What Is Bipolar Disorder? – A Complete Guide

The ancient Greeks used to consider bipolar disorder as a divine gift from the gods!

A divine gift! Wow!

“Mania” and “melancholia” were the first two diseases ever categorized. Even Socrates and Plato understood that mania was a religious state with various characteristics. These characteristics included “erotic inspiration” sent from the god of love or “protreptic inspiration” derived from the Muses. They even say that the god Apollo is the source of this divine inspiration! 

The term bipolar is good in that it has raised public awareness of what the condition really is. In Britain, the term “bipolar” didn’t really pick up among the general public until after 2000.

Before then, the public viewed a “manic depressive” as someone prone to severe depression, and manic depression was seen as severe depression. The science behind this is incredible. Typically, people go undiagnosed for several years after their first experience with bipolar disorder, and some people even get the wrong diagnosis.

It is common to have your first episode during puberty. However, some people don’t have an episode until their early twenties.

Bipolar can also cause hallucinations, delusions, and paranoia when either in extreme mania or depression. Most people aren’t informed about that and only talk about mood changes. It’s a dangerous illness. It hurts every time the mood changes.

Simultaneously, the hope to live reduces with every emotional feeling. And feeling hurts like physical pain. Anger, grief, pain, brokenness, and unreasonable happiness are all part of it. You can even hallucinate certain things, like someone next to you, following you, and criticizing you.

Common Complaints from Patients

  • Hearing some voices when you are in depression. 
  • A high headache like some stone is kept in your head or someone is pulling your head is a significant physical pain.
  • Moreover, acting like you are happy and positive in front of others and crying alone, or if you are angry, you show it to yourself. Sometimes to suppress your emotional pain (depression or anger), physical pain helps, like scribbling your hand with sharp objects.
  • Most times, suicide comes to mind as a savior from all the pain and emotional cocktails, but family and scare of dying by self resist it. 
  • Lack of concentration in work and study, sleeping for long, eating more than you want, screaming, crying, punching at the wall, scribbling in hand, and being reckless are all things you remember when someone asks, “how was your day.”

The obstacle in treating manic depression in a person lacks any insight. Not only will they deny the problem, but they will blame external triggers for the elevated dopamine high as a form of addiction. They are addicted to their illness sometimes, and they ‘feel’ alive off the medicines. The problem is convincing them to break the addiction. 

10 Most Common Symptoms of Bipolar Disorder

It is a debilitating disorder that makes everyday life feel almost impossible to live through. It is commonly called out through discrimination and enables a person to live life with uncertainty.

Bipolar Disorder is actually unpredictable due to rapid cycling and mixed episodes at times. It is known to shorten the lifespan of that individual. It’s no joke living with bipolar or living with some who have bipolar.

Many don’t understand it and choose to walk away (nothing wrong with that). But those who choose to understand, stay, and help that person is always a blessing.

We suggest holding on to those people because as long as you are open and honest about your moods, how you feel, and when they start, it helps prepare better working progress to assist the person helping you deal with your episode. They have patterns we may not pick up on, but their loved ones can tell if and when they slip into them.

This is a big help to ease the episode making it more manageable than uncontrollable and undetected episodes. Suicidal tendencies are not a cry for help for those who have bipolar, especially if that person can not see a way out.

It’s as accurate as any other action and intention that an average person does to “better” their circumstances in life. It can happen so fast for bipolar individuals that they have no idea what they are, in fact, doing due to the intense emotion they are feeling.

Every day is a struggle, a rollercoaster, or an uncertainty. Medication may help, but it does not take it away. It’s a constant work in progress, and those who have it are courageous and strong.

This is one of the most unpredictable illnesses due to its spectrum. Doctors can not formulate a specific plan or criteria to isolate the cause because of the behavior and inconsistencies it regulates.

Every bipolar patient is different from the next. It’s a game of trial and error. Unfortunately, that can cause significant disadvantages in their lives, hence why most bipolar cases go untreated.

