occur as well, typically lasting at least two weeks. Episodes of mood disturbance with mixed features are also possible.
- Bipolar II Disorder is defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.
- Cyclothymic Disorder is defined by persistent hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes. The symptoms usually occur for at least two years in adults and for one year in children and teenagers.
- Other Specified and Unspecified Bipolar and Related Disorders is a category that refers to bipolar disorder symptoms that do not match any of the recognized categories.
Did You Ever Try To Kill Yourself
SOMEONE I DIDNT KNOW ONCE ASKED ME THIS. It was at a really bad gig at a rundown club, and I honestly didnt think the night was going to sink any further. Then a friend-of-a-friend asked me this. Dont ask someone this. I mean, obviously do ask if you are friends and youre having a one-on-one heartfelt conversation four pints in, but, in general, I wouldnt ask this until youre 99.9% sure it wont make you a dick for asking this.
Decreased Need For Sleep
Do you or a loved one stay awake until 4 a.m. and then awake at 8 a.m. ready to go? A decreased need for sleep is common during the emergence of mania symptoms. Unfortunately, sleep problems and bipolar disorder can feed off each other, with manic episodes leading to sleep problems and vice versa.
Bipolar Disorder And Depression
Bipolar disorder can have two extremes: up and down. To be diagnosed with bipolar, you must experience a period of mania or hypomania. People generally feel up in this phase of the disorder. When youre experiencing an up change in mood, you may feel highly energized and be easily excitable.
Some people with bipolar disorder will also experience a major depressive episode, or a down mood. When youre experiencing a down change in mood, you may feel lethargic, unmotivated, and sad. However, not all people with bipolar disorder who have this symptom feel down enough to be labeled depressed. For instance, for some people, once their mania is treated, a normal mood may feel like depression because they enjoyed the high caused by the manic episode.
While bipolar disorder can cause you to feel depressed, its not the same as the condition called depression. Bipolar disorder can cause highs and lows, but depression causes moods and emotions that are always down. Discover the differences between bipolar disorder and depression.
Bipolar disorder is a common mental health disorder, but its a bit of a mystery to doctors and researchers. Its not yet clear what causes some people to develop the condition and not others.
Possible causes of bipolar disorder include:
Can Children And Teens With Bipolar Disorder Have Other Problems
Young people with bipolar disorder can have several problems at the same time. These include:
- Misuse of alcohol and drugs. Young people with bipolar disorder are at risk of misusing alcohol or drugs.
- Attention-deficit/hyperactivity disorder . Children and teens who have both bipolar disorder and ADHD may have trouble staying focused.
- Anxiety disorders. Children and teens with bipolar disorder also may have an anxiety disorder.
Sometimes extreme behaviors go along with mood episodes. During manic episodes, young people with bipolar disorder may take extreme risks that they wouldnt usually take or that could cause them harm or injury. During depressive episodes, some young people with bipolar disorder may think about running away from home or have thoughts of suicide.
If your child shows signs of suicidal thinking, take these signs seriously and call your childs health care provider.
If you think your child is in crisis and needs immediate help, call 911. You also can call the National Suicide Prevention Lifeline at 1800273TALK , or text the Crisis Text Line . These services are confidential, free, and available 24/7.
How Do I Get Help If I Think I Have Bipolar Disorder
The usual first step to getting help is to speak to your GP.
It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page.
Your GP cant diagnose bipolar disorder. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:
- depression, and
- ever felt very excited or not in control of your mood or behaviour for at least 4 days in a row.
They might refer you to a psychiatrist at your local NHS community mental health team .
Your GP should make an urgent referral to the CMHT if they think that you might have mania or severe depression. Or there is a chance that you are a danger to yourself or someone else.
Your GP should refer you to your local NHS early intervention team if you have an episode of psychosis and its your first one.
Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.
You can find more information about:
- NHS mental health teams by clicking here.
Common Signs & Symptoms Of Depression
- Feeling very sad or hopeless
- Feeling lonely or isolating themselves from others
- Eating too much or too little
- Having little energy and no interest in usual activities
- Sleeping too much
Teens and young adults with bipolar disorder symptoms may think and talk about self-harm or suicide. If someone you know is expressing these thoughts, seek help immediately.
Addressing The Stigma Of Bipolar Depression
People with bipolar disorder and the depression associated with it are often misunderstood by others. Stigma often comes from lack of understanding or fear. Inaccurate information or representations can contribute to both of those factors. It could be due to the way bipolar depression is viewed in society, including by friends and family. It could also be due to a lack of general awareness.
