Bipolar Disorder Information: Treatment and Support Questions

Q: How can I tell bipolar disorder from depression?
A: Bipolar disorder is a condition characterized by periods of euphoria, or mania, and episodes of depression. Such mood swings are typical for all patients, but can differ from person to person ranging from mild to severe. Periods of euphoria may last for several hours or even months, but then the patient is likely to go back to depression; this repeats throughout life and can get worse if left untreated.
It’s sad, but it’s a fact: depression and bipolar disorder are often confused, which leads to incorrect diagnoses and complications. It happens because the periods of euphoria, characterized by great mood, increased energy levels and sex drive are not interpreted as a problem by the patients; so they are likely to tell their doctor only about something they see as a problem – the periods of depression.
Depression and bipolar disorder are different conditions, although the former may be one of the symptoms of the latter. People with mania are likely to make decisions without giving them careful consideration, which may cause unnecessary and serious consequences. At the same time, accurate diagnosis and proper bipolar disorder treatment will let the person live a normal life without any complications.
If you realize that your diagnosis may have been wrong, you need to talk to your doctor as soon as possible and tell him about the episodes you missed during the previous visit. There are a number of tests you can take to determine whether there is any probability that you have any other symptoms of bipolar disorder. Living with bipolar disorder is not easy, but it’s always best to know if you have it or not instead of hoping it’s merely a depression.

Q: Is there any difference between bipolar disorder and unipolar depression?
A: If someone has already experienced an episode of mania or hypomania, the diagnosis is most likely some kind of bipolar disorder. In case of hypomania it may also be cyclothymia.
If it’s impossible to determine whether the person in depression experienced the episodes before, there are some things that can help diagnose bipolarity.

People diagnosed with unipolar depression are not likely to display certain symptoms or have some conditions; so if they do, the chances are the diagnosis has been inaccurate:
-    Sleeping too much when depressed
-    Bipolar disorder in close relatives
-    Eating too much when depressed
-    Ability to laugh and joke when depressed
-    History of frequent depressive episodes
-    Sensitivity to rejection
-    History of taking lithium or being diagnosed with bipolar syndrome, except for the cases when it was necessary to take lithium to potentiate antidepressants

However, it doesn’t mean that a person with unipolar depression cannot sleep or eat more than usual. All these signs and conditions are for you to be able to detect the disease earlier, but if you have any doubts it’s always best to talk to your doctor.

Q: What is dysphoric mania and dysphoria?
A: This is another name for dysphoria, which is quite a vague term used by some people to characterize mood disorders. The term itself may be confusing as it’s used in different meanings.

In general dysphoria is the feeling of being ill at ease, which is very general, as pretty much any illness can be described this way. Some dictionaries define it as a form of anxiety, but they all miss the point, not giving the idea of the way dysphoria is present in the patient.
So, while some people use this term to characterize the feelings during a manic episode others may use it for episodes of depression. In fact, because of its vagueness dysphoria really can describe both conditions.

Here are the main symptoms of dysphoric mania:
•    Confusion
•    Indecisiveness
•    Loss of sleep
•    Persecutory delusions
•    Suicidal or racing thoughts
•    Aural hallucinations
•    Grandiosity
•    Restlessness (physical agitation)
•    Crying
•    Trouble making decisions

Dysphoric depression perceived by many people as a mixed case is characterized by intrusions of hypomanic symptoms into a major retarded depressive episode. So, while the patient is experiencing depression, he or she may also have overactivity or hypomania. Here are some symptoms:
•    Fatigue
•    Guilty ruminations (feeling guilty)
•    Anxiety
•    Pressured speech
•    Panic attacks
•    Enhanced libido (extra sex drive)
•    Irritability and sudden anger
•    Intractable insomnia (serious trouble falling asleep and staying asleep)
•    Behaving in a melodramatic way about the depression

Q: I’ve heard about Post-Traumatic Stress Disorder. What exactly is it?
A: Post-Traumatic Stress Disorder (or PTSD) is a psychological condition, characterized by anxiety, withdrawal, and a proneness to physical illness that may follow a traumatic experience. Although this is different for different people, the most common traumatic events include rape, kidnapping, military operations, catastrophes, torture, mugging, child abuse and other events that make the person feel extremely helpless and terrified.
Many PTSD patients are not able to get rid of thoughts, nightmares and flashbacks that make their symptoms even worse. Some of these symptoms include: feeling of being estranged, trouble falling asleep, trembling, sweating, racing heart and shortness of breath. If these symptoms continue for longer than a month, you need to talk to your doctor as the probability of having PTSD is quite high. Just like with other mood disorders, it’s not enough to wait till everything goes away on its own.

