Bipolar disorder: Swinging sickness

Bipolar disorder can take a person on an emotional rollercoaster leaving them feeling miserable in its wake. But a positive outlook might be all that is needed to put the brakes

Figurine with excited and depressed shadow

Everyone experiences changing emotions from time to time. At times, for no known reason, we find ourselves feeling low and depressed, and then, out of the blue, we snap out of the mood. Emotional ups and downs are part of life. But, what happens when someone is completely at the mercy of such ups and downs, like Laila was?

A cultured and successful fashion designer, Laila never understood why she would often find herself in the pits of depression. For no cause, she would be tearful and feel extremely unhappy and fatigued. She felt drained of energy and would see no purpose in carrying on with life. This phase would last for a few weeks, and suddenly one morning she would wake up cheerful, excited and keyed up. She would unexpectedly become a powerhouse of energy, creating and discarding hundreds of designs in a day, blabbering excitedly with clients, often without realising that what she was saying made no sense. After a week or two of this ‘high’ phase, she  would be down in the dumps again. She felt like a yo-yo, constantly shuttling between these extreme emotional states. After months of battling the emotional upheavals, Laila was diagnosed with bipolar disorder. She learnt that her mood swings were not ordinary mood swings, but indicated a far more serious condition, one that required considerable care and attention.

What is bipolar disorder?

To put it simply, it is a condition where a person suffers from extreme mood cycles, swinging between elation and depression. In technical terms, it is a mood or affective disorder, where the key symptom is extreme fluctuations in mood, ranging from mania to depression. It is a disruptive psychiatric condition and can wreak havoc in the normal day-to-day functioning of the person suffering from it. In fact, one of the key indicators of bipolar disorder is that the changing moods impact the person’s social, occupational or educational life and create disruption. This inability to function is what sets apart bipolar disorder from temperamental mood swings.

The symptoms of bipolar disorder

Typically, a person may experience depression and mania in a cyclic fashion, each phase lasting from a few hours to a few weeks.

Depression: Most of us are familiar with the typical ‘low’ feeling that we experience at various points in our lives. Today, most of us are also aware of clinical depression, which is a far more severe and debilitating form of your everyday depression. Some typical symptoms of being in a depressed mood are:

  • Generalised feelings of helplessness and hopelessness
  • Loss of interest in everyday activities
  • Considerable change in appetite [either loss or excess]
  • Significant weight gain or loss
  • Sleep changes [insomnia or hypersomnia]
  • Loss of energy or feeling tired all the time
  • Anger or irritability.

Mania: A manic episode is the opposite of a depressive episode. A manic person tends to be excessively active, has high energy levels and can show some or all of the following symptoms:

  • Impulsive, reckless behaviour
  • Excessive and fast speech
  • Loss of sleep
  • High energy levels
  • Racing or fast thoughts
  • Inflated sense of self.

Both these mood and behaviour patterns are not typical of the person’s normal personality. That is one of the hallmarks of the disorder. So, it’s not just a moody or temperamental person having one of his ‘fits’.

A word of caution

Deliberate self-harm is a very real concern with people suffering from bipolar disorder. These people are twice as likely [when compared to the general population] to attempt or commit suicide, and think about harming themselves on a regular basis. Thus, it is important that any talk about ending one’s life, no matter how transient, be taken with utmost seriousness.

The changing moods impact the person’s social, occupational or educational life

23-year-old Saahir had a lot going for him. He was a hardworking and motivated individual pursuing success on the academic front. His journey toward his goals, however, was cut short by the sudden onset of a manic episode during the last semester of his MBA course. The episode lasted three to four days, during which he ended up fighting with all his friends, maxing out his father’s credit card on a shopping spree, getting into a violent tizzy when questioned at home and flunking his most important exam. He was never known to be depressed or manic before, and this episode left a deep imprint on him. This manic phase was followed by a lull period, in which he thought that life was not worth living after all, and ended his life one evening, after a minor fight with his girlfriend.

What causes bipolar disorder?

Unfortunately, as is the case with many other psychiatric conditions, there is no clearly defined cause for the disorder. However, several factors have been implicated, some of which are:

Neurochemical imbalance: Certain chemicals in the brain, when imbalanced, result in symptoms of this disorder.

