Dealing With The Uncertainty of Bipolar Disorder Episodes

What is Bipolar Disorder?

Bipolar disorder is a mental health condition that is marked by severe and sudden shifts in mood.(1) A person with this illness tends to experience an extremely elevated mood known as mania, to extreme depression.(2) While some people experience these mood shifts several times a year, others rarely encounter them. This depends on which type of bipolar disease you are diagnosed with. There are four main types of bipolar disorder, and the symptoms of the disease vary according to the kind of bipolar disorder you have.(3) It is expected that nearly 2.8 percent of adults in the United States alone are affected by bipolar disorder.(4) At the same time, an estimated 82.9 percent of people with bipolar disorder are known to have a serious impairment, which is one of the highest percentages of serious impairment among any type of mood disorder.(5) While the symptoms of the illness depend on which type of bipolar disorder is diagnosed, some symptoms tend to be shared in most people.

These include:

  • High level of anxiety
  • Irritability
  • Trouble concentrating
  • Experiencing mania and depression at the same time
  • An inability to feel happy when good things happen
  • Lack of interest in most activities
  • Psychosis that causes a detachment from real-world happenings, usually resulting in delusions and hallucinations(6)

If you have a family member, friend, or a partner with bipolar disorder, it can be challenging to deal with the uncertainty that this condition brings with it. Here’s how you can help and deal with the uncertainty of bipolar disorder.

Dealing With The Uncertainty of Bipolar Disorder Episodes

Dealing with Uncertainty During a Manic Episode

When a person with bipolar disease undergoes a manic episode, they are likely to experience feelings of high energy, creativity, and even joy. They are expected to talk very fast, sleep very little, and are prone to act in a hyperactive manner. They are also likely to feel invincible, which can increase the likelihood of indulging in risky or impulsive behavior.(7)

Here are some of the common symptoms you can observe during a manic episode:

  • Extreme irritability
  • Unusually optimistic or ‘high’ attitude
  • Abundant energy

Unreasonable beliefs about one’s power or skills – they are likely to criticize family members or partners for being beneath them or less accomplished than themselves

  • Rapidly jumping between different ideas
  • Being easily distracted
  • Having trouble concentrating or focusing
  • Reckless behavior with no thought about consequences
  • Impulsiveness behavior combined with poor judgment
  • Delusions and hallucinations (though this is less commonly observed symptoms)

During these manic episodes, a person with this condition is likely to act recklessly and go as far as endangering themselves or the lives of people around them. (8) It is important to remember, at this stage, that this person does not have full control over their actions during manic episodes. Therefore, trying to reason with them to stop behaving in a dangerous way is unlikely to work.

This is why it is essential that caregivers or family members need to keep an eye out for the warning signs that follow before a manic episode. This helps you react accordingly and keeps you more prepared. While people with bipolar disorder are known to have different symptoms, there are some common warning signs as well, such as:

  • A sudden surge in energy and talkativeness
  • Very rapid lift in mood
  • Unrealistic sense of optimism
  • Sudden onset of irritability and impatience
  • Expression of unreasonable ideas
  • Spending money in irresponsible ways

How you react during a manic episode has to depend on the severity of the person’s actions during this period. In many cases, doctors recommend that the medication dosage should be increased, medication might be changed, or they may even advise that the person should be admitted to the hospital for treatment. This prevents the person from harming themselves or their near and dear ones during the high of a manic episode. However, convincing such a person to go to the hospital is not going to be an easy task since they feel excellent during these episodes and are confident that there is nothing wrong with them.

It is best to avoid indulging any of their unrealistic and grand ideas, as this will only increase the likelihood of engaging in risky or irresponsible behavior. Talking calmly to the person and encouraging them to contact their doctor will help.

