Bipolar Lifestyle

Life can be tough. Just like a roller coaster it’s full of ups and downs that can take an individual through periods of joy and happiness or heartache and sorrow. It’s the normal functioning of human behavior to enjoy periods of happiness and fulfillment. Especially when gifted with something such as a new promotion at work or when life is going satisfyingly well. It’s also normal to experience sadness in times of loss or hardships. However, what would happen if an individual experienced a constant struggle with these emotions during unexplainable times? What if that individual felt as if they were doing great and “on top of the world” whiles their vehicle was being repossessed and their home was in foreclosure? What about plunging into an unexplained suicidal hopelessness after their company signed a multibillion dollar merger that promoted that individual into the pinnacle of their career, after marrying the one they love, and buying the home of their dreams? These may be extreme examples, but when an individual experiences feelings of severe depression that alternate with manic episodes without always coinciding with the surrounding environmental stimuli, that person may be suffering from bipolar disorder.

Psychological mood disorders are estimated to affect 20.8 percent of adults at some point in their lives (Gerrig & Zimbardo, 2007). Some of these disorders can carry the burden of a lifetime existence such as bipolar disorder. Rarer than major depressive disorder, partly because it requires the presence of both severe depression and alternations of manic episodes, bipolar disorder occurs in about 3.9 percent of adults (Gerrig & Zimbardo, 2007). Bipolar disorder is generally diagnosed in two variations, Bipolar I and Bipolar II, with Bipolar II being the more frequent of the diagnoses. According to Fast and Preston (2004), those individuals diagnosed with Bipolar II are more likely to spend three times as much time suffering from major depressive episodes as individuals with Bipolar I, but will generally only experience what is called hypomania in the absence of the full blown manias that Bipolar I individuals must endure. While hypomania generally consists of extremely poor judgment, decreased need for sleep and excessive increases in self-esteem, those who suffer full blown manias can experience psychotic episodes of delusion, hallucinations, and paranoia during their manic episodes.

So what does an individual with this diagnosis do? How do they live, cope, or adjust? Is there a cure? Unfortunately there is no cure for sufferers of bipolar disorders at this point, but by taking the proper steps in establishing a holistic plan of treatment it is generally possible to live a normal life. This means that aside from the expected medications and behavior therapies that are involved in treatment, it becomes extremely important for these individuals to establish a well balanced diet, a regular exercise plan, and a plan of action during the first appearances of a possible manic or depressive episode or their triggers.

The first and probably most important step in the treatment of bipolar is getting a correct and early diagnosis. If improperly diagnosed or left untreated, individuals with this disorder gradually worsen in their condition and are often confused and distraught, getting down on themselves with questions such as, “what is wrong with me?” According to Berk et al. (2007), early treatment of bipolar with lithium prophylaxis has been suggested to have a greater response for those individuals that have experienced fewer episodes. However, the proper diagnosis of bipolar has remained inadequate and is commonly confused with major depressive disorder. This can probably be largely attributed to the disorders general development. In a research study by Berk et al. (2007), the median age of the first symptoms of depression for 207 study participants started at age 18, whereas the first manic symptoms averaged around age 21. This study further showed that the median age of seeking treatment wasn’t until age 24 and that proper diagnosis wasn’t given until approximately 30 years of age (Berk et al., 2007). Although most participants have experienced their first mania prior to seeking treatment, many are not even aware that they have even experienced an episode. Because manias generally bring about feelings of euphoria, elevated self-esteem, and pretentiousness, many patients don’t initially discuss these episodes with their therapist. The loss of inhibition, increased energy, and decreased need for sleep are almost welcoming after an episode of depression. However, these manic episodes generally lead to careless spending of family finances, dangerous behavior, and sexual promiscuity creating other issues that eventually come out during therapy. Once this happens, a trained Psychologist begins to see the more complete problem revolving around manias and depressions, not just the depressions. For this reason it is extremely important for those diagnosed with major depressive disorder to consider their behavior outside of depression and discuss it with their doctors as well.

