Bipolar disorder is better known as manic depression. In the case of bipolar disorder, the mood is disrupted. Bipolar literally means ‘two poles’. The mood alternates between ‘downwards’ and ‘upwards’. The one time someone is depressed (silent, gloomy) and the other time manic (busy, apparently cheerful). This pattern usually only becomes visible over time, if someone has already gone through one or more periods of mania and depression.
Bipolar disorders are much less common than depression. It is estimated that one percent of adults in the Netherlands suffer from manic depression. The bipolar disorder is therefore not a rare condition. About as many men and women have to deal with it.
Symptoms of bipolar disorder
In bipolar disorder, periods of depression alternate with periods in which the mood is extremely cheerful, elated or busy.
Characteristics of depression The most important characteristics of depression are:
- a gloomy, depressed mood that lasts longer than two weeks
- not being able to enjoy things or not having fun anymore; constant tiredness, no energy, the feeling that everything takes effort
- think, move and react more slowly or are very restless and hunted
- sleeping problems, such as not being able to fall asleep and waking up too early or having an excessive need for sleep, being unable to get out of bed in the morning, wanting to stay in bed all-day
- eating problems, such as no longer having an appetite with losing weight or, on the contrary, tending to eat excessive amounts
- increased irritability, be irritated faster
- problems with concentration, difficult thoughts to keep track of for a longer period of time, difficult to make decisions
- a negative self-image, a negative image of others and a negative image of the future
- thoughts of death and / or wishes. More information about depression can be found in the doctordokter.nl information folder ‘Depressive disorder’
Characteristics of mania In addition to one or more depressive periods, bipolar disorder also always involves at least one manic period. Mania can be recognized by an extremely cheerful, excited or irritable mood. Such a manic period must last at least a week and is accompanied by one or more of the following characteristics:
- great ideas, for example, the idea of being very special and capable of great achievements. These ideas can take the form of delusions, for example being Jesus or being able to fly. Other psychotic characteristics, such as hallucinations, can also occur
- a reduced need for sleep, whereby someone sometimes sleeps only a few hours a night and still feels rested
- very talkative, unable to stop talking
- very easily distracted by small things
- engage excessively in activities that involve certain hazards. For example, spending huge amounts of money in a short time while sometimes incurring large debts and frequent unsafe sexual contact
People who are manic usually do not complain about their symptoms. They often feel great and do not realize that something is wrong. Family members and friends are usually the first to notice that someone behaves very differently than normal. They see it, for example, by changes in appearance, such as clothing or makeup that does not suit someone.
A manic period often starts suddenly, after which it can quickly get worse over the course of a few days. The periods often last from a few weeks to months and can also end quite suddenly. It is not uncommon for the mood to turn into depression. About sixty to seventy percent of manic periods occur immediately before or after depression. The depressive periods usually last longer than the manic.
How does bipolar disorder develop?
Research shows that in bipolar disorder, biological factors such as congenital vulnerability play a greater role than in depression. This is evident from, among other things, the fact that first-degree family members of people with bipolar disorder are more likely to get the disease.
If someone has this vulnerability, he or she is more likely to end up in mania or depression, especially after periods of stress. The average starting age of a bipolar disorder is around twenty, but there are also people who already start it at puberty, or much later in life.
There are many drugs (drugs, drugs) that can cause manic symptoms. That is why it is always important to check whether this can occur. There are also physical disorders that produce manic characteristics, without bipolar disorder. This concerns, for example, certain neurological disorders, such as multiple sclerosis, metabolic diseases, certain forms of cancer and all kinds of infections.
Is it serious and what can you expect?
Manic depression is a disorder that does not pass. If you have had a manic period, there is a good chance (around ninety percent) that you will experience problems again in the future.
How often someone goes through a manic or depressive period can vary greatly. There are indications that the time between periods becomes shorter as someone gets older. Most people do not suffer from complaints between periods. For some people complaints of lability, problems in contact with others or work problems remain in between.
Although the disorder does not pass, manic depressed people with the right support and guidance are often perfectly capable of leading a pleasant and productive life.
When to the doctor?
If you suspect that you or someone in your area is suffering from bipolar disorder, it is always wise to contact your doctor. He can check with you if your idea is correct and refer you to an expert, usually to a psychiatrist.
Medications: Medications are very important in the treatment of the bipolar disorder. They must be used for a long period of time, often throughout life. The best-known agent is lithium, but there are also other so-called mood stabilizers. The medication must restore the balance in the brain so that someone is no longer (extremely) unbalanced. These remedies do not ‘cure’, but can prevent excessive outliers.
After stopping the medication, the chance of the return of violent mood changes will increase sharply. The medication is prescribed by a psychiatrist, who will also continue to regularly monitor how the disorder develops. The dosage of lithium is very precisely tailored to the person and regularly checked in the blood.
Therapy In addition to prescribing medication, in many cases another form of therapy is recommended. The purpose of this may be to adjust the lifestyle, for example. Structure and regularity are of great importance for manic-depressed people. Disruptions in the daily rhythm can have major consequences. They must also learn to cope with the fact that they have an illness that they probably cannot cure and for which they have to use medication for the rest of their lives. This is often difficult to accept.
Having this disease can also affect important people in a person’s environment, such as partners, family members, and children. Relationship or family therapy can help with this.
Admission Sometimes a temporary admission to a psychiatric hospital may be necessary. This may be the case if the mood is so seriously disturbed that there is a danger for the patient or his environment. For example, a person can be so depressed that he wants to end his life.
But a manic period can also take dangerous forms, the person sometimes no longer knows what he is doing and sees no more dangers. In extreme cases, a forced admission (against the will of the patient) may be necessary. The duration of a recording varies depending on how quickly someone recovers. When the danger has passed and the mood is somewhat stabilized, someone will return to their own environment. The thread will be resumed there under supervision.
What can you do about it yourself?
For someone with bipolar disorder, stability is very important. You can try to ensure that this stability is compromised as little as possible. Here are some advises:
- Make sure you lead a regular life. That means adequate sleep at regular times, adequate and healthy eating and drinking and regular relaxation. It is best not to deviate too much from this fixed daily routine
- Ensure that the stress does not rise too high and intervene in time when this threatens to happen. Set your limits and make it clear to others
- Watch out with alcohol and drugs. These resources can get you off the balance that is just as important
- Make agreements with important people around you (your partner, family, friends) about what they can and cannot expect from you. You can also find out with them how they can possibly help or assist you in difficult times
General advice and precautions
Bipolar disorder is a serious condition that has a major impact on your life. Talk to others about this so that you are not on your own. Try to express and share your feelings, such as sadness, fear, and anger. Healing of bipolar disorder is not possible.
Manic depressed people, however, with the right support and guidance are often perfectly capable of leading a pleasant and productive life. There are indications that people with bipolar disorder are often above average creative. Many manic-depressed people also indicate that their valleys are very deep, but that they feel better at the top of their mood than ‘normal’ people will ever feel.