Living with Bipolar Disorder

Bipolar disorder affects approximately 2.6 % of the population in the United States. That is around 5.7 million people. Another source estimates 4.4 % of the population will experience bipolar during their lifetimes. While there are specific characteristics that most will experience, bipolar disorder is a unique journey for every individual experiencing it.
Defining bipolar disorder can be difficult, as it is such a different experience. Some descriptions are:
“I am good for a while. I’ll talk more, laugh more. Sleep and eat normally. But then something happens, like a switch turns off somewhere and all I am left with is the darkness of my mind” (unknown).
“It’s like having the motivation to change the world one moment, then not having the motivation to wash yourself.” (Unknown).
“I was actually manic a lot of the times that I would take on workloads…I was conquering the world, but then it would all come crashing down, and I would be more depressed than ever” (Demi Lovato).
Bipolar disorder is a very complex condition, and understanding what it is can help us to understand those who live with it better. To better understand bipolar disorder, knowledge of the concept of ‘Mood” is necessary. Mood can be defined as an individual’s emotional tone, that influences behavior, personality, and perception. Our mood consists of depression, joy, anger, and elation (Morgan & Townsend, 2021). Bipolar disorder is considered to be a mood disorder.
We all have changes in our moods, and everyone has ups and downs. This is normal. But it is when these mood changes become extreme and pervasive that problems can arise. There are certain terms that are used frequently, and you may hear when bipolar disorder is discussed. Mania, mood lability, rapid cycling, and hypomania are used frequently when describing the moods of bipolar disorder (Morgan & Townsend, 2021).
Mania: is a key symptom of bipolar disorder. It is recognized by an elevated, expansive, and irritable mood. The need for sleep decreases and energy increases.
Mood Lability: This refers to rapid shifts in mood. One month the individual with bipolar disorder is happy, and the next month they are sad and depressed.
Rapid Cycling: This is a continuous cycle that occurs between mania and depression.
Types of Bipolar Disorders
Adding to the complexity of bipolar disorders, is the fact that there are different types, and everyone who experiences this disorder experiences it differently. In order to understand this condition, it is essential to have an awareness of these different types which include.

• Bipolar I Disorder
• Bipolar II Disorder
• Cyclothymic Disorder

Bipolar I Disorder
You may have heard this referred to as Manic-Depressive Disorder in the past. Bipolar I is one of the most common forms experienced. Those with this type have persistent and severe episodes of depression and mania.  In between these episodes, the individual may return to their normal mood state or baseline. This is known as euthymia. To be diagnosed with bipolar I, the person must experience depression lasting at least two weeks and at least one episode of mania, which lasts a week or results in hospitalization. Someone with bipolar I may also experience delusions or hallucinations. Individuals with bipolar I have difficulties maintaining relationships and employment.
Bipolar II Disorder
Bipolar II is also one of the more commonly experienced forms of this disorder. These individuals experience depression that lasts over two weeks. This depression is chronic and usually more severe than bipolar I. Another difference between I and II, is that those with bipolar II do not experience mania, but will have a less extreme form called hypomania.
Cyclothymic Disorder
Cyclothymic disorder or cyclothymia, is less common and also less severe than bipolar I and II. While the person experiences the highs and the lows they are not as severe. However, cyclothymic disorder can develop into bipolar I or II
Coping Strategies for Bipolar Disorder
Bipolar disorder is ongoing and can be a lifelong condition. It usually will not go away on its own. People that experience this disorder can feel alone and overwhelmed. Therefore, it is important they receive the care and support they need. Treatment for Bipolar disorder can include medications, psychotherapy, and long-term treatment.
However, it is just as important to have personal coping strategies and lifestyle habits that can assist in managing this disorder.  Some ideas that have been shared include.

• Develop a sleep schedule.
• Have a daily routine.
• Good nutrition and exercise.
• Have fun or ‘play’ time and laugh.
• Keep a mood journal.
• Avoid alcohol and other substances.
• Simplify your life and avoid stress.
• Have a support network.
• Explore available resources.
• Have a purpose.
• Volunteer.

Hope
There is no doubt that bipolar disorder is a difficult, and sometimes life changing, disorder for those who have it. As more people speak out and share their experiences, awareness and hope grows. March 30th of every year is World Bipolar Day.  This provides global education, open discussion, and improved sensitivity about the disorder. It also provides an opportunity for those living with bipolar disorder to connect. “The ultimate goal is to inspire a global shift in thinking that will eliminate social stigma and promote acceptance” (www.ISBD).
If this goal can be achieved, then hope will flourish!
 
“Though I am often in the depths of misery, there is still calmness, pure harmony, and music inside me” (Vincent Van Gogh).
 
                                                                                     Peggy Fossen, DNP, RN, CNE

 
 
 
 
References
Bipolar disorder. SAMHSA. (n.d.). https://www.samhsa.gov/mental-health/bipolar
Cleveland Clinic. (2024, March 19). Do you know the different types of bipolar disorder? https://health.clevelandclinic.org/bipolar-1-vs-2
Collins, D. (2021, July 21). Quotes about bipolar disorder: You’re not alone. Psych Central. https://psychcentral.com/bipolar/bipolar-disorder-quotes#bipolar-disorder
Morgan, K. I., & Townsend, M. (2021). Davis advantage for Psychiatric Mental Health Nursing. F. A. Davis Company Publishers.
Team, B. E. (2024, March 3). 21 quotes about living with bipolar disorder. BetterHelp. https://www.betterhelp.com/advice/bipolar/33-bipolar-quotes-and-sayings/
WebMD. (n.d.). What are the types of bipolar disorder?. WebMD. https://www.webmd.com/bipolar-disorder/bipolar-disorder-forms
9 essential coping strategies for bipolar disorder. (n.d.). https://www.healthcentral.com/slideshow/essential-coping-strategies-for-bipolar-disorder
 
 
Additional Links
https://my.clevelandclinic.org/health/diseases/21603-mania
https://www.verywellhealth.com/euthymic-mood-in-bipolar-disorder-5208599
https://www.verywellmind.com/hypomania-vs-mania-5208167
https://www.everydayhealth.com/bipolar-disorder/guide/resources/
https://www.isbd.org/world-bipolar-day