For those diagnosed with bipolar disorder (bipolar disorder)

In this article, I have attempted to answer the questions that clients with newly diagnosed bipolar disorder ask me . I will try to answer in a simple and understandable way, based on scientific facts and information that I received during my practical work with BAR.            

According to what the symptoms are diagnosed with “bipolar disorder”? How does the disease manifest itself? 

Bipolar disorder is characterized by severe mood swings. The mood for several months, weeks, or (less often) for several hours “goes to extremes” – it becomes too cheerful and too bad.     

The mood for several months, weeks, or (less often) for several hours “goes to extremes” – it becomes too cheerful and too bad.     

Mania or hypomania is an elevated mood and intense physical and mental activity. Mental activity becomes heterogeneous – attention catches every detail, but it is difficult to concentrate it on one thing for a long time . Thoughts are constantly “jumping”, one idea is quickly replaced by another. All emotions intensify: joy – to euphoria, irritation and resentment – to aggression, suspicion – to paranoia. Physical activity also increases: I almost do not want to sleep (three hours of sleep seems to be enough), sexual desire increases. Behavior becomes impulsive, reckless, sometimes even adventurous and eccentric. A person can become obsessed with some idea. In an episode of mania, delusions and hallucinations may appear .                 

Hypomania is liked by everyone who has experienced it at least once. In hypomania, in contrast to mania, delusions or hallucinations occur less often, criticality remains, aggression is lower. Nevertheless , hypomania is not a normal state for the psyche, the brain works in an enhanced mode. On the acceleration of mental processes are redundant resources, and when they end, comes complete exhaustion. With hypomania, the psyche runs a sprint, as it were. Imagine if all your life you will only run – the body will quickly become depleted and worn out. So it is with the psyche. Hypomania can turn into more unpleasant states – mania or depression.                    

On the acceleration of mental processes are redundant resources, and when they end, comes complete exhaustion. With hypomania, the psyche runs a sprint, as it were.   

Another sign of bipolar disorder is not just a bad mood, but depression, from mild short- term to severe long-term. The opposite is true here. Activity falls: when you need to do something, there is neither strength nor desire. Mental activity is even more difficult: in addition to the lack of desire and strength, it is difficult to concentrate attention, remember, analyze, make a decision. The experience of emotions is dulled, with the exception of aggravated resentment, feelings of guilt, hopelessness, confusion, anxiety or indifference. Appetite changes, insomnia or excessive sleepiness appears. Even if you are a very cheerful person, with severe depression, suicidal thoughts appear. With severe depression, delusional ideas and hallucinations may occur.         

These phases can replace each other, they can manifest themselves simultaneously. For a long time, only one pole can appear – then even doctors, instead of a correct diagnosis of “bipolar disorder”, may first put “depression”. The intervals between episodes (intermissions) are different for everyone – it can be a month, a year, three years, five years.   

In a healthy person, changes in the activity of mental processes are not so contrasting, more amenable to regulation. They do not lead to a deterioration in daily functioning – a person can successfully cope with the professional, academic responsibilities assigned to him, establish and maintain relationships with others.          

In what causes bipolar mental disorder? 

By Unfortunately, science does not could answer why there is a bar. It is only known that many factors interacting with each other are involved in this .    

Now the onset and development of the disease is considered through the biopsychosocial model (BPSM). According to this model, the development of the disease is influenced by three factors – biological, psychological and social.    

The biological factor includes genetics, physiological and biochemical characteristics of the organism.   

The psychological factors in the development of bipolar disorder include the number and intensity of stressful experiences, coping strategies, character traits, emotional sphere, and thinking.   

Social factors – cultural and political environment, economic situation, microsocial environment (family, friends, professional environment, acquaintances). 

The emergence and development of bipolar disorder is not due to one of these factors, but is a consequence of their interaction.     

By Unfortunately, science does not could answer why there is a bar. It is only known that many factors interacting with each other are involved in this .    

Questions like “Why me?”, “What causes BAR?”, Which cannot be answered, are called ruminations. Thought chains that arise when thinking about such questions do not lead to an answer, but lead to a decrease in mood, an increase in anxiety and a feeling of hopelessness. Psychotherapeutic techniques and communication with loved ones will help to switch or abstract from such thoughts .         

