BipolarChatroom

Monday, 30 January 2012

BipolarChatroom Blog 4

What I want to do with this blog is go back to the very beginning and define what Bipolar Affective Disorder/Manic Depression actually is. I've discussed my experiences in great detail, and will continue to do so, but what is it? It's definition needs to be known before we can actually have a full understanding of it and then we can have some kind of idea how to 'manage' it on a day-to-day basis.
Do all of us actually know what we are suffering from?

What is Bipolar Disorder?

Bipolar Disorder used to be called 'manic depression'. As the older name suggests, someone with Bipolar Disorder will have 'mood swings', sometimes severe. These can last several weeks or months and are far beyond what most of us experience. They are:-

* Low or 'depressive' feelings of intense depression and despair
* High or 'manic' feelings of extreme happiness and elation
* Mixed eg, depressed mood & the restlessness of overactivity of a manic episode

Over the years, I have had my fair share of all three of the above emotions. The third being most common for me now. Ever since I lost my job I have had more 'lows' than 'highs'. It doesn't mean to say that I don't get them anymore, they're just far and few between. I experienced a few highs the other week, but I find with the highs, they exhaust me and I can feel myself, as the day moves on, getting 'back down to earth' which, for me, brings on a low and I end up feeling depressed.

How common is Bipolar Disorder?

About 1 in every 100 adults has Bipolar Disorder at some point in their life. It usually starts during or after the teenage years. It is unusual for it to start after the age of 40. Men and women are affected equally. I was diagnosed at 27, so I fit into that category.

What types of Bipolar Disorder are there?

If you thought that there was just one type of Bipolar you would be wrong. I didn't realise the different types until I looked it up. I thought if you were diagnosed 'Bipolar' that was it, like asthma, but it appears not.

Bipolar I

*There has been at least 1 high or manic episode, which has lasted for longer than 1 week.

*Some people with Bipolar I will have only manic episodes, although most will also have periods of

depression.

*Untreated, manic episodes generally last 3 to 6 months.

*Depressive episodes last rather longer - 6 to 12 months.

Bipolar II

There has been more than 1 episode of severe depression, but only mild manic episodes - these are called 'hypomania'.

Rapid Cycling

More than 4 mood swings happen in a 12 month period. This affects around 1 in 10 people with Bipolar Disorder , and can happen with both types I and II.

Cyclothymia

The mood swings are not as severe as those in full Bipolar Disorder, but can be longer. This can develop into full Bipolar Disorder.

What causes Bipolar Disorder?

The brain, even to this day, and after years of studies, is a very complex thing and enough is still known about it and what causes Bipolar, but research suggests that:

*Bipolar Disorder runs in families & can be hereditary - it seems to have more to do with genes

than upbringing.

*There may be a physical problem with the brain systems which control our moods - this is why

Bipolar Disorder can often be controlled with medication.

*Episodes can sometimes be brought on by stressful experiences or physical illness.

What does being Bipolar feel like?

Depression

Obviously this will depend on which way your mood has swung.

We all experience depression from time to time. It can even help us to recognise and deal with the problems in our lives, but in Clinical Depression or Bipolar Disorder, the feeling of depression is worse. It goes on for longer and makes it difficult or even impossible to deal with the 'normal' things in life. If you become depressed, you will notice some of these changes :-

Emotional

feelings of unhappiness that don't go away
feeling that you want to burst into tears for no reason
losing interest in things
being unable to enjoy things
feeling restless and agitated
losing self-confidence
feeling useless, inadequate and hopeless
feeling more irritable than usual

Thinking

can't think positively or hopefully
finding it hard to make even simple decisions
difficulty in concentrating

Physical

losing appetite and weight
difficulty in getting to sleep
waking earlier than usual
feeling utterly tired
constipation
going off sex

Behaviour

difficulty in starting or finishing things - even everyday chores
crying a lot - or feeling like you want to cry, but not being able to
avoiding contact with other people

Mania

Mania is an extreme sense of well-being, energy and optimism. It can be so intense that it affects your thinking judgement. You may believe strange things about yourself, make bad decisions, and behave in embarrassing, harmful and - occasionally - dangerous ways.

Like depression, it can make it difficult or impossible to deal with life in an effective way. A period of mania can affect both relationships and work. When it isn't so extreme, it is called 'hypomania'.

If you become manic, you may notice that you are :-

Emotional

very happy and excited
irritated with other people who don't share your optimistic outlook
feeling more important than usual.

