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Experiencing Bipolar Disorder?

W. Nate Upshaw, MD

W. Nate Upshaw, MD

Dr. William Nathan Upshaw is the Medical Director of NeuroSpa TMS®. Since receiving training from the inventor of TMS Therapy nearly a decade ago, Dr. Upshaw has been a pioneer, champion and outspoken advocate of TMS Therapy. Dr. Upshaw’s holistic experience in the field has transformed him into Florida’s leading advocate for widespread accessibility to TMS Therapy.

About Dr. Upshaw

Bipolar disorder is a common, serious psychological disorder experienced by about 6 million American adults every year. Formerly called manic depression, bipolar disorder has two groups of symptoms: mania and depression.  In between these poles, or phases of bipolar disorder, people typically have a normal mood (euthymia). Depression in bipolar disorder is the same as that experienced by people with major depression. It’s the manic phase that differentiates bipolar disorder from major depression

Bipolar Disorder: The Highs and the Lows

For a diagnosis of bipolar disorder to be made, a person must have significant symptoms of depression that have at least once alternated with a condition called mania, or its milder form, hypomania. A person doesn’t have to have alternating cycles of depression and mania, although some people do. Just one manic episode is enough for a mental health professional to diagnose bipolar I disorder, also called bipolar type I.

Symptoms of Bipolar Mania

A person having a manic episode feels intensely happy, even euphoric. They may become dangerously impulsive, energetic, and unable to control themselves. People in a manic episode often believe themselves to be capable of any feat and may become psychotic.

Other symptoms of mania include:

  • pressured speech (a person can’t get their words out fast enough)
  • many new ideas emerging all at once
  • high levels of enthusiasm
  • inability to sleep, sometimes for days at a time
  • elevated, even overwhelming levels of energy
  • leaping from one idea to another (flight of ideas)
  • delusions
  • unusually risky behavior, like promiscuity, overspending, gambling
  • flashes of irritability, anger, outbursts that look like rage
  • making impulsive, life-altering decisions, like quitting one’s job, with no planning
  • grandiosity

Hypomania, a milder form of bipolar mania, isn’t as extreme as full-blown mania, but it still constitutes a debilitating part of bipolar disorder. This combination of depression alternating with hypomania is called bipolar II disorder.

 

Symptoms of Bipolar Depression

Remember, for a person to be diagnosed with bipolar they must have experienced one episode of mania, with longer episodes of depression. Bipolar depression is quite similar to that experienced by people living with major depression. It involves the following symptoms:

  • Feelings of deep sadness that are present most of the time
  • Loss of pleasure in activities you used to enjoy or the inability to feel pleasure at all (anhedonia)
  • Feelings of emotional numbness
  • Lack of energy, persistent fatigue
  • Sleep problems (too much or too little sleep)
  • Difficulty concentrating, problems with memory, decreased ability to concentrate, or an inability to make decisions
  • Feelings of guilt and hopelessness
  • Preoccupation with death
  • Withdrawing from friends, family, and/or social situations

Bipolar disorder usually develops in a person’s early 20s, although it can affect teenagers. It’s vital to take action after a person’s first manic episode, as the earlier a person gets treatment, the better their mental health recovery will be.

 

I’m Bipolar—Now What? Living with Bipolar Disorder

While dealing with bipolar disorder can be challenging, this disorder responds well to proper treatment and is a manageable condition. Getting started with treatment is essential, as over 80 percent of all people with bipolar experience severe and disruptive symptoms. Managing bipolar disorder requires a combination of treatment approaches and lifestyle changes. Lifestyle changes alone won’t help bipolar disorder, as the causes are in part rooted in a person’s unique biology.

The most effective way of coping with bipolar disorder requires psychotherapy combined with medication. Great strides have been made in the last 20 years in developing medications that treat bipolar disorder without the side effects of lithium, the 20th century medication of choice for bipolar disorder.

Medication

Treating bipolar disorder with medication can be tricky, as antidepressants can trigger mania. Typically, bipolar disorder is treated with a mood-stabilizing medication. Lithium carbonate is exceptionally effective as a mood stabilizer but requires regular blood tests to ensure its levels are just right. It also has a narrow range of effectiveness, which can make getting the correct amount challenging.

Newer medications, like topiramate, lamotrigine, and divalproex sodium, have proven to be effective with fewer side-effects. Medication for bipolar disorder must be taken consistently to work correctly.

Therapy

Talk therapy, also called psychotherapy, helps a person deal with the issues that come from living with bipolar disorder. Common and effective types of talk therapy include:

  • Cognitive-Behavioral Therapy (CBT). CBT is helpful in identifying and changing habitual patterns of thinking that contribute to poor outcomes in a person’s lives. Automatic thoughts and judgements often keep a person from adapting to difficult situations, which is where CBT can be exceptionally effective. 
  • Interpersonal and Social Rhythm Therapy (IPSRT). IPRST helps people understand how disruptions to the natural rhythms of life, like the sleeping and waking cycle, can make bipolar disorder worse. Its goal is to stabilize personal and social rhythms, which make a person more resilient. 

 

Social Support 

Social support is an essential part of recovery from bipolar disorder. Online forums for bipolar disorder, bipolar blogs, and bipolar support groups can all provide contact with others living with bipolar disorder. Connecting with people who are coping with similar situations can help you form a stronger support system while providing support for them as well.

Transcranial Magnetic Stimulation (TMS) for Bipolar Disorder

If you’re living with bipolar disorder and looking for treatment, transcranial magnetic stimulation (TMS) is a newer treatment approach. TMS uses high-powered magnetic fields to precisely stimulate areas of the brain that are responsible for a person’s mood. TMS is FDA-approved for the treatment of Major Depression Disorder, produces no systemic side effects and is a medication-free treatment. TMS is eligible for coverage by most private health insurers, as well as Medicare and Tri-Care.

 

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

 

Works Cited

Agarkar, S., Mahgoub, N., & Young, R. C. (2011). Use of transcranial magnetic stimulation in bipolar disorder. The Journal of neuropsychiatry and clinical neurosciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102108/. 

Bipolar disorder. (2018, January 31). https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961. Retrieved July 18th, 2021

Bipolar Disorder: Age of Onset. National Alliance on Mental Illness. (n.d.). https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder. Retrieved July 18th, 2021

Butler, M. (2018, August). Treatment for Bipolar Disorder in Adