Bipolar (Manic Depressive) or Mood Swings Disorder
Bipolar Disorder causes a person to function as if
their brain has a 3 speed gear box. They have periods when they are Normal,
periods when they are Depressed, and
other periods when they are Manic or
“Hyper” or “Hypo”. They have
unbalanced and unstable production and flows of the chemicals and electricity
in their brain that determine their moods, energy levels, emotional intensity
and the pace or speed of their thoughts, activities or actions. This
disorder is basically an inherited disorder which runs in families, but its
severity is influenced by lifestyle (diet, exercise, stress, drugs, etc) and by
life traumas. Undiagnosed, untreated
Bipolar (Mood Swings) Disorder is one of the commonest causes of a troubled
life and when all else fails chronically troubled people should be given a mood
stabiliser for a week’s trial during an overactive, irritable, anxious period
and they will very quickly know if they have Bipolar Disorder. Chronic
Anxiety that doesn’t respond well to tranquilizers often responds to
anticonvulsant mood stabilizers and turns out to be Hypomania, not Anxiety or
Hypomania and Anxiety.
In the Manic “Hyper” Periods you are racy, fast, go
go, emotionally very intense, with non stop loud talking, over optimism or
euphoria, “racing thoughts” that fly through your mind, and far too much
energy. You can’t or don’t sleep much, may be irritable and may spend your
money thoughtlessly and recklessly. Serious Manic Periods can get you into
financial difficulties or even send you bankrupt if you overcommit yourself
because of hypomanic recklessness and over-optimism. Manic Periods stress and
damage your relationships and can lead to losing your job, serious family difficulties,
or divorce. A few people become sexually driven and uninhibited when manic.
People with Bipolar Disorder usually prefer being Hypo to being Depressed but
being Hypo is usually more dangerous than being Depressed. Some Bipolar people
are mostly Depressed and seldom “Hypo”, some are mostly “Hypo” and rarely
Depressed and some are mostly normal and only infrequently Depressed or Hypo.
Bipolar Disorder doesn’t usually develop fully till
the teens or twenties. It is sometimes present but difficult to be sure of in
childhood. In a few cases it doesn’t show up till the thirties or later. Bipolar Disorder is frequently
misdiagnosed as Anxiety and/or Major Depression. It is often not diagnosed when
it develops in a person who already has ADD – it is just thought that their ADD
has got worse and isn’t responding to treatment. The average person with
Bipolar Disorder takes 10 years to get it correctly diagnosed. Some
people have it for 40 or 50 years before it is correctly diagnosed. No doubt
some people suffer with it all their adult life and die with it without ever
being diagnosed or treated properly. They are just thought to be difficult or
eccentric. Some Bipolar People resort to self-medication with large amounts of Alcohol,
Benzodiazepines, Marijuana or even Heroin, when they are Manic, to try to calm
themselves, or to be able to sleep, or to block out all the troubles they get
into when they are Hypo. Neither Alcohol, nor Benzodiazepines nor Marijuana are
strong enough to control Hypomania but if they don’t receive Mood Stabilizers
or Major Tranquilizers these people may take such large amounts of Alcohol,
Benzos and/or Marijuana that they become heavily addicted to them.
Most of our Bipolar patients do very well because we
correctly diagnose them early by getting every patient to do our comprehensive Beck
Mini DISCOMFORTS/DYSFUNCTIONS Checklist. That way nothing gets missed. We then teach
Bipolar (Mood Swing) patients to quickly recognise when their brain changes
gears from Normal
to Depressed or to Manic and how to adjust their medicines according to
whichever gear their brain is in. We put them on an Anticonvulsant/Mood
Stabilizer and/or a Major Tranquilizer as well as an SNRI antidepressant, usually
Escitalopram is the best. They take small to medium doses of these medications
permanently and increase the Mood Stabilizers when manic and increase the
Antidepressants when depressed. We teach them how to prevent, minimise and
manage the Low and the High Periods. It has been found that Bipolar patients do
better if they eat at regular times, sleep at regular times and minimise
alcohol consumption.
Tricyclic antidepressants sometimes stimulate Bipolar
patients to become Hypomanic and should be given with caution. This problem is
much less common with SNRI antidepressants, but should still be watched for and
Escitalopram seems least likely to do this. Many Adult ADD patients also have
Bipolar Disorder and Bipolar Disorder should always be looked for in people
with ADD. If it is present Dexamphetamine should only be given with care, to
avoid causing Hypomania. I usually prefer stimulant SNRI’s to Dexamphetamine in
these cases. If a Bipolar patient is changing rapidly from hypomania to
depression to hypomania (called Rapid Cycling) the antidepressant could be
causing this and may need to be reduced, changed or stopped.
We teach our Bipolar patients to take full advantage
of their artistic and musical gifts, originality, inventiveness, lateral
thinking, literary and problem solving gifts, above average intelligence and
sporting gifts that so often go with Bipolar Disorder. Sir Winston Churchill,
Prime Minister of Great Britain during World War II, suffered from Bipolar
Disorder, was a failure at school and left school at the age of 12. Some people
consider he was the greatest Englishman who ever lived, and that without his
wartime efforts we would have been ruled by the Nazi’s. Bipolar Disorder definitely has positives and people who have this
Disorder should be helped to look for and take advantage of these Positives.
A very significant proportion of high achievers have Bipolar Disorder but they
may crash and burn from going over the top into Mania, or from drug use if
their Disorder is not diagnosed and treated. It is probable that that was Heath
Ledger’s problem. Many gifted performers and high flying business people who
crash have Bipolar (Mood Swing) Disorder.
See also Chapter 11 Section iv. of Dr Neil Beck's book "Beating Heroin"
The Big 7 Commonest Disorders
The Sleep Disorders
The Anxiety Disorders
Major (Unipolar) Depression
The Attention Deficit Disorders (ADD, ADHD and Others)
The Post Trauma Brain Shock Disorders (Post Traumatic Stress Disorder, Acute Distress Disorder etc)
The Paranoia/Hallucination/Delusion Disorders