Thinking

full of new and exciting ideas
moving quickly from one idea to another
hearing voices that other people can not hear

Physical

full of energy
unable to sleep
more interested in sex

**A magic eye design**

Behaviour

making plans that are grandiose and unrealistic
very active, moving around very quickly
behaving unusually
talking very quickly-other people may find it hard to understand what you're talking about
making odd decisions on the spur of the moment, sometimes with disastrous consequences
recklessly spending your money
over-familiar or recklessly critical with other people
less inhibited in general

If you are in the middle of a manic episode for the first time, you may not realise that there is anything wrong-although your friends, family or colleagues will. You might even feel offended when someone tries to point this out to you.

You increasingly lose touch with day-to-day issues-and with other people's feelings.

Psychotic symptoms

If an episode of mania or depression becomes very severe, you may develop psychotic symptoms.

In a manic episode-these will tend to be grandiose beliefs about yourself-that you are on an important mission or that you have special powers and abilities.
In a depressive episode-that you are uniquely guilty, that you are worse than anybody else, or even that you don't exist.

As well as these unusual beliefs, you might experience hallucinations-when you hear, smell, feel or see something but there isn't anything (or anybody) there to account for it.

Between episodes

It used to be thought that if you had Bipolar Disorder, you would return to normal in between mood swings. It is now known that this is not the case for many people with Bipolar. You may continue to experience symptoms and problems in thinking even when you seem to be better.

Bipolar Disorder may result in you to stop driving for a while. Visit the DVLA website for further information.

Treatments

There is a lot of medication out there today. A lot more than when I was first diagnosed 12 years ago.

The main ones for Bipolar Disorder are those to try and control your mood swings and keep them stable, as this is the 'main' symptom of Bipolar Disorder, and to also treat a manic or depressive episode. See the picture below regarding mood swings:

You can see that the top of the arrow is 'severe mania' when you are in manic mode.

The middle is 'normal/balanced' mood. This is how you would expect a person without Bipolar Disorder to feel.

The bottom is the opposite of the 'severe manic' mood which is 'severe depression'.

The two in between are quite self-explanatory.

There is also further medication out there to help combat Bipolar Disorder. If you don't feel like your medications are not working, or you are not feeling any better then please see your GP or Psychiatrist, if you have one, as they may be able to offer you alternative treatment or additional medication.

Stopping the mood swings-helping yourself

Self-monitoring

Learn how to recognise the signs that your mood is swinging out of control so you can get help early. You may be able to avoid both full-blown episodes and hospital admissions. Keeping a mood diary can help to identify the things in your life that help you-and those that don't.

Knowledge

Find out as much as you can about your illness-and what help there is. I will give you further sources of information at the end of this blog of places you can further help and advice from.

Stress

Try to avoid particularly stressful situations-these can trigger off a manic or depressive episode. It's impossible to avoid all stress, so it may be helpful to learn ways of handling it better. You can do relaxation training with Cd's or DVD's, join a relaxation group, or seek advice from a clinical psychologist.

Relationships

Depression or mania can cause great strain on friends and family-you may have to rebuild some relationships after an episode.
It's helpful if you have at least one person that you can rely on to confide in. When you are well, try explaining the illness to people who are important to you. They need to understand what happens to you-and what they can do for you.

Activities

Try to balance your life and work, leisure and relationships with your family and friends. If you get too busy you may bring on a manic episode.

Make sure that you have enough time to relax and unwind. If you are unemployed, think about taking a course, or doing some volunteer work that has nothing to do with mental illness.

Exercise

Reasonably intense exercise for 20 minutes or so, three times a week, seems to improve mood.

Fun

Make sure you regularly do things that you enjoy and that give your life meaning.

Continue with medication

You may want to stop your medication before your doctor thinks it is safe-unfortunately this often leads to another mood swing. Talk it over with your doctor and your family when you are well. Never stop taking your medication until you have seeked advice from your doctor.

Have a say in how you are treated

If you have been admitted to hospital for Bipolar Disorder, you may want to write an 'advance directive' with your doctor and family to say how you want to be treated if you become ill again.

What can I expect from my GP? (England & Wales only)

If you are taking Lithium or any other medication for your Bipolar Disorder, your GP is now expected to give you an annual physical health check. This will include :-

a blood pressure
weight
smoking and alcohol use
plasma glucose levels
lipid levels-for all patients over the age of 40

A Lithium check will need to be done everyn3-6 months and a blood test for thyroid and kidney function at least every 15 months.

Advice for family and friends

Mania or depression can be distressing-and exhausting-for family and friends.