However, the fact is many people with bipolar depression have successful careers and satisfying relationships. These are just a few reasons why you should not worry about how others may view your condition.
If others express belief in the stereotype or just dont understand, it may be an opportunity to start a conversation with them about your experience with bipolar depression. However, this may be a challenging talk. Be patient with them. Here are some tips on how to start the conversation.
- Try to talk when youre well so you can plan for the talk and ensure it is a calm and productive one
- Explain your experiences and feelings so they can better understand what youre going through
- Let them know why being stigmatized is harmful and ask for their support
The Warning Signs Of A Manic Episode
If you’ve already been diagnosed with bipolar disorder, know your own warning signs of mania, says Dr. Duckworth. For example, you may start:
- Driving faster than usual
- Having agitated mannerisms
- Singing a certain song or using certain phrases
“One thing we’ve learned is that people have predictable episodes of mania. If you can recognize patterns and allow people in your life to give you feedback without activating your own defensiveness, then you can participate in collaborative problem-solving,” says Dr. Duckworth.
Also, realize that early manic episodes can be “seductive,” says Dr. Duckworth. “Some people prefer it because they feel that they’re more open, funnier, and interesting. The experience can be reinforcing in the beginning,” he says. However, mania can also lead to extreme agitation or irritability, which ultimately won’t feel good.
How Is Bipolar Disorder Treated
Children and teens can work with their health care provider to develop a treatment plan that will help them manage their symptoms and improve their quality of life. It is important to follow the treatment plan, even when your child is not currently experiencing a mood episode. Steady, dependable treatment works better than treatment that starts and stops.
Treatment options include:
Asking Others For Help And Support
Think about the people in your life and how they can best support you. One person may be great at practical things. Another person may offer emotional support by listening. The reality is, both of them can help you to:
- Remember to take and refill your medication as your doctor prescribed
- Make and keep doctor appointments
- Prioritize health through exercise and healthy eating
- Monitor your mood and ask how youre feeling
- Connect with your loved ones and make sure you are not isolating
Asking for help can be difficult, but in the end, your friends and family are your support system. Tell them what you need and be honest about how youre feeling.
What Is Rapid Cycling
Some people with bipolar disorder develop rapid cycling where they experience four or more episodes of mania or depression within a 12-month period. Mood swings can occur very quickly, like a rollercoaster randomly moving from high to low and back again over a period of days or even hours. Rapid cycling can leave you feeling dangerously out of control and most commonly occurs if your bipolar disorder symptoms are not being adequately treated.
The different faces of bipolar disorder
Bipolar I Disorder This is the classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode. Usuallybut not alwaysBipolar I Disorder also involves at least one episode of depression.
Bipolar II Disorder In Bipolar II disorder, you dont experience full-blown manic episodes. Instead, the illness involves episodes of hypomania and severe depression.
Cyclothymia Cyclothymia is a milder form of bipolar disorder that consists of cyclical mood swings. However, the symptoms are less severe than full-blown mania or depression.
There Was A Lot To Learn About Bipolar Ii
I had a lot of learning to do I had to educate myself on what bipolar II was and what it means. I learned that bipolar II mood disorder has elevated mood swings that are highly insightful and creative. It means that we are at our very best. It is on a level that we want to stay forever.
The low moods of bipolar II are incapacitating. Living through this depressive stage is frightening. The bad feelings just do not stop. The emptiness is indescribable. No one can fully understand it unless they have experienced it.
For me, it means that I have to stay acutely aware of how I am feeling at any given moment. It means that I keep track of my moods. I need to stay on guard and recognize signs that alert me that my current mood is changing and not in a good way.
No matter how much I try to prepare myself for the down times, they always catch me by surprise. Even though I know that these times will not last, the mere experience of having this mood change brings back all the old feelings of depression.
These low moods are not nearly as intense as a full-blown clinical depressive episode, and that is only because I am currently on two medications. One is for depression, and the other is meant to be a mood stabilizer. This combination of medicines keeps me from experiencing a full-blown clinical depressive event.
Unfortunately, I still have depressive episodes at least every three to four months
Its Important To Keep Talking
Initially, your loved one may not understand completely. Thats OK. Give them time.
Explain to them that youre working to manage your condition and get the help you need. And that their encouragement and support is needed as well. Let them know the conversations you share help build a strong foundation from which you can hopefully move forward.
Is That What Stephen Fry Has Are You Like Stephen Fry
Yes, its what Stephen Fry has, according to the brilliant and informative documentary he made for the BBC in 2006, entitled The Secret Life of the Manic Depressive. Yes, I am Stephen Fry. *poses for selfie with fan*.