It has been estimated that PTSD has been found in as many as 5.2 million US citizens. According to the studies, 70% of people will go through something that can be characterized as a traumatic event; 8% of men and 20% of women are likely to develop PTSD after such an experience.
PTSD is commonly treated with psychotherapy and a combination of drugs (mostly SSRIs – selective serotonin reuptake inhibitors). SSRIs help the brain correct the imbalance of serotonin. There is another group of drugs – SNRIs (serotonin-norepinephrine reuptake inhibitors) that correct the imbalance of two chemicals at the same time – serotonin and norepinephrinel.

Q: How can I make sure the treatment for bipolar disorder I’ve been prescribed is working for me?
A: Living with bipolar disorder means taking drugs for a lifetime. The changes that happen if your bipolar disorder treatment method is working are obvious: you feel better both emotionally and physically. If your emotional response (its intensity) alters, it means you are on the right track.
However, you really need to listen to your body to understand something is changing, as it is more of a gradual movement ahead. The period of time necessary for every patient to feel the changes is different and depends on the severity of the condition and a number of personal characteristics. Some of these changes are subtle enough, so recognizing them may take time and a bit of patience.

Here are some signs that may indicate your treatment for bipolar disorder is efficient:
•    Certain events that used to elicit abnormal emotional response (crying, irritation) do not have the same effect anymore.
•    You become less obsessed with certain ideas and objects than before; your thoughts become more organized and are not fragmented that much. Even though you may still experience fatigue, your mind is able to concentrate and you can think more clearly. This is likely to only improve with time.
•    Your constant “triggers” – be that people or events – are not so irritating for you anymore. You feel you are able to talk to them or participate in them and they don’t cause such strong negative emotions in you.
•    Something that used to cause the feeling of anxiety doesn’t bother you that much anymore, and you can look at it soberly and clearly. However, be careful with this sign, as if you are also taking benzodiazepines, this may indicate you are developing an addiction. Talk to your doctor to make sure drug interaction will not affect your health and well-being in any way.
•    Sadness is now different from depression for you. Now you may feel sad, but it doesn’t mean you will feel depressed, as you are able to stop it right there. The feeling of sadness is likely to go away within a 24 hour period. The symptoms of bipolar disorder that you always experienced along with sadness are not present anymore: trouble thinking, numbness, sick stomach and tearfulness.

Bipolar disorder treatment is quite easy once the doctor has established the exact dosage and combination. The purpose of treatment is not to simply relieve but to eliminate all the symptoms of bipolar disorder. There are many things you can do to ensure maximum effectiveness of the process. Make sure you get plenty of bipolar disorder information and try different techniques, as some of them don’t work for everyone. If you feel positive changes but think you could do better, tell your doctor about it and he may agree to adjust the dosage accordingly. Do not attempt to do it yourself.
A lot of patience is needed to go through treatment, so don’t hesitate if you feel you need bipolar disorder support from your relatives and friends or a qualified professional. Give yourself a promise that you will continue the treatment during a certain period, which should be enough to see if it’s effective for you or not. Even if you experience mild side effects, this may be worth trying as you will know for sure how this or that medication affects you. The most important period for you is the very beginning of a new method of treatment (several weeks), as some side effects can be unpleasant and no obvious changes are happening, but you need to stick to the plan and talk to your doctor if any questions arise.

However, it’s not rare for people to get disappointed and give up their medication just because of some symptoms and their own impatience. Even though some meds do not work for everyone, you shouldn’t drop the medication prescribed by your doctor just because you think it’s not working and are not wiling to give it some time.

Another very important thing is bipolar disorder support: if there is something in your life you can share everything with, or you know there is a local support group, do not hesitate to use their help. Your family, friends and support groups will help you keep going even when you feel like giving everything up. You may need to call the person you trust if you feel like doing something you shouldn’t, such as skipping a dose, for example. You also need to give your loved ones all the bipolar disorder information they may need to help you.

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