Yet, the most common symptoms are:

  1. Mood swings
  2. Cycles of depression
  3. Risky behavior 
  4. Intense multitasking or energy
  5. Grandiosity or feelings of importance
  6. Talking faster than normal
  7. Difficulty concentrating.
  8. Extreme irritability or Agitación 
  9. Irregular sleep
  10. Changes in appetite

Types of Bipolar Disorders

People with bipolar disorder mostly show extreme, disturbing, and intense emotional states. These are known as mood episodes.

Extreme excitement or happiness (mania) and melancholy (depression) are symptoms of mood episodes. People who have bipolar disorder can also have normal moods occasionally. However, we must be careful not to replace one lousy stigma with another. 

Explaining this disorder by associating it with wildfires, car crashes, prostitution, talking to god, emergency psychiatric hospitals, etc., is heavy-handed and, potentially, narrow-minded.

Using these descriptors alone may harm the reputation and self-esteem of people trying to converse with loved ones, employers, colleagues, educational institutions, etc. Bipolar comes in many forms and presents in many ways. There are many ways it is treated and many levels of manageability.

There are various types of bipolar disorders based on factors such as period, intensity, episode durations, etc.

  • Bipolar Disorder Type 1

Hypomania and Depression (Full blown episodes).

Patients have been seen displaying more depressive episodes than manic, and the depression episodes are so severe and last months at a time. The longest being around 6 months. Dome manic episodes last from 5 to 14 days.

At times many may go up and down constantly. While experiencing depression episodes, people have no appetite, tend to lose so much weight, and lose interest in everything.

Patients often say that they just want to sleep forever. When they’re manic, they can not sleep, are hyper, more outgoing, and tend to spend money they shouldn’t be spending due to impulsive issues.

People display signs of:

  • Distractibility – cannot sit still or finish any task
  • Impulsivity – doing things without thinking, rash thinking
  • Grandiosity – inflated sense of self 
  • Flight of ideas – ideas coming out one after the other very quickly 
  • Agitation or activity level increase
  • Tending to not need sleep
  • Rapid and pressured speech
  • Bipolar Disorder Type 2

Hypo Mania and Depression (symptoms will not be as prominent as type 1). Knowing that every person who has bipolar can present differences.

Based on other people’s episodes of bipolar 1, diagnosing this type started with observing patients with catatonic depression lasting for three months, which improved with ECT.

This threw them into a mania with many of the symptoms described above for another three months, not reaching psychosis that time, for they weren’t treated correctly and were instead put on antipsychotics.

These patients show signs of:

  • Mood swings, irritable bowel migraine, electrical epileptic type symptoms
  • Hypomania usually makes one lose sleep for up to 3 or 4 days
  • Loss of appetite 
  • Irritability, confusion, and distress
  • Episodes of meltdowns with lesser frequency yet high intensity 
  • They are often too curious 
  • They will display distractibility, impulsivity, and grandiosity, along with talking too much.
  • They all of a sudden have a flight of ideas.
  • Bipolar Disorder 3: Cyclothymia 

If not treated, Cyclothymia can develop into Bipolar. Insomnia can be one of its symptoms. Some patients use melatonin, up to two pills per time, for 7-8 hours of sleep. There are other options.

Most like this one because it’s the least addictive. Patients also use Solstice, a natural energy booster, and Emergen-C for colds and also as an energy booster. Most have found counseling very helpful. Cyclothymia can cause one to have sudden onset of suicidal feelings. They are so strong that people have acted on them or made extensive plans for a long time. 

People with this type of disorder show the following symptoms:

  • High phases in Cyclothymia aren’t as high as hypomania. 
  • They have been seen overeating and displaying a lack of appetite.
  • They tend to overeat at times. Then have normal eating times.
  • Constant mood swings
  • A sudden boost of energy
  • Often over work or could seem fixated 
  • They can have chronic energy loss and spend months in bed every day. Only getting out of bed for 5 minutes at a time.

What is Hypomania?

Hypomania is not a “milder” version of mania. It is like you have more of an uncomfortable amount of energy. You feel more friendly and awkward in a way that you can’t really control yourself.

