Bipolar: The Facts

All this time I’ve been talking about bipolar, mania and depression...but I’ve never actually formally described what these things are. I suppose I have assumed my expression of the experiences I have had have provided a description of the disorder. And I do believe experiences trump a cold clinical description any day. But there is so much misunderstanding and stigma surrounding Bipolar disorder, so today I thought I’d look at the facts. :)

Bipolar disorder is a universal mental illness. It doesn’t discriminate. People of all ages, nationalities and from all walks of life can experience bipolar. Perhaps this is due to the genetic component of the disorder. Scientists have identified several genes, including the Dysbindin, Neuregulin and G72  genes which when damaged contribute to Bipolar disorder. As such, bipolar tends to run in families, although episodes can be triggered by significant stressors, and in women, childbirth. It is estimated that about 1.1% of the population suffer from bipolar disorder

People with bipolar disorder are 50 times more likely to commit suicide than the general population. That is huge. The suicide rate for the average population is around 0.01%, in the Bipolar population it is around 13%. What’s more, nearly half of individuals with Bipolar disorder will attempt suicide at least once. Extreme depression and psychosis resulting from lack of treatment are the usual cause for suicide.

A bipolar depression is nothing less of horrific. Unlike Major Depression, often there is no apparent cause for bipolar depression. A bipolar depression can persist for months and may become so severe that psychosis results. Traditional anti-depressants used alone generally have little effect, and can even trigger manic episodes. Unfortunately, because many individuals affected by bipolar seek help during depression rather than mania (which may be enjoyable), they are often misdiagnosed with Major Depression and treated accordingly. Individuals who present with mania may be misdiagnosed with Schizophrenia. Consequently bipolar is one of the most difficult mental illnesses to correctly diagnose.

Symptoms of mania can include pressured speech (or talking REALLY fast), racing thoughts, needing less sleep and not feeling tired, grandiose beliefs (for example, I started to believe that I was superior to everyone else because I didn’t need sleep to function but they did), and general euphoria. People may become impulsive (e.g. spending lots of money, quitting their job) and promiscuous.  But there is a dark side to mania; during a manic episode people can quickly turn irritable and even aggressive. They may experience hallucinations and delusions.

There are three main types of bipolar disorder; Bipolar Type 1, Bipolar Type 2, and Cyclothymia. Bipolar 1 is often described as your classic manic depression. Individuals experience episodes of depression and ‘classic’ mania. Episodes are generally severe (particularly manic episodes) and often result in hospitalization.

Bipolar 2 is often described as a less severe form of Bipolar. But I’m not sure I agree with that. People with Bipolar 2 spend more time experiencing depression, which can be incredibly severe. While individuals with Bipolar 1 may have months or even years between episodes, those with Bipolar 2 are more likely to rapid cycle between episodes and experience chronic mood swings. People with bipolar 2 are also more likely to take their own life. However people with Bipolar 2 do not experience full manic episodes. They experience hypomania instead. Symptoms of hypomania are similar to mania, but on a lesser scale, and there is rarely any psychosis. As it was described to me once; during a board meeting someone with hypomania may talk excitedly and present many ideas. On the other hand, someone with mania may dance and sing upon the table. Hypomania is difficult to detect because it can be disguised as productivity. Hypomanic individuals often feel creative, complete many tasks and feel exceptionally confident.

Cyclothymia (or ‘Bipolar Lite’ as Stephen Fry once described it), is a milder of form bipolar where individuals experience mood swings from mild depression to emotional highs chronically over many years.

If you are wondering what type I am...I’m not actually sure ;) Out of curiosity I have asked two psychiatrists whether I am a Type 1 or 2 and neither were able to answer. One told me that she didn’t believe in ‘typing’, that if an individual had bipolar, they had bipolar. The other told me that it was very difficult to fit people into a specific box, that everyone experiences their own illness differently. Looking at the symptoms I can’t even decide for myself what I would be, and I’m guessing this may be the case for others too.

So there it is. A description of Bipolar disorder. I promise I will write about something more meaty next time ;)

An accurate representation of Steven and I ;)