One of the most read articles on my blog is The Effect of Complex PTSD Among People With Bipolar Disorder and this week I have been receiving a lot correspondence about Bipolar disorder. Here is some concrete information on the disorder and it’s relationship to PTSD.
Bipolar disorder, also known in some parts of the world by its older name, “manic depression,” is a mental disorder that is characterized by serious and significant mood swings. A person with this condition experiences alternating “highs” (what clinicians call “mania“) and “lows” (also known as depression).
Both the manic and depressive periods can be brief, from just a few hours to a few days. Or the cycles can be much longer, lasting up to several weeks or even months. The periods of mania and depression vary from person to person — many people may only experience very brief periods of these intense moods, and may not even be aware that they have the disorder.
According to the American Psychiatric Association, there four major categories of bipolar disorder: bipolar I disorder, bipolar II disorder, cyclothymic disorder, and bipolar disorder due to another medical or substance abuse disorder (APA, 2013). Anyone can be diagnosed with bipolar disorder, but bipolar disorder in children is called disruptive mood dysregulation disorder and carries a different set of symptoms.
All types of bipolar disorder generally respond well to treatment, which usually includes medication management for many years and for some, psychotherapy. Like many mental disorders, professionals generally don’t talk about a person being “cured” of this condition, so much as learning to manage it well. Medication and psychotherapy help a person do that.
Learn more: Frequently Asked Questions
People often have common questions about the basics of manic depression. These are some of the most commonly asked questions — and their answers — about manic depression (also known as bipolar disorder):
Is there a test to tell me if I have, or may inherit, bipolar disorder?
Currently, no test can tell a person if he is at risk of developing bipolar disorder. It is unlikely that a single gene will be discovered that is responsible for the illness in all people with bipolar disorder.
Can someone have a medical condition that appears to be bipolar disorder but actually is something else?
Certain conditions mimic mood disorders, including bipolar disorder. Common ones are:
- thyroid conditions
- neurological diseases, such as multiple sclerosis, brain tumors, stroke, or epilepsy
- infections of the brain from conditions such as HIV infection, syphilis, sleep apnea, and lyme disease
- deficiencies of certain vitamins, such as vitamin B12
- corticosteroid use, especially in high doses
- medicine used to prevent diseases like tuberculosis and AIDS
Telling your doctor about your medical history and the medications that you are currently taking can help her determine the cause of your condition.
What if someone I know has bipolar disorder?
Family members may want to express their concern by describing the specific behaviors to that person in a nonjudgmental fashion. The person with the disorder is less able to dismiss the observation if there is a consensus among friends or family members that a distinctive pattern has emerged.
At the work site, violations of safety codes or negligence may need to be reported to supervisors so that the person can receive a medical evaluation before injury or disability occurs.
If I am diagnosed with bipolar disorder, will I be on medication for the rest of my life?
Not necessarily. However, patients are encouraged to stay on medication indefinitely if an episode was very frightening or associated with great risk to their health, finances, or family relationships.
Is there anything I can do to help my disorder?
Yes. First, learn all you can about your illness by reading books, going to lectures and talking to your doctor. Get support from others who also have the illness.
How can lifestyle affect bipolar disorder?
Lack of a consistent routine and disrupted sleep can trigger a mood episode. Choosing work and leisure activities that allow proper sleep and rest is vital to healthy emotional functioning. Families can support good mental hygiene by going to bed and getting up at the same time each day.
Symptoms of Bipolar
For bipolar disorder to be diagnosed, a person needs to have experienced at least one manic (or in bipolar II, hypomanic) episode, and one depressive episode during their lifetime.
A manic episode (bipolar I disorder) is characterized by extreme happiness, extreme irritability, hyperactivity, little need for sleep and/or racing thoughts, which may lead to rapid speech. People in a manic episode feel like they can do anything, make plans to try and do all those things, and believe that nothing can stop them. For bipolar I to be diagnosed, this episode must have lasted at least a week and represents a noticeable change from a person’s usual behavior.
A hypomanic episode (bipolar II disorder) is characterized by the same symptoms as a manic episode, except the symptoms need to only have been present for at least four (4) days.