Genetic causes: Research has consistently shown that mood disorders tend to run in families, pointing toward a possible genetic connection. So far however, the specific gene involved in the manifestation of symptoms has not been identified. All that is known is that there could be a genetic predisposition to bipolar disorder.

Environmental factors: Factors such as a dysfunctional home atmosphere, physical or sexual abuse and alcoholism are said to aggravate symptoms. Again, research is not conclusive about this.

What are the treatment options?

Unfortunately, there is no simple, straightforward ‘cure’ for bipolar disorder. It is a chronic condition that calls for long-term management and a multi-pronged treatment approach.

Medication: This forms the first line of treatment. The medications primarily work on correcting the neurochemical imbalance, thereby reining in the symptoms. At times, medication may also be required to calm down the agitation, anxiety, and at times the aggressiveness that accompanies the disorder.

Psychotherapy: Counselling and therapy forms the other major arm of the treatment plan. Counselling helps patients and the families understand and come to terms with the disorder and its short- and long-term impact on their lives.

Alternative treatment modalities: More and more people are also turning toward alternative treatment modalities. Homoeopathy, ayurveda, reiki, hypnotherapy are treatment options that are known to have some beneficial effect on reducing the frequency and intensity of the manic and depressive episodes.

Other than this, there are several ways to minimise the onset of symptoms. If you have been diagnosed with bipolar disorder, here are some things you must bear in mind:

Recognise your triggers: Usually [though not always] there are certain things that trigger an episode for you. This could be anything ranging from conflict with a loved one, stress at work or engaging in a particular activity. Try to understand what ‘sets you off’ either into a manic state or hurtles you into depression. Once you have identified your trigger, stay away from it to the extent possible.

Maintain a healthy lifestyle: Erratic eating and sleeping patterns are known to exacerbate the symptoms of mood disorder. Thus, try to ensure adequate sleep and proper meals on time to ensure that your body is functioning smoothly and optimally.

Build a strong support network: Let people around you know of your disorder and its manifestations. Make sure they know what to do, especially if you have a sudden manic episode.

Join a support group: It helps to know that you are not alone. A support group puts you in touch with others who are sailing in the same boat, and there is so much scope for learning from peoples’ experiences.

Indulge in your hobbies: Spending time doing activities that you enjoy is immensely calming. Giving this kind of time to yourself also helps centre yourself, so you focus on things that matter to you. This is one of the best stress-busters you can create for yourself.

Erratic eating and sleeping patterns are known to exacerbate the symptoms of mood disorder

Learn relaxation techniques: Learning any technique or tool that helps you relax deeply will help you manage your mood better. Yoga, Vipassana, Brahma Vidya and Pranayama are some techniques that can help you achieve relaxation.

How to support someone suffering from bipolar disorder?

There are a lot of big and small ways in which you can support a loved one, a friend or a colleague who may be suffering from bipolar disorder.

Remain non-judgmental: This is the best gift that you can offer someone who may be suffering from the disorder. Often, these people tend to be very hard on themselves, especially after they are out of the cyclic phase, and find it difficult to come to terms with their own behaviour as it is contrary to their usual personality. Being supportive and non-judgmental can go a long way in making them feel accepted.

Keep calm: It can be hard to live with a person who tends to shuttle between extreme emotional states. It is almost like handling two different persons. Be patient and calm. It is easy to get irritated by someone who acts in reckless, impulsive and insensitive ways. At such times, remember that it’s not the person but the illness that is making them behave in these ways. It can be equally frustrating when the same person is depressed and talks of ending his life. Again, try to keep perspective, and know that this too, is a phase.

Educate yourself: Learn as much as you can about the disorder. It will help you to understand the person and his symptoms and you will learn ways to handle him in both manic and depressive states.

While it is true that there is no known cure for bipolar disorder, it can certainly be managed—so much so that a person suffering from it can lead a healthy and happy life. Accepting the disorder, and having a positive, proactive approach toward its management is the key to normalcy.

This was first published in the June 2015 issue of Complete Wellbeing.

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