Jessica is a 32-year-old nurse, who presents to her primary care provider complaining of frequent headaches, irritable bowel, insomnia, and depressed mood. She takes no medication and has never abused substances. Her only mental health issue has been a single depressive episode when she was a college freshman, which was alleviated by going to therapy. She has no underlying medical illness. Her family history is notable for several ancestors who have been affected by psychiatric illness, including depression, bipolar disorder, and schizophrenia. Jessica has had 3 prior episodes of several weeks’ duration characterized by erratic behavior at work, irritability, excessive energy, and decreased sleep. She finds herself regretting impulsive financial decisions that she took during these episodes, and has recently filed for personal bankruptcy. For the past month, Jessica’s mood has been persistently low, and she has had reductions in sleep, appetite, energy, and concentration, with some passive thoughts of suicide.
Jessica is suffering from Bipolar Disorder. Bipolar disorder, also known as Manic Depressive Disorder, is characterized by unusual mood changes. People experiencing bipolar disorder have recurrent periods of mania, followed by periods of depression. About 5.7 million Americans suffer from bipolar disorder affecting both men and women. The symptoms of mania and depression in those with bipolar disorder make it difficult to maintain healthy relationships, focus on school, or succeed at work. Bipolar disorder is a lifetime illness, which typically presents during the late teens or early adult years, however children and established adults can also develop bipolar disorder.
Common Symptoms for a Manic Episode:
- Feeling “high”
- Disordered sleeping
- Being more active than usual
- Being irritable
- Engaging in risky behaviors (often financial or sexual impulsivity)
Common Symptoms for a Depressive Episode:
- Feeling “down”
- Excessive sleeping
- Feeling worried
- Concentration Issues
- Thoughts of death or suicide
Diagnosis for bipolar disorder is often tricky, because the symptoms that manifest themselves can also be symptoms of other disorders, such as depression, anxiety, substance abuse disorder or schizophrenia. With the help of a trained professional, however, these disorders can be distinguished, and a proper treatment plan can be developed.
Treatment for bipolar disorder often includes a combination of therapy and medication. In therapy, those suffering from bipolar disorder learn how to manage their emotions, and can explore behavior management for stressful situations and mood swings. Psychoeducation can also help them understand how bipolar disorder works, and how they can best handle the symptoms they are experiencing. Common medications for bipolar disorder include mood stabilizers, antipsychotics, antidepressants, or anti-anxiety medication.
For people like Jessica, bipolar disorder will be a lifelong journey. She will likely need medication long-term, as well as psychotherapy and continued psychological assessment. There is hope, though. With proper treatment, those with bipolar disorder can live full and exciting lives, full of support. If you think you may have bipolar disorder and would like to schedule an assessment, call our office at (757) 827-7707 to schedule an appointment!
Depression and Bipolar Support Alliance
National Institute for Mental Health: Bipolar Disorder
PsychCentral Resources for Bipolar Disorder
Article By: Sarah Warner, MS