I believe in knowing as much as you can about what you have been diagnosed with. If you don’t you are putting all of the control and life changing decisions into someone else’s hands. I’m not okay with that. I learned too late that just because a person has “Doctor” in front of their name it doesn’t necessarily mean they’re automatically right.
All of the information presented here is taken from College Curriculum that everyone needs to take to work in the Mental Health field. All of it is from 2017 so it’s up to date.
BIPOLAR DISORDER: Shifts in mood, energy and ability to function. Ranges from severe Mania to severe Depression.
- Biological: question of decreased gray matter in the brain.
- Neurotransmitter Imbalance
- Life events may trigger a mood disorder in someone with a genetic pre-disposition.
- First degree relative with Bipolar Disorder.
- Substance or alcohol abuse.
- Major life changes such as death of a loved one or other traumatic experience.
- Increased risk if person has existing mental illness.
- Substance/Alcohol use 60 to 70 % of people with Bipolar Disorder meet the diagnostic criteria for a lifetime history of substance abuse/dependence.
- Suicide/Suicide attempts
- Financial problems
ETIOLOGY: Early onset is more severe and harder to treat. Young people have more mood switches, mixed episodes, are sick more often and have a higher risk of suicide attempts. Theories of development are focused on biological, psychological and environmental factors.
PHYSICAL: There can be physical symptoms that occur with Bipolar Disorder. The more common ones are dehydration, poor nutrition, weight loss, asthma, bronchitis, hypothyroidism, migraines and gastric ulcers.
BIPOLAR DISORDER I
For a person to be diagnosed with Bipolar Disorder I they have to have had at least one week long manic episode that results in excessive activity, energy and alternates with depression or a mixed state of agitation and depression.
There are many aspects to Mania some of them include an extreme drive and energy, inflated sense of self-importance or grandiosity*, reduced need for sleep, excessive talking combined with pressured speech*, a personal feeling of racing thoughts or flight of ideas*, easily distracted by environmental events, unusual obsession with or over focus on goals and risky behavior.
RISKY BEHAVIOR includes indiscriminate spending or spending sprees, reckless sexual encounters or promiscuity, and taking financial risks like gambling or investments.
There are two types of Mania, Euphoric and Dysphoric.
EUPHORIC MANIA: Starts out as a wonderful feeling then turns dark as euphoria moves toward confusion and loss of control.
DYSPHORIC MANIA: This is a mixed state or agitated depression. There are depressive symptoms along with mania.
The “clinical findings” or outcome of medical research and diagnostics for Bipolar I are the following:
- Euphoria of manic episode causes patient to have little insight as to what they’re doing.
- Person can also be irritable.
- Spring and Summer seem to be peak periods.
- Person may believe they have special abilities outside the normal range of talents or training.
- Inflated self-esteem may reach delusional proportions.
- Goal driven energy that leads to poor judgement.
- Talking excessively.
- Answers questions at length when it isn’t necessary.
- Talks when no one else is listening or interrupts when others are talking.
- Shifts from one topic to the next.
Mania onset is fast in Bipolar I and can last a few days to months. It’s usually briefer than Depression and ends as abruptly as it begins.
Manic Episodes are usually followed by Depressive Episodes.
HYPOMANIA: Patients will have elevated mood and other classic symptoms but are usually not delusional or have hallucinations. Hypomania usually lasts no longer than 4 days.
Five or more symptoms need to be present during a two week period and represent a change in previous functioning.
Symptoms: Feelings of worthlessness, indecisive, guilt, difficulty thinking/concentrating, thoughts of death/suicide, Somatic symptoms, change in appetite/weight, sleep, motor skills, agitation, and loss of energy.
Assessment: Relies on clinical picture, history and response to medications. Structured interviews are helpful to gather relevant history and a medical evaluation is critical. Traditional psychological testing isn’t useful until the patient has been stabilized.
*grandiosity- Exaggerated unrealistic sense of importance
*pressured speech- Disturbed speech pattern where logical speech is replaced by loud rapid and confusing language.
*flight of ideas- Over productive speech with rapid shifting from one topic to another.
I’m going to stop here for now. As I was researching Bipolar Disorder and had the actual exams and study guides that Doctors, Therapists, Nurses, and other people working in the Mental Health field had I found myself becoming angry.
You could put a check mark next to almost every single symptom/criteria needed for a diagnosis of Bipolar Disorder for me.
It started at a young age and by the age of 21 I had already been court ordered to see two Psychiatrists, two Therapists and a Drug and Alcohol Counselor. Not one of them ever did a real assessment. All they saw in front of them was a young girl with low self-esteem who drank too much and maybe had anxiety. They would give me a 6 month supply of an antidepressant and send me on my way. Unfortunately some of what they gave me made things worse.
Over the years I would be court ordered to see more Psychiatrists and Therapists who still didn’t ask why I was drinking or what I was trying to escape or numb with alcohol. I told all of them that my family has an unusually high amount of mental illness from Bipolar Disorder, Borderline Personality Disorder and Schizophrenia. This included my Mom, Grandmother, and two of my Mom’s siblings. Her brother and sister were both diagnosed with Paranoid Schizophrenia. My Uncle hallucinated quite a bit but he was harmless, my Aunt on the other hand was manipulative and cruel.
The fact that I had to wait 25 years for a diagnosis is ridiculous and now has made me basically untreatable. I was given the wrong medications for years, I self medicated with alcohol for 20 years, manic and depressive episodes put me in situations that resulted in memories my brain won’t allow me to remember so I stutter and shake instead when I’m upset. My brain was nice enough to leave me with memories I wish it hadn’t that it likes to play on a loop when I’m having a really bad day which is often. I now here my own voice constantly whispering “They were right. No one will ever want you. You’ll never be pretty enough, smart enough, thin enough, good enough. No matter how hard you try you will always be that 250 pound fat drunken slob who slept with any guy to try to prove she was worth something.” I won’t get into the other things I hear.
It doesn’t help that the Generic Brand of Topamax changed their formula and I’m the one that has to suffer for it. It’s been pretty horrible I have to say. I have not thought of hurting myself in years. A few weeks on this new formula and that changed dramatically so I had no choice but to taper off of it for now until I can research a replacement. You would think my Doctor would do that but I don’t let him because they will go with whatever company has been by to push their new drug and I’m not a guinea pig anymore.