Once properly diagnosed, it becomes necessary to discover the proper balance of medication needed to maintain the balance that falls between depression and mania. With the assistance of a licensed Psychologist, sufferers of bipolar will initially have to go through a time period of finding the proper medication and dosage needed to assist in the control of their manic and depressive episodes. Smith, Cornelius, Warnock, Bell, and Young (2007) conducted a review in which they suggest that no mood stabilizer has been found similarly efficient for the treatment of both mania and depression. Without a holistic medication targeting bipolar, medical treatment for these individuals usually consists of the use of both antidepressants and mood stabilizers that are consistent with the controlling of manic episodes. However, it might be noted, that in the review by Smith et al. (2007), they supported lamotrigine as an effective long-term prevention of depressive episodes, but found valproate semisodium to be more efficient preventing depression than in its current use for acute mania. This would probably make valproate semisodium the closest to a balanced treatment as currently available because it has at least some effect in both types of episodes.

Although it is important for all individuals to establish and maintain a well balanced diet, patients with bipolar disorder run additional risks when they neglect to take on proper methods of nourishment. As Soreca, Mauri, Castrogiovanni, Simoncini, and Cassano (2007) suggest, the long term use of psychopharmacologic treatments, such as lithium, valproate, and olanzapine that are common used mood stabilizers for bipolar, could contribute to weight gain by reducing a patient’s basal metabolic rate. By maintaining a well balanced diet individuals with bipolar can actively work to reduce their risks of obesity and the added health risks that obesity can contribute. However, this isn’t the only reason for establishing good eating habits and maintaining them. It isn’t uncommon for individuals to experience a lack of appetite while suffering from bouts with depressive episodes. Having established regular healthy eating habits can aid in increasing the possibility that a patient will maintain a regular diet even in the absence of appetite. Psychologists have been know to instruct a bipolar patient to take great measures to ensure that they don’t get too hungry, too tired, or too lonely during crucial depressive episodes which only emphasizes the need of maintaining good eating habits.

In a pilot study conducted by Ng, Dodd, and Berk (2007), preliminary support concluded that physical activity established therapeutic roles in patients diagnosed with bipolar disorders. According to Ng et al. (2007), the physical activity of walking seemed to create a direct positive change in mood-enhancing neurotransmitters and stress neurochemical pathways while indirectly, sunlight and fresh air could account for the possible deviation from stressors. This suggests that something as simple as an evening walk can stimulate positive responses from within the brain that can help elevate moods on a healthy level while the activity itself gives an individual a temporary break for daily stresses such as house chores, work, finances, or other stressors that take part in triggering depressive episodes.

Although it can seem as though bipolar episodes can come about without cause or warning, many, if not all, episodes are usually set into motion as a result of a trigger. Fast and Preston (2004, chap. 6), wrote an entire chapter on discovering the lists of triggers in an individual in order to modify or stop bipolar symptoms before they occur. Triggers often vary between one patient and the next depending upon their age, sex, and lifestyle, but it can probably be safely stated that all patients have some variety of triggers. The best plan of action for controlling these triggers is for an individual to identify the list that most applies to them. Things such as instability, varying away from sleep habits, shopping malls, or financial problems can all be triggers that begin symptoms of a bipolar episode. Identify these triggers and then establish a plan for avoiding, controlling, or minimizing their exposure.

When left untreated or a more holistic approach to treatment is ineffective or ignored, patients with bipolar disorder are left vulnerable to a numerous variety of other disorders and harmful behaviors. McIntyre, McElroy, Konarski, Soczynska, Wilkins, and Kennedy (2007) recently reported that the Canadian Community Health Survey of 36,984 respondents found 6.3 percent of bipolar respondents had a frequency with problem gambling as compared to the 2.5 percent of respondents with major depressive disorder and 2.0 percent of the general population. It was further founded by McIntyre et al. (2007) that the odds of problem gambling increased when there was a presence of drug or alcohol dependence. Unfortunately, a report by Santosa, Strong, Nowakowska, Wang, Rennicke, and Ketter (2007) shows there is a lifetime history of substance abuse in up to 60 percent of patients diagnosed with bipolar disorder. According to Mitchell, Brown, and Rush (2007), these patients that struggle with substance abuse also become four times more likely to suffer from comorbidity with disorders such as generalized anxiety, antisocial personality, and post-traumatic stress. While the risk of gambling problems, substance abuse, and comorbidity are of great concern, further reports found even more serious problem behaviors when bipolar continues with inadequate treatment. According to Simon, Hunkeler, Fireman, Lee, and Savarino (2007), there are consistent reports of an increase in suicide attempts made by bipolar patients with comorbidity or problems with substance abuse and an increased risk of completed suicides associated with comorbid anxiety disorder. For this reason it becomes even more important to insure that bipolar disorder doesn’t go untreated, misdiagnosed, or inadequately handled in order to control and decrease the existence of abnormal behaviors.