How is bipolar personality disorder treated? Am I going to be in a mental hospital?  

The need for hospitalization may not arise if you approach treatment responsibly . If treatment is neglected, episodes of mania and severe depression are more likely to lead to hospitalization. However, hospitalization does not put an end to a person’s life, but helps to get out of an episode of depression or mania and return to normal life.             

As mentioned earlier, there are three factors that influence the course of bipolar disorder – biological, psychological, and social. To minimize the impact of bipolar disorder on your life as much as possible , you need to take control of all three factors. In this case, you do not have to go to the hospital and outpatient treatment will be enough.        

The biological factor will be taken over by drugs and a healthy lifestyle. Your psychiatrist will prescribe the medication you need. The drugs should be taken regularly, you should not pause without consulting your doctor. If you experience any side effects, talk with your doctor and decide together – should there be patient, change the dosage or switch to another medication.          

A healthy lifestyle helps to maintain the normal state of all body systems , including the nervous system. Taking medications will not give a good effect if drugs or alcohol are acting on the brain in parallel . To maintain the nervous system, and therefore all mental activity, will help you in good condition: stable good sleep (at least seven hours), absence of bad habits (alcohol, drugs, smoking), regular physical activity, good rest, adherence to the daily routine, correct nutrition.       

The drugs should be taken regularly, you should not pause without consulting your doctor. If you experience any side effects, talk with your doctor and decide together – should there be patient, change the dosage or switch to another medication.        

The psychological factor will help regulate and take control of psychotherapy. The recommended psychotherapy for bipolar disorder is cognitive behavioral therapy (CBT). Psychotherapy will not cure the disease, but will allow you to develop skills in problem solving, effective communication, coping strategies. New skills or habits will help you cope with stress and anxiety and resolve intrapersonal conflicts. After completing psychotherapy, you will be able to independently apply these skills in life. Depressive episodes will be easier to experience, and their consequences will cease to be so severe. Psychotherapy promotes the development and harmonization of the personality, which prevents the emergence of some stressful situations (conflicts, destructive relationships).           

The social factor in the development of bipolar disorder is relationships with loved ones, work or study, social activity. The support of relatives and friends has a positive effect on the psychological state, helps to cope with episodes more easily. Stable work is also important, not only as ensuring economic stability, but also in order to observe the daily routine, expand the circle of friends, and feel their own importance and need. Spending time with friends and comrades has a positive effect, brings positive emotions, distracts from sad thoughts in a depressive episode.           

I would like to summarize the above about the treatment of bipolar disorder:  

Bipolar Affective Disorder (BAD) Treatment Cheat Sheet 

Control of biological factors:

  1. Observe a psychiatrist (at least once every three to four months);   
  2. Take medications prescribed by a psychiatrist;
  3. Lead a healthy lifestyle;
  4. Set the daily routine.

Controlling psychological factors:

  1. Accept yourself with bipolar mental disorder; 
  2. Take a course of psychotherapy;
  3. Apply independently acquired skills to prevent and resolve stressful situations; 
  4. If possible, minimize the number of stressful situations. 

Control of social factors:

  1. Help and support of family members; 
  2. Stable and feasible work; 
  3. Communication, pastime with friends and acquaintances;  
  4. Social activity, expanding the circle of acquaintances.

In this memo is clearly visible that you yourself can do a lot to improve their condition. Almost everything depends on you.   

Remember, when protective factors outweigh risk factors , this is a good tool to reduce the frequency and intensity of episodes.  

Is it possible to completely remove the symptoms, be cured? 

Bipolar personality disorder is a chronic disorder. You cannot be cured forever, but you can minimize the symptoms , sometimes even completely remove them . With the combination of pharmacotherapy, psychotherapy and prevention methods, the manifestations of the disease can be minimized. If there are more protective factors than risk factors, then the symptoms of bipolar disorder will not affect your life or will go away altogether.       

Is it possible to remove a bad mood (depression) and leave only good mood (hypomania)?  

No, unfortunately, you cannot remove depression and leave only hypomania.  

How will bipolar disorder affect my life? 

If a patient with bipolar disorder takes pharmacotherapy and adheres to the rules for preventing episodes, the number and intensity of episodes is minimized, and symptoms are completely absent in intermissions. Under these conditions, bipolar disorder does not significantly affect life.        

