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Bipolar Disorder

According to the National Institute of Mental Health, about 4.4% of Americans are affected with bipolar disorder sometime during their lives. PhD level psychologists and psychiatrists (who are MDs) are the most qualified to make a diagnosis. Similar symptoms can be induced by certain drugs (including alcohol), or caused by a medical condition like Cushing's disease, multiple sclerosis or stroke. So, you need a qualified person to make the diagnosis.

Bipolar disorder was previously called Manic-Depression, or Manic-Depressive Psychosis because the illness is characterized by wild mood swings. All of us have days when we’re up and feel energized, as well as days when we feel down in the dumps. That’s normal. People with bipolar have extreme manic phases when they have so much energy, they work nonstop without sleeping, sometimes for days, followed by episodes of deep depression where they may become suicidal. Their highs are higher and their lows are lower.

Medication is needed for anyone who is bipolar because the disease is caused by an imbalance in chemicals in the brain. A psychiatrist is by far the best person to prescribe medication for any mental illness, and will also want to follow up regularly to adjust the dosage. Too much can be toxic. Too little won’t do much good. It’s very likely that you’ll need to take medication the rest of your life. That’s ok.

But medication is not a cure-all. The medicine will knock out the extreme highs and the extreme lows so that you can work with a therapist to balance and integrate the lows and highs.

Bipolar disorder is currently classified in two types. Bipolar I Disorder is the designation given to people who have episodes of depression followed by episodes of mania or hypomania. Mania and hypomania are the same thing, except hypomania is milder and lasts for a few days, whereas mania can go on for weeks or months. Hypomania and mania are periods of over-active and excited behavior that can have a significant negative impact on your life.

Bipolar II is the designation given to people who have had at least one major depressive episode and at least one hypomanic episode, but never had a manic episode. Just to confuse things further, there is also cyclothymic disorder, which is the same thing only milder still.

The depressive stage of bipolar is dangerous because it can lead to suicide. Like any deep depression, you are sapped of energy, feel hopeless, sluggish, disinterested, and disconnected. People in the depressive phase want to get out of it.

In some ways, the manic (or hypomanic) phase is even more dangerous because you feel on top of the world. You feel highly creative, full of almost supernatural energy; you are over-confident, feel invincible, are full of swagger. You might even feel like you’re a genius. You may get narcissistic. Some people are also be highly angry and irritable.

It is in the manic phase that people spend themselves deeply into debt, ruin their credit, destroy good relationships, are attracted to highly toxic relationships, and create a plethora of marital, familial, financial, interpersonal, and legal problems for themselves and others. People in the manic phase often love the high and won’t listen to warnings until they crash and burn.

And then the cycle repeats.

There’s no more shame in being bipolar than there is in having high blood pressure. It’s genetics and neurochemistry, not sin or choice. You can’t just snap out of it.

Bipolar Disorder is very treatable.

First, you (or your loved on) need a qualified person to make an accurate diagnosis.

Second, you need a psychiatrist to find and prescribe the right medication at the right dosage for you.

Third, you need a good therapist skilled in helping you recognize your triggers and bring your highs and lows into balance.

And finally, I’d highly recommend spiritual direction with an elder in the faith. Spiritual direction and therapy fit nicely together – the latter addressing emotional issues, and the former drawing us deeper into the ever-loving heart of God.

God loves you. God wants you to be whole.

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