Bipolar Disorder

Carolyn Phelps, Ph.D

December 17, 2013

I hope everyone had a nice Thanksgiving! What a wonderful show we had on Thursday, December 12, 2013, and I think we will all agree that Heather Bates was the star of the evening.  She so graciously agreed to share her story with us and what a remarkable story it is!

Just to recap, Heather’s main point is that there is hope and with treatment, a person can get better.  I think another significant point was that Heather really hung in there having seen different treatment providers and being prescribed different medications until she could be diagnosed correctly and was prescribed the medications that now work for her.  Heather also said it was not just medications that helped in her recovery.  She was very clear that psychotherapy has helped her immeasurably. 

So, just to recap, here are the facts about Bipolar Disorder:  

With Bipolar Disorder, there are two distinct mood phases, a depressed phase and a manic phase (or hypomanic phase in “Bipolar II” Disorder).  In the depressive phase of the illness, people experience a number of symptoms from the following symptom group: 

  • Sadness.
  • Hopelessness.
  • Suicidal thinking or behavior.
  • Excessive guilt.
  • Problems in sleep, appetite, fatigue, energy level and sex drive.
  • Loss of interest in activities generally considered to be enjoyable. 
    In the depressive phase, people often become isolative and describe themselves as lacking in ambition or motivation. 

In contrast, during a manic phase, people will typically either experience euphoria or irritability and may experience a number of the following symptoms: 

  • Inflated self-esteem or grandiosity.
  • Poor judgment.
  • Rapid speech where others in particular can identify that the person speaks faster than normal.
  • Racing thoughts.
  • Agitation.
  • Increased energy.
  • Decreased need for sleep.
  • Increased sex drive.
  • Easily distracted.
  • An urge or actually engaging in risky behavior, which often includes spending sprees or unwise financial decisions. 

Symptoms are grossly impairing in either one of these phases.  Treatment with a mood stabilizer medication plus psychotherapy is the standard treatment of choice.  Other support services may be necessary as well.

Here are some of the other questions we did not get to:

QUESTION:  What are the causes of Bipolar Disorder? 

ANSWER:  We do not know the exact cause but we do know that there are several factors that may come into play regarding whether a person develops Bipolar Disorder.  These include chemical imbalances in the brain, structural changes in the brain, hormonal imbalances and genetic factors (Bipolar Disorder is more common among family members in families with a person with Bipolar Disorder).  

QUESTION:  A caller asked what are the resources available when your son is over 18 and has been diagnosed with Bipolar Disorder?

ANSWER: The resources available to your son are the same.  What has changed is that he will need to access the services himself unless he is an immediate danger to himself or others.   One of the best recourses available to family members is NAMI, the National Alliance on Mental Illness.  Check out the NAMI Duluth website.  It lists both support groups and family education workshops that they run. 

QUESTION:   A caller wanted to ask the guest what she would do if she did not have the support from family members in order to deal with “her lows.” 

ANSWER:  If a person does not have the supports then the first thing they need to do is to go about building supports.  That can start with building support through treatment providers but also may include accessing support groups.  Again, NAMI would be a good first choice for that.  Dr. Glick mentioned two websites, the NIMH website and the Manic-Depressive Association website.  

QUESTION:   A caller asked can children develop Bipolar Disorder?

ANSWER:  Yes, children are diagnosed with Bipolar Disorder.  However, Bipolar Disorder is still a relatively rare disorder and is even more rare in young children.  The difficulty with Bipolar Disorder is that prior to the full syndrome expressing itself, symptoms can manifest themselves as other disorders.  If you are concerned that your child could have Bipolar Disorder, you should see a mental health professional (you do not need a referral from your primary care physician in order to access mental health care).  The American Psychiatric Association has adopted a new diagnostic category “Disruptive Mood Dysregulation Disorder” to account for the extreme temper tantrums found in a small minority of children which are persistent over time and do not appear to be solely out of opposition.  These children may have been diagnosed previously (and perhaps overly so) with Bipolar Disorder which in the end may not have been the best diagnosis to describe the mental illness the child was manifesting.  Diagnoses exist to help inform and direct us to which treatment might be most effective for the person with the illness – just like in physical illnesses. 

Thanks to all of you who called in.  We had a whopping number of calls, which was fun.  On our next show Maria Bamford, a nationally renowned comedian and Duluth native, will be joining me on the set.  Bring your popcorn!  We will not be taking any questions for that show but I think you will find the conversation enjoyable as she openly talks about coping with her own mental health problems over the years.  See you Thursday night, December 19, 2013, at 7:30.

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