For example, you call your least favorite relative out of the blue just to chat, reach out to a toxic ex, or contact a Facebook friend you haven’t spoken to in years. Still, you have nothing particular to talk about. You can also become hyper-focused on specific tasks and become extraordinarily anxious/irritable. You may say stuff you don’t mean or do something you usually wouldn’t do.

The other significant difference is the length of these episodes. Not to mention mixed episodes, which are pretty standard.

Another critical point is the prevalence of comorbidities (for example, eating disorders and ADHD are pretty common in conjunction with bipolar, which will impact experience and treatment options). It is challenging to bring all these different experiences together.

Hence you can’t generalize these disorders. You need to let the people who have them share their unique conditions and journey. This will allow them to get help and mitigate the difficulties with this condition.

The bipolar community shares some basic things, but all have different versions of the disorder, and it’s important to remember that it won’t look the same for everyone. Even the treatment won’t be the same for everyone. And we should preface any discussion with “if you are experiencing these, or any other mental health symptoms, speak to a professional”

 How to Analyze a Person with Bipolar Disorder?

Psychiatrists and mental health professionals in the US are paid using diagnosis codes. There is a DSM-5 list that covers every mental health disorder and the criteria that comes under it to meet them.

At the moment, complex post-traumatic stress disorder does not come under the DSM-5. So mental health professionals have left a quandary.

They can’t diagnose their patients with CPTSD and get paid for treating them. This leaves doctors and therapists no choice but to choose bipolar disorder or another mental health challenge as their client’s diagnosis.

Many doctors believe that nearly everyone who destroys their circadian rhythm abuses stimulants and faces hardship. They would undoubtedly see changes in their serotonin/dopamine/brain-derived neurotrophic factor production.

Ultimately changing gray matter/brain cells in return. Is Bipolar Disorder causing this, or are these things causing it?

It seems people don’t have a specific BPD disorder so much as they’re creating circumstances that allow for a Bipolar Disorder expression. BPD would then, to some extent, live in everyone waiting on the right triggers.

Mania is not something that sneaks up on you and is not something anyone could ever misunderstand. Mania is insane. It involves someone talking and describing things in a way that no average person could ever understand.

People who misunderstand mania think it’s like someone being super excited about something. This is totally incorrect. Someone suffering from mania will actually make a lot of sense, except when you look down on it as a passive observer. It’s almost impossible to explain, except to those that have met people on meth.

An example would be a guy who wakes up after being depressed for several weeks. This is essentially their brain accidentally or incorrectly saving up all the happy hormones. And these happy hormones will be released in one giant wave into their brain. They will almost always have some insane plan for making money.

 Manic episodes can be triggered easily. They’re usually terrifying and make the sufferer feel like they’re out of control, sometimes with accompanying delusions and psychotic symptoms.

Many patients who have bipolar disorder also have ADHD. A large Danish study from 2018 found some exciting things about the relationship between bipolar disorder, anxiety, and ADHD.

The incidence rate of bipolar disorder has been 2.17 in individuals with no prior diagnosis of ADHD and pressure, 23.86 in individuals with a previous diagnosis of ADHD only, and 66.16 in those with a primary diagnosis of ADHD and anxiety.

Meaning that the combination of ADHD and anxiety increased the risk of bipolar disorder THIRTY-FOLD compared with those with no previous ADHD or anxiety. Studies are still being carried out to understand the relationship between ADHD and bipolar disorder.

The Connection between Bipolar Disorder and Previous Drug Addiction

When discussing bipolar disorder, people often think hypomania and mania are the same.

Why?

Because they invoke a sense of invulnerability and elevation that feels blissful and euphoric. Even though it can feel that way at first, that state of overdrive and hypersensitivity to everything becomes quite uncomfortable and even painful.

People around those with bipolar disorder can’t see what that sufferer is feeling. A lot of impulsive behavior can be driven (usually subconsciously/instinctively) by that state of discomfort to ease the unrest and hyperdrive.

This impulse can manifest in many ways. The underlying pain is a significant catalyst for substance abuse; the desire to feel good but to numb the extreme discomfort that underlies mania and hypomania. The experience is different for each person who falls within the bipolar spectrum.