Dealing with a mood episode

Depression

It can be difficult to know what to say to someone who is depressed. They see everything in a negative light and may not be able to say what they want you to do. They can be withdrawn and irritable, but at the same time need your help and support. They may be worried, but unwilling or unable yo accept advice. Try to be as patient and understanding as possible.

Mania

At the start of a manic mood swing, the person will appear to be happy, energetic and outward-going-the 'life and soul' of any party or heated discussion. However, the excitement of such situations will tend to push their mood even higher. So try to steer them away from such situations. You can try to persuade them to get help, or get them information about the illness or self-help.

Practical help is very important-and much appreciated. Make sure that your relative or friend is able to look after themselves properly.

Helping your loved ones stay well

In between mood episodes, find out more about Bipolar Disorder. It may be helpful to go with your friend or loved one to any appointments with the GP or Psychiatrist. I have been with my mum on numerous occasions to appointments, whether it be to the GP or Psychiatrist, and I personally found it to help. Also, the person you take with gets a better understanding of your condition.

Staying well yourself

Give yourself space and time to recharge your batteries. Make sure that you have some time on your own, or with trusted friends who will give you the support you need. If your relative or friend has to go into hospital, share the visiting with someone else. You can support your friend or relative better if you are not too tired.

Dealing with an emergency

In severe mania, a person can become hostile, suspicious and verbally or physically explosive.
In severe depression, a person may start to think of harming themselves.

If you find that they are:-

seriously neglecting themselves by not eating or drinking
behaving in a way that places them, or others at risk
talking of harming themselves

get medical help immediately.

Keep the name of a trusted professional (and their telephone number) for any such emergency. A short admission to hospital may be needed.

Doing this blog and going though all the information I found on the internet has definitely 'opened my eyes'.

I have been diagnosed 12 years and have found things out even I didn't know!

|It does make you think though as I have had a lot of the symptoms mentioned:-

feeling i'm the 'life and soul' of the party when on a high.
feeling 'worthless' and like 'nothing' when I am majorly depressed.
not being able to sleep.
racing thoughts as though my brain is going 'twenty to the dozen'.
weight gain.
having people I know not able to brace the subject of 'depression', so they carry on as per usual and I feel isolated.
recklessly overspending. I once went to Debenhams and spent, I think, £250 on various aftershaves. The blog mentions overspending in a manic mode, but I would also overspend in a depressive mode to try to cheer me up.
losing contact with friends, but not necessarily rebuilding these friendships, as these people chose to 'not' see my depression, being ignorant.
wanting to be on my own.
not wanting to go out of the house.
getting frustrated easily.
finding it difficult sometimes to talk about how I feel.
crying for no reason.
unable to cry when I feel I should be doing so.
repeating myself (which is not mentioned, but I have been told this is a symptom).
feeling paranoid.
feeling i'm being judged for having a Mental Health condition.
affecting my job. Well, I got dismissed from my job of 14 years.
feeling tired a lot of the time
avoiding contact with other people.
worrying.
restless nights.
difficulity in making simple decisions.
lack of concentration.
short attention span.
thinking a lot.

I bet many of you can make a list like me, and I suppose it makes you realise, seeing it in black and white, you do actually have a disorder. Now i've seen what I have researched, I feel 'i do have something wrong with me'. Half of what I have written has never been discussed by my Psychiatrist!!

I said I would list some support groups and caring organisations for those with Bipolar:-

Bipolar UK

11, Belgrave Road, London SW1V 1RB: tel 020 7931 6480; email : mdf@mdf.org.uk

Provides support, advice and information for people with Bipolar Disorder, their friends and carers.

Bipolar Fellowship Scotland

Tel: 0141 560 2050. Provides information, support and advice for people affected by Bipolar Disorder and all who care for them. Promotes self-help throughout Scotland, and informs and educates about the illness and the organisation.

Depression Alliance

Tel: 0845 123 23 20: email information@depressionalliance.org. Information, support and understanding for people who suffer with depression, and for relatives who want to help. Self-help groups, information, and raising awareness for depression.

Journeys - towards recovery from depression

Tel: 029 2069 2891: email: info@journeysonline.org.uk

Welsh organisation which supports people affected by depression.

Samaritans

Tel: 08457 90 90 90 (ROI 1850 60 90 90): email: jo@samaritans.org. Confidential, non-judgemental support 24 hours a day by telephone and email for anyone who is worried, upset or suicidal.

A lot of the information I gathered for this Blog came from The Royal College of Psychiatrists' Public Education Editorial Board.

I would like to thank them, as without them, I couldn't have written this Blog.