Preston John D. - Bipolar 101: a Practical Guide to Identifying Triggers, Managing Medications, Coping with Symptoms, and More

This chapter will give you a broad research-based overview of bipolar disorder, including its symptoms, course, diagnosis, treatment, and management, as well as state-of-the-art knowledge gleaned from reliable sources such as the National Institute of Mental Health, classic texts, and current academic literature.

You may ask, whats the difference between the blues, happiness, or depression and bipolar disorder? Although everyone has shifts in mood (for example, anger, sadness, or happiness) related to his or her surroundings and life circumstances, people with bipolar disorder (also known as manic-depressive illness) experience unusual, and sometimes drastic, shifts in mood, energy, thoughts, behavior, and ability to function that are out of proportion or unrelated to their environments. Moods swing from extremely high or irritable to sad and hopeless with short or extended periods of stable mood in between. These shifts in mood are called episodes and are chronic (that is, recurrent over time) and severe in intensity of symptoms.

The use of new brain-imaging technology, such as magnetic resonance imaging (MRI), positron-emission tomography (PET), and functional magnetic resonance imaging (fMRI), have begun to give clues to the process of bipolar disorder in the brain. These technologies have revealed differences in the brains of people with bipolar disorder and those of people without the disease.

The body of research on bipolar disorder points to instability in the transmission of nerve impulses in the brain, which is related to the brains biochemistry. This tendency toward mood instability is considered to be genetically transmitted. People with this biochemistry are more vulnerable to emotional and physical stresses, and the negative impact of stress on treatment is reduced effectiveness. Stress is also a major trigger for the onset of symptoms (Kleindienst, Engel, and Greil 2005).

Although the cause of the disease has not yet been identified, the known triggers for episodes are amenable to intervention and prevention. The major triggers are lack of sleep and high levels of stress. Trauma has also been known to trigger bipolar episodes.

Trauma and Bipolar Disorder

Recent studies have found that childhood trauma does not directly causebut does hastenthe onset and severity of bipolar disorder. Children who had been abused were more likely to have early onset, in adolescence or earlier (Leverich and Post 2006; Garno et al. 2005).

Action Step 1.1: Assessing YourExperience of Past Trauma

Consider writing about any past history of childhood trauma in your life. However, if this trauma still negatively affects your life, you should only consider doing this exercise under the supervision of a mental health practitioner, because it may be emotionally difficult. If you feel ready to write about your experiences, do so in as much detail as possible, mentioning times, places, people, and details of what occurred. Dealing with this trauma can often be a significant piece of treating your bipolar disorder and may help explain other symptoms or co-occurring mental illnesses that you may have. You will want to discuss this with your mental health care provider or in a self-help group.

Increasing your knowledge about your illness and doing the series of exercises in this book will help you better understand bipolar disorder and its impact on your life. Doing these exercises gives you useful information that you can share with your mental health care provider, and it also can help you manage your symptoms, avoid your triggers, and get control of your life. First, start to understand your emotions, because bipolar disorder is about swings between extremes of the emotional spectrum. Keeping track of your emotions will help you see patterns that can be useful in deciding how and where you can make changes in your life that might relieve you of some of bipolar disorders devastating impacts.

Normal Mood Changes or Bipolar Disorder?

The most marked symptom of bipolar disorder is significant shifts in mood from a high feeling, sometimes associated with irritability (mania), to sometimes-severe feelings of sadness and hopelessness (depression).

These episodes can occur over years or within weeks, days, or even hours, depending on the rate of cycling, the period between mood swings. Symptoms for episodes can be mild, moderate, or severe. The various mood states can be viewed as on a continuum, with people who have bipolar disorder experiencing the extremes of the range.

Symptoms of Mania

According to the Diagnostic and Statistical Manual of Mental Disorders