Many people find it challenging to live with a person with bipolar disorder, primarily due to the negative behavior exhibited during the manic episodes. Having an honest discussion with them while they are not in the midst of a manic episode and getting them counseling might be helpful. Joining a support group, talking to other family members for support, talking to their doctor, and educating yourself about this mental health condition can help you deal with such uncertainty during a manic episode.(9)

Dealing With Uncertainty During A Depressive Episode

This does not mean that dealing with a bipolar person through a depressive episode is any less challenging. It can be equally tough to help them through an episode of depression. Here are some of the commonly observed symptoms of a depressive episode in people with bipolar:

  • Irritability
  • Feelings of hopelessness and sadness
  • Inability to feel happy while doing activities they used to love
  • Loss of energy
  • Fatigue
  • Changes in weight or appetite, including suddenly gaining weight and overeating, or eating too little and losing weight
  • Problems with sleep, including sleeping too little or too much
  • Feelings of physical and mental lethargy
  • Feelings of guilt or worthlessness
  • Thoughts about suicide or death

During a depressive episode also, doctors recommend a change in medication, increase in the dosage, or admitting the person in a hospital, especially if they are having suicidal thoughts and have tried to harm themselves.(10)

It is better to have a well-thought-out plan for dealing with depressive episodes even when your loved one is not showing any symptoms. This is because often when an episode is going on, you are unlikely to have the motivation or energy to come up with such a plan at that time.(11)

It is best to listen attentively, offer coping advice, and try your best to boost them up by drawing attention to their positive attributes.

Remember that talking in a non-judgmental way and offering to help with their day to day activities and chores may prove helpful.

Conclusion

It is essential to realize that there is no cure for bipolar disorder, and it is a lifelong condition. It can often feel like a significant challenge to care for a person with this condition, and it is necessary to take care of your own needs as well. Keep in mind that without proper treatment, the symptoms of bipolar disorder are only going to get worse. It is always best to seek immediate treatment if you notice any sudden changes in their symptoms or behavior. Keep their doctor in the loop about what is happening and make sure that they take their medications on time.

There are many support groups online, and at hospitals as well that help families and friends of people with bipolar disorder. Over time, most people with bipolar disorder can continue to manage their condition and go on to live a happy and healthy life.

References:

  1. Miklowitz, D.J. and Johnson, S.L., 2008. Bipolar disorder. John Wiley & Sons Inc.
  2. Müller-Oerlinghausen, B., Berghöfer, A. and Bauer, M., 2002. Bipolar disorder. The Lancet, 359(9302), pp.241-247.
  3. Grunze, H., 2015. Bipolar disorder. In Neurobiology of brain disorders (pp. 655-673). Academic Press.
  4. Nimh.nih.gov. 2020. NIMH » Bipolar Disorder. [online] Available at: <https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml> [Accessed 26 July 2020].
  5. Kessler, R.C., Chiu, W.T., Demler, O. and Walters, E.E., 2005. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), pp.617-627.
  6. Baethge, C., Baldessarini, R.J., Freudenthal, K., Streeruwitz, A., Bauer, M. and Bschor, T., 2005. Hallucinations in bipolar disorder: characteristics and comparison to unipolar depression and schizophrenia. Bipolar disorders, 7(2), pp.136-145.
  7. Najt, P., Perez, J., Sanches, M., Peluso, M.A.M., Glahn, D. and Soares, J.C., 2007. Impulsivity and bipolar disorder. European Neuropsychopharmacology, 17(5), pp.313-320.
  8. Chandler, R.A., Wakeley, J., Goodwin, G.M. and Rogers, R.D., 2009. Altered risk-aversion and risk-seeking behavior in bipolar disorder. Biological psychiatry, 66(9), pp.840-846.
  9. Russell, S.J. and Browne, J.L., 2005. Staying well with bipolar disorder. Australian & New Zealand Journal of Psychiatry, 39(3), pp.187-193.
  10. Isometsä, E.T., Henriksson, M.M., Aro, H.M. and Lönnqvist, J.K., 1994. Suicide in bipolar disorder in Finland. The American journal of psychiatry.
  11. Oquendo, M.A., Galfalvy, H., Russo, S., Ellis, S.P., Grunebaum, M.F., Burke, A. and Mann, J.J., 2004. Prospective study of clinical predictors of suicidal acts after a major depressive episode in patients with major depressive disorder or bipolar disorder. American Journal of Psychiatry, 161(8), pp.1433-1441.

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