A depressive episode is characterized by extreme sadness, a lack of energy or interest in things, an inability to enjoy normally pleasurable activities and feelings of helplessness and hopelessness. On average, someone with this condition may have up to three years of normal mood between episodes of mania or depression.
When left untreated, the severity of episodes can vary. People with this condition can often predict when a new cycle is starting, as the severity of their symptoms increase.
Causes & Diagnosis
As with most mental disorders, researchers are still not certain what causes this condition. There is no single risk factor, gene, or other predisposition that puts a person at increased risk for bipolar disorder. It is likely a combination of factors increases a person’s risk. According to research, these factors may include a different brain structure and way of functioning, a set of genetic factors, and family history (as this disorder tends to run in families).
Bipolar disorder, like most mental disorders, is best diagnosed by a trained mental health professional — such as a psychologist, psychiatrist, or clinical social worker. While a family physician or general practitioner may offer a preliminary diagnosis, only a mental health specialist offers the experience and skills necessary to diagnose this condition reliably.
Bipolar Disorder Treatment
According to researchers at the National Institute of Mental Health (NIMH), the exact cause of bipolar disorder is not yet known — but it can still be effectively treated. Research is ongoing about finding the most effective treatments.
Like most mental disorders, this condition is treated with psychotherapy combined with psychiatric medications (most people benefit more quickly from combined treatment of the two). Treatment for this disorder is generally effective and helps most people keep a balanced mood throughout their day, most days of the month. It may take anywhere from one to two months before a person starts feeling the full, beneficial impact of their treatment.
Self-help strategies for this condition vary in their effectiveness, depending upon the person and the severity of the disorder. Some people find it beneficial to join a support group, read books explaining effective self-help strategies, or keeping a journal (either paper or through a mood or journaling app).
One of the biggest challenges of treatment of bipolar disorder is finding and maintaining a treatment routine that works best for a person over the long-term. Most people with this condition benefit from medications for much of their life, but it can be a challenge to stick with the medications when all seems well years down the road. Commonly prescribed medications for this disorder include a mood stabilizer (like lithium), while some treatments may also involve the use of additional medications (like an atypical antipsychotic or, in some cases, an antidepressant).
Living With & Managing Bipolar
There are many challenges to living with this condition on a daily basis. What are some of the long-term, successful strategies to staying well, sticking with treatment, and maintaining a balanced mood?
One important component of living with this condition is learning to build routines and sticking with them, no matter what. What can often drive a person into a manic or depressive episode is going off of their routine, or deciding one day that the mood stabilizer that helps them regulation their moods is no longer needed.
These articles were written to help a person learn to live more successfully with this condition:
- Living with bipolar disorder
- Building a successful routine that works
- The 4 Keys to Managing Bipolar Disorder
- Helping Your Partner Manage Bipolar Disorder
There are many ways to get started in your journey of recovery from bipolar. Many people start by seeing their physician or family doctor to see if they really might suffer from this disorder. While that’s a good start, you’re encouraged to also consult a mental health specialist right away too. Specialists — like psychologists and psychiatrists — can more reliably diagnose a mental disorder than a family doctor can.
Watch a short video about bipolar disorder
The Relationship Between Bipolar Disorder and PTSD
Studies have found that anywhere between 11% to 39% of bipolar patients also meet criteria for PTSD. It is not entirely surprising that high rates of PTSD are found among people with bipolar disorder, as many people with bipolar also have a history of traumatic exposure.
Traumatic exposure may be more likely to occur during a manic episode when a person with bipolar disorder is more likely to make risky or impulsive decisions. In addition to being a risk factor for the development of PTSD, traumatic exposure during childhood, such as childhood physical or sexual abuse, may also be risk factors for the development of bipolar disorder.
The Effect of PTSD Among People With Bipolar Disorder
Having PTSD along with bipolar disorder can have a major negative impact on your life. People with PTSD and bipolar disorder appear to have more problems across a number of different areas in their lives. For example, PTSD has been found to reduce the quality of life for people with bipolar disorder. It has also been found to make the bipolar disorder worsen, resulting in more rapid cyclingand increased risk for suicide attempts. Finally, PTSD has also been found to be associated with greater levels of depression among people with bipolar disorder.