From personal experience and those who share their own, all express this simultaneously uncomfortable bliss. Despite its painfulness, hypomanic and manic states still seem better to feel intensely than to be in the heavy and numbed state of major depression.

For example, driving a car at high speed is exhilarating and fun. Still, when the engine revs too high, the vehicle vibrates, and the driver can lose control with the slightest bump or diversion. There’s so much we’re still learning about genetics and most disorders.

Bipolar Disorder and Hypersexuality 

Many link hypersexuality to bipolarism. People say they have a sudden rush of sexual desire or a complete flip to sexuality (being gay) due to suffering from bipolarism. An insecure attachment explains it.

Studies have shown that securely attached people, according to John Bowlby have sex much less frequently than those who are insecurely attached. Disorganized attachment is associated with hypersexuality, substance abuse issues, impulsivity, gambling, run-ins with the law, etc. 

Patients usually have minimal concern for self-control/decency – which is often embarrassing after mania fades into depression/shame. It means they can’t be too discrete about the act or the location.

What helps many immensely to minimize fallout is:

  • Correct medication
  • Med compliance
  • Cbt and dbt classes
  • An understanding, non-judgemental therapist who holds them accountable
  • Keeping a diary to keep track 
  • Finding a partner who understands bipolar disorder and hypersexuality 

Medication That is Commonly Given for Bipolar Disorders

Lithium is most commonly given to patients to help with their bipolar disorder. Studies have shown that Lithium helps regulate mood. It works by lowering dopamine and glutamate, and it increases GABA and serotonin. It also up-regulates the brain-derived neurotrophic factor (Bdnf) receptor called miracle-gro for the brain.

It also increases the number of neurons in the prefrontal cortex, hippocampus, and amygdala. Lithium also reduces oxidative stress, commonly thought to be a mania trigger. It inhibits glycogen synthase kinase.

Lithium is neuroprotective. It lowers thyroid function, protects against mitochondrial dysfunction, decreases lipid peroxidation levels, and enhances cyclic adenosine monophosphate. It is a fantastic element for the brain and body.

Lithium is in the same column as the periodic table, with one free electron on the outermost shell. The way Lithium “inactivates” the Sodium channel. It does not inactivate anything. The shape of Lithium itself is the same as Sodium.

Thus, it can “sit” at the site of the sodium channel, preventing sodium binding and leading to activation. Preventing the activation is an inhibition process, not an inactivation process. By inhibiting the binding of Sodium, both polar emotional extremes cannot be swung either way: Bipolar Type 1: Manic and/or major Depression or Bipolar Type 2: Hypomanic plus Major Depression.

Most doctors have not even realized more about it than this, and that is how Lithium’s look-alike capability to sit in a Sodium channel will affect the Renal tubule system. This is more important during dehydration, where the renal cell works with ADH (Antidiuretic Hormone) to reabsorb Sodium via osmosis and reabsorb H2O.

The problem here is that Lithium can end up being reabsorbed instead. Lithium toxicity has a shallow threshold. Thus a dehydrated bipolar patient (who happens to be drinking alcohol outside during the summer) can be at significant risk for Lithium toxicity via the renal system trying to reabsorb Sodium than water at the distal convoluted tubules via V2 aquaporin.

Lithium carbonate has a narrow therapeutic and toxic range, and its concentration quickly changes according to the body’s hydration status.

Thyroid function tests, serum amylase, and blood urea & creatinine tests have to be performed regularly as Lithium is toxic to the thyroid, pancreas, and kidney.

Lithium carbonate is naturally occurring in the water supply of El Paso, Texas, one of the USA’s safest cities (over 500k people). The attack in August of 2019 was by an outsider. It’s a city with very low violent crime statistics. Many have said that the people there are charming.

Most patients take an antidepressant with Lithium. It also comes as a mood stabilizer called Lamotrigine. The early Romans used Lithium to treat madness. They would take people to soak in lithium springs.