Although bipolar is a disorder and it comes with the need for a heightened awareness of self and well-being, it doesn’t have to be a life crippling illness. With proper treatment and planning, episodes can usually be controlled to be minimally invasive. In fact, a resent study by Santosa et al. (2007) shows that individuals’ with a bipolar diagnosis tend to display enhanced abilities in creativity. Santosa et al. (2007) reported that after completing the Barron-Welsh Art Scale, those with bipolar scored 45 percent higher than the healthy controls and had similar scores recorded in architects and creative writers. It is believed by Santosa et al. (2007) that affective processing and altered visual in bipolar patients could be the reason for this enhancement.

It is also important that those diagnosed with this disorder know that they are not alone in there affliction. Perhaps in relation to the reported enhancements in creativity many important and even famous individuals have been found to be diagnosed with bipolar disorder. Even the smallest amount of research could possibly identify a famous painter, musician, or actor inconvenienced with this disorder. It’s just living proof, that with a little bit of treatment and planning, a happy and successful life can be achieved.

Reference List

Berk, M., Dodd, S., Callaly, P., Berk, L., Fitzgerald, P., Castella, A.R. de, et al. (2007, November). History of illness prior to a diagnosis of bipolar disorder or schizoaffective disorder. Journal of Affective Disorders, 103, 181-186.

Fast, J.A., Preston, J.D. (2004). Loving Someone with Bipolar Disorder: Understanding & Helping Your Partner. Oakland, CA: New Herbinger.

Gerrig, R.J., Zimbardo P.G. (2007). Psychology and Life. 18^th ed. Boston, MA: Pearson Education.

McIntyre, R.S., McElroy, S.L., Konarski, J.Z., Soczynska, J.K., Wilkins, K., & Kennedy, S.H. (2007, September). Problem gambling in bipolar disorder: Results from the Canadian Community Health Survey. Journal of Affective Disorders, 102, 27-34.

Mitchell, J.D., Brown, E.S., & Rush, A.J. (2007, September). Comorbid disorders in patients with bipolar disorder and concomitant substance dependence. Journal of Affective Disorders, 102, 281-287.

Ng, F., Dodd, S., Berk, M. (2007, August). The effects of physical activity in the acure treatment of bipolar disorder: A pilot study. Journal of Affective Disorders, 101, 259-262.

Santosa, C.M., Strong, C.M., Nowakowska, C., Wang, P.W., Rennicke, C.M., & Ketter, T.A. (2007, June). Enhanced creativity in bipolar disorder patients: A controlled study. Journal of Affective Disorders, 100, 31-39.

Simon, G.E., Hunkeler, E., Fireman, B., Lee, J.Y., & Savarino, J. (2007, August). Risk of suicide attempt and suicide death in patients treated for bipolar disorder. Bipolar Disorders, 9(5), 526-530.

Soreca, I., Mauri, M., Castrogiovanni, S., Simoncini, M., & Cassano, G.B. (2007, November). Measured and expected resting energy expenditure in patients with bipolar disorder on maintenance treatment. Bipolar Disorders, 9(7), 784-788.

Smith, L.A., Cornelius, V., Warnock, A., Bell, A., & Young, A.H. (2007, June). Effectiveness of mood stabilizers and antipsychotics in the maintenance phase of bipolar disorder: A systematic review of randomized controlled trials. Bipolar Disorders, 9(4), 394-412.