Bipolar disorder, like any chronic disease, makes changes in the regimen: systematic visits to the doctor, medication, preventive measures.  

If bipolar disorder is left untreated, episodes can significantly impact work and personal life.   

BAD, like any chronic disease, makes changes in the regime: systematic visits to the doctor, taking medications, preventive measures.  

During the hypomanic and manic phases, mental and physical activity increases, but becomes impulsive and chaotic. The work will be easy, but it will not bring results . You will be able to deal with many things at the same time, but no one is not to be brought to an end. In relation to close people, hostility and aggression arise , which gives rise to conflicts. Without malicious intent, you can offend loved ones and not even notice it, quickly switching to something else. A manic episode can be accompanied by delusions and hallucinations, therefore, the likelihood of hospitalization increases.                   

In a depressive episode, there is neither the desire nor the strength to do anything, so work and study will be difficult. Severe depression forces them to take an academic leave from studies, leave from work. In relation to close people, indifference, resentment and isolation appear .         

In addition to what has already been said, such a “swing” tire not only you, but also the people around you. For the employer, this is an unstable worker who cannot be relied upon . For loved ones (especially if they do not know about the diagnosis of bipolar disorder) , unpredictability of mood causes emotional stress, this leads to misunderstandings and conflicts.          

Can you have children while taking pharmacotherapy? 

There are no contraindications for men. Women should discuss pregnancy with their healthcare provider beforehand . During pregnancy, the doctor may change the combination of drugs and their dosage.    

Will children inherit bipolar disorder? 

According to the Center for Clinical Interventions, children of patients with bipolar disorder have an 8% risk of inheriting the disease. According to Bebbington (2004), the probability of inherited bipolar disorder is 5-15%. At the same time, the likelihood that relatives of bipolar patients will develop unipolar depression is twice as likely (that is, ordinary depression without the second pole – without mania / hypomania).         

This does not in any way mean that you do not need to have children. This is a reason to take care of the biological, psychological and social components of their development. Do not forget that the probability of staying healthy in children of patients with bipolar disorder is 65-75%.            

How to explain to loved ones what is happening?

A negative attitude towards mental disorders still persists in society , so it is difficult for a person with a psychiatric diagnosis to tell even close people about it. However, the support of family and friends plays a very important role in psychological well-being and gives strength to cope with stressful situations.        

Talking about the features and symptoms of bipolar disorder, you can always use the description of its symptoms given at the beginning of this article.    

Why is it important to inform loved ones about your condition: 

  1. Family and friends will be able to spot dangerous behavioral changes that precede episodes and advise you to go to an unscheduled doctor’s appointment. The doctor will have the opportunity to correct pharmacotherapy in time, which will shorten the duration and intensity of the episode.       
  2. Relatives will not take the behavior during the episode personally and it will be easier to tolerate irascibility, resentment, aggression. The amount of conflict and additional stress for you will be reduced . If you tell people about meaningful diagnosis, it will help make communicating with them more environmentally friendly, positive, less traumatic.         

If you do not want to explain your condition in detail, at least do not isolate yourself from loved ones. Avoid creating new stress for yourself in the form of conflict and breaking up with family and friends. You can simply reduce the amount of communication. Spending less or less time with loved ones during an episode does not necessarily raise suspicion. We all have periods of high utilization and employment. And only you can decide whether to tell someone about your diagnosis or not.                    

And only you can decide whether to tell someone about your diagnosis or not.   

Support can be found in psychotherapy and bipolar disorder support groups . These are special groups with certain rules in which you can meet people with the same diagnosis, discuss issues of concern to you about bipolar disorder, gain understanding and support.           

Where to go for advice and help?  

There are different options for receiving psychiatric and psychotherapeutic help. 

State psychiatric hospitals and neuropsychiatric dispensaries at the place of residence.   

Private clinics licensed to provide medical care. The authenticity of the license can and should always be checked on the website of the licensing authority. Do not forget to verify the authenticity of the education specialists you contact.      

No option can 100% guarantee the best mental health care. If you have any doubts or discomfort, you can always change your doctor, listen to several opinions and try different treatment options. A good specialist will always be able to tell you about the diagnosis and the course of treatment, back up his words with data from modern research. The choice is yours.       

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