Lithium is also a protective factor against suicidality. Very few patients with bipolar that were on Lithium for years developed something of an ultra-rare side effect called pseudotumor cerebri. Which increases the pressure on one’s head. Your body acts like you have a tumor, but you don’t. However, they were taken off immediately and were given C13H9NOSe, Ebselen as a potentially safer alternative to Lithium.

Lithium can also have serious side effects, like liver and kidney damage, lithium rash, and motor function impediments. All of these are monitored by your doctor, but if you have an unrelated condition that would also cause the same symptoms, like adult acne, rash, etc.

How to Manage Bipolar Disorder?

Those with bipolar disorder spend most of their time in a depressive state. The self-perception is that those hypomanic episodes are what “normal” should feel like.

Thus, they never consider that what they think of as usual isn’t actually normal. People with BPD achieve more, think faster, and function at a high level. When in those seemingly perpetual depressive episodes, family and friends tell them that they’re not themselves, they often get frustrated.

People are commonly misdiagnosed with depression. Such people may continue because the deceptive self-perception doesn’t recognize hypomania. When prescribed antidepressant medication that pushes some people with bipolar disorder into hypomania or mania, they feel that they are normal again.

We can only communicate what we can perceive, and usually, peoples’ self-perceptions are pretty distorted. This is why friends and loved ones must know what is best to approach patients who appear to be going through these mood cycles and encourage them to seek help. 

While it is difficult to cope with the illness, it is manageable. Many doctors recommend psychotherapy in a clinic/clinical hospital attached to a University (if possible). Art therapy helps many a lot, KIP as well.

KIP means you have to relax, go into a semi-unconscious mood, imagine a pond/meadow, etc., and what you see in it/feel attached to the picture. This will come alive through your unconscious, united with your conscious, and your thoughts/fears/anxieties hidden in your subconscious will come alive.

It is challenging and often makes you feel terrible before you feel better. Do not do this at home, only with a trained psychotherapist. The person will help you face yourself.

What is helping many patients today is to do something creative, like narrations -even on a CD as narrators, giving voices to different manga characters, custom campaigns in computer games (fan-made ones) not voiced before.

Also, drawing, writing poems, reading, etc. Even though it is hard to forget traumas you imagine as traumas or real ones, such as being beaten in broad daylight in the street, and nobody helps, not one person out of fear and ignorance.

Yet the same people always speak about tragic events they were involved in as a child. Such as a patient who saw her father beat her mother many times. And now she has major trusting issues with men. She sometimes acts out violently, followed by many other attributes such as being loving, welcoming, and caring.

This person has struggled to have relationships with others. The other was sexually assaulted at a very young age. While complaining about her parents not listening and not caring about the assault she went through at a young age. That person is not violent at all. But acts like her parents.

Demanding, working at times of having authority over others, and simply not acknowledging others’ emotions at times.

Many say what helps the most is meditation, music, and self-awareness. Take responsibility for your actions and thoughts, never judge others, and accept yourself for who and what you are. And lastly, living by the motto that everything happens for a reason and everyone is here for a reason and the most important things.

You must focus on having healthy relationships and creating boundaries against the people who stigmatize mental illness.

Conclusion

Physical exhaustion can overcome a hyperactive mind, and you will sleep. Exercise and work strenuous for hours. Opposite action for early prodrome includes sensory and psychological stimulation.

Deprive your mind off the stimulant it is seeking. If you want excitement, listen to ASMR (low voice recordings). The most significant part one would like to put out there is the “emerging personality family therapy technique.”

Keep reassuring yourself and negotiating whenever you feel like your Jekyll is growing unpleasant and irritable. Similar to code-switching, doctors believe we have a berserker mode that evolutionarily benefits us. 

Bipolar isn’t a complex illness to understand, yet casually drop the word mania in a convo, and people look at you like a newborn baby deer. It takes 10 minutes of reading or watching a video to put two and two together and figure out what it’s about.

People just want it out of sight and out of mind like they do with the homeless. It will be a long road for society to come to terms with mental illnesses while not blatantly discriminating and stigmatizing.