Mandy is currently 25 years old and works as an assistant manager in one of the insurance companies. Since she was a teenager while in secondary school, Mandy had suffered mood swings.
She recalls being extremely unhappy with no appetite, poor sleep, lack of interest in her school work, lack of enjoyment or excitement while at other times she was full of energy, excited, elated and generally hyperactive. She was often taunted while in boarding school due to this with people calling her names like ‘blowing hot and then cold’, ‘erratic girl’ etc.
Unknown to her, she had a condition called Bipolar Affective Disorder or Manic Depression.
Her parents felt this was just a way of life for her and she got into a lot of trouble at home because of her poor performance at school. However she managed to finish school eventually and go into University where she performed fairly better but had poor relationships with friends.
She graduated and by the time she got her first job, the mood swings were re-occurring more frequently and affected her appraisals and performance at work. It was not surprising one day when her boss suggested that she proceed on an extended leave and see a therapist. This turned out to be the beginning of the solution to Mandy’s problems.
Bipolar disorder is a brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out daily life activities. It is a chronic illness that must be managed throughout life.
It was formerly called manic depression and these mood changes vary, occurring only few times a year or several times a week. It usually manifests in late teens or early adult years while most of the cases start before the age of 25.
The disease tends to run in families. Children with a parent or sibling who has the disorder are more likely to develop the illness compared with children who don’t have a family history of it. Environmental and psychosocial factors also play a role.
Bipolar disorder comes with intense emotional states that occur in distinct periods called mood episodes. Each mood episode is a drastic change from the person’s usual mood and behaviour. An overexcited state is called a manic episode while an extremely sad or hopeless state is a depressive episode. Sometimes one can have symptoms of both mania and depression called a mixed state.
Symptoms of mania or a manic episode include: long period of feeling happy, excited and elated, irritability, inability to control the train of thoughts, talking very fast, restlessness and inability to sleep. Others are restlessness, being unusually distracted, taking on new activities, not feeling tired and being impulsive. An individual with mania may be disinhibited, engage in risky sexual activities and may have an unrealistic belief in his or her abilities.
In our society, this could be manifested as individuals feeling they have some special powers to heal or do miraculous things which they couldn’t do previously. Even when such a person doesn’t sleep adequately at night or doesn’t sleep at all, he or she gets up energized and active.
On the other hand depression comes with prolonged periods of low mood or sadness, feelings of hopelessness or worthlessness, difficulty concentrating, forgetfulness, sluggishness, loss of interest in activities once enjoyed including sex and changes in the eating or sleeping patterns. A depressed individual may also have nightmares, have thoughts of death, self-harm or suicide. Carrying out daily activities becomes a lot of effort and the individual just wants to be left alone.
Sometimes a person with severe episodes of mania or depression has psychotic symptoms such as hallucinations and delusions such as in schizophrenia. For example in a manic episode an individual can believe he is famous or interacts with famous people and is special and more important than others. While a depressed individual may feel his life is ruined and can’t be redeemed hence it would be better to just die. He may also hear strange voices talking to him and confirming these beliefs.
Bipolar disorder may also lead to the abuse of alcohol and psychoactive drugs. Poor performance in school and work has also been noted. Bipolar disorder is often reoccurring but in between the episodes the individual may be free of symptoms while some have lingering symptoms. If left untreated, bipolar disorder can worsen and episodes can become more frequent or more severe over time.
Proper treatment for bipolar disorder helps people to gain better control of their mood swings and other symptoms and continuous treatment may be required throughout life to control the symptoms. Treatment usually involves a combination of medication and psychotherapy. Family involvement and support are also essential.