Im also available for personal appearances as: Catherine Zeta-Jones and Kerry Katona.
Symptoms Of A Mixed Episode
A mixed episode of bipolar disorder features symptoms of both mania or hypomania and depression. Common signs of a mixed episode include depression combined with agitation, irritability, anxiety, insomnia, distractibility, and racing thoughts. This combination of high energy and low mood makes for a particularly high risk of suicide.
What Being ‘normal’ Means To Me As A Person With Bipolar
When I was young, I wanted more than anything to be normal. I didnt know what normal meant, but I knew I wasnt it.
I had a lot of the trappings of what passed for normal in that day and age: parents still married, one sister, suburban house in a town with good schools, church down the street, same-age children living within a block, working father, stay-at-home mom, abundant books and toys, and vacations to visit the relatives.
But I knew. There was something different about me. Everyone else knew it too. I wasnt normal. I was too sensitive, whatever that meant. I was precocious. I didnt fit in and I didnt know how to.
As I reached my tween and teen years, I encountered a dilemma. I desperately wanted to be normal. Normal kids had friends, got to hang out with each other, laughed and smiled a lot, wore what was in fashion. They gave off an aura of being normal. I longed for that. I was in love with the idea of normalcy.
But every time I tried, I failed. I was always too weird, too emotional, too smart, too something.
So I began to hate the idea of normalcy. If I didnt fit in, then by God, I would scorn the idea of fitting in. I would embrace non-normalcy. I would hang with the few other misfits I could find. I would eschew the latest fashions and trends. I didnt rebel, exactly. I was too timid for that .
And it worked, at least partially. But by that time, it was too late for me to ever be normal.
Photo by David Cassolato from Pexels
What Is Bipolar Disorder
People who have bipolar disorder can have periods in which they feel overly happy and energized and other periods of feeling very sad, hopeless, and sluggish. In between those periods, they usually feel normal. You can think of the highs and the lows as two “poles” of mood, which is why it’s called “bipolar” disorder.
The word “manic” describes the times when someone with bipolar disorder feels overly excited and confident. These feelings can also involve irritability and impulsive or reckless decision-making. About half of people during mania can also have delusions or hallucinations .
“Hypomania” describes milder symptoms of mania, in which someone does not have delusions or hallucinations, and their high symptoms do not interfere with their everyday life.
The word “depressive” describes the times when the person feels very sad or depressed. Those symptoms are the same as those described in major depressive disorder or “clinical depression,” a condition in which someone never has manic or hypomanic episodes.
Most people with bipolar disorder spend more time with depressive symptoms than manic or hypomanic symptoms.
How Can I Help My Child Or Teen
Help begins with the right diagnosis and treatment. Talk to your family health care provider about any symptoms you notice.
If your child has bipolar disorder, here are some basic things you can do:
- Be patient.
- Encourage your child to talk, and listen to your child carefully.
- Pay attention to your childs moods, and be alert to any major changes.
- Understand triggers, and learn strategies for managing intense emotions and irritability.
- Help your child have fun.
- Remember that treatment takes time: sticking with the treatment plan can help your child get better and stay better.
- Help your child understand that treatment can make life better.
Can I Take Medicine For Bipolar Disorder While Breastfeeding
Yes. Certain medicines to treat bipolar disorder are safe to take while breastfeeding. Talk to your doctor about what medicines you can take after giving birth.
Learn more about medicines and breastfeeding in our section. You can also enter your medicine into the LactMed® database to find out whether your medicine passes through your breastmilk and, if so, any possible side effects for your nursing baby.
Bipolar Relationships: What To Expect
Ups and downs are natural in any romantic relationship, but when your partner has bipolar disorder it can feel like youre on an emotional rollercoaster. Not knowing what to expect each day is stressful and tiring. Over time, it wears on the relationship.
Understanding why your partner acts out sometimes or becomes withdrawn is the first supportive step you can take in strengthening your relationship. Learn exactly what a bipolar diagnosis means, how it could affect your partners behavior and what you can do to foster a healthy, stable relationship.
How Is Nimh Addressing Bipolar Disorder
The National Institute of Mental Health conducts and supports research on bipolar disorder that increases our understanding of its causes and helps develop new treatments. Researchers continue to study genetics and bipolar disorder, brain function, and symptoms in children and teens who have bipolar disorder, as well as family history in health and behavior.
Learn more about NIMHs research priorities and current studies.
What Are Your Treatment Options
Treatment will depend on which type of bipolar disorder you have, and what your symptoms are. Most of the time, youll need medication to manage your symptoms, along with therapy. Medications that may be used include:
Antidepressants Antipsychotics Mood stabilizers Anti-anxiety medications
Sometimes traditional medication therapy isnt enough. At Boston MindCare, our doctors offer a unique treatment option when nothing else has worked. Ketamine infusion therapy can help the symptoms of depressive episodes associated with bipolar disorder. It works by inhibiting glutamate in your brain to stabilize your mood.
Like many of the other medications used to treat this disorder, ketamine comes with some side effects, so its important to talk to our doctors to see if this treatment is right for you.
You dont need to deal with bipolar disorder on your own. If youre looking for help, call our office at 701-207-9841 or book an appointment online today.
Changing Your Outlook May Help
Sometimes it can be a challenge when you have a bad day, such as arguing with a loved one or friend, experience a financial problem, or go through an unexpected event. However, with some practice, you may be able to change how you view these stressful times.
Changing how you view events may help you see stressful events as more manageable. And, it may be enough to have a positive effect.
To start, try these tips:
Notice your thoughtswhen you start to get upset by stressful events, take noteThink about the factstry to avoid black-or-white thinking. Take a step back and examine the eventCreate a positive viewtry thinking of the positives regarding stressors. And remember, sometimes something that seems bad may eventually result in a positive
Try practicing positive thinking as events and stressors arise and see how it works for you.
Help Your Loved Ones Understand
Accepting your diagnosis is the first step. While it may be difficult, your loved ones may have a hard time understanding your diagnosis. It may even feel like they arent being as supportive as they could be at times. Thats why its important to talk with them. And keep talking.
To start and keep the conversation going
- Ask your loved ones how they feel about your condition
- Keep them informed of steps youre taking to manage your symptoms
- Ask them for support
What Does A Person With Bipolar Disorder Experience
Bipolar disorder does not have a set pattern and differs from individual to individual. Patients may feel a particular emotion several times before switching to another state.
Symptoms of mania are:
- Patients may feel that they are on the top of the world
- Highly irritable
When medication therapy is ineffective, electroconvulsive therapy might be considered. During electroconvulsive therapy, an electric current is passed through the brain to treat the disorder. In some, talk therapy has proven to be beneficial in treating mood episodes. Another part of treatment is psychoeducation where patients and their families are educated regarding symptoms and importance of medication compliance.
What Are The Different Types Of Bipolar Disorder
There are different types of bipolar disorder.
What is bipolar disorder I disorder?
What is bipolar II disorder?
A diagnosis of bipolar II disorder means it is common to have symptoms of depression. You will have had at least 1 period of major depression. And at least 1 period of hypomania instead of mania.
What is bipolar I or II disorder with mixed features?
You will experience symptoms of mania or hypomania and depression at the same time. You may hear this being called mixed bipolar state. You may feel very sad and hopeless at the same time as feeling restlessness and being overactive.
What is bipolar I or II disorder with rapid cycling?
Rapid cycling means you have had 4 or more depressive, manic or hypomanic episodes in a 12-month period.
What is bipolar I or II with seasonal pattern?
Seasonal pattern means that either your depression, mania or hypomania is regularly affected in the same way by the seasons. For example, you may find that each winter you have a depressive episode, but your mania doesnt regularly follow a pattern.
There can be some similarities between bipolar I or II with seasonal pattern and another conditional called seasonal affective disorder.
What is cyclothymia?
A diagnosis of cyclothymic disorder means you will have experienced regular episodes of hypomania and depression for at least 2 years. You wont be diagnosed with bipolar because your symptoms will be milder. But they can last longer. Cyclothymia can develop into bipolar disorder.
Bipolar Disorder And Stigma
Many people have heard of bipolar disorder, but this doesn’t mean they understand the diagnosis fully. You might find that some people have misconceptions about you or have a negative or inaccurate image of bipolar disorder. This can be very upsetting, especially if someone who feels this way is a friend, colleague, family member or a health care professional.
But it’s important to remember that you aren’t alone, and you don’t have to put up with people treating you badly.
You can read more about dealing with stigma on our page on stigma and misconceptions.
Here are some options for you to think about:
- Show people this information to help them understand more about what your diagnosis really means.
- Get more involved in your treatment. Our pages on seeking help for a mental health problem provide guidance on having your say in your treatment, making your voice heard, and steps you can take if you’re not happy with your care.
- Know your rights. Our pages on legal rights provide more information.
- Take action with Mind. See our campaigning page for details of the different ways you can get involved with helping us challenge stigma.
“What helps me the most is the ongoing realisation and acceptance that the way in which my bipolar disorder manifests itself, and the symptoms I display, are not personality traits or ‘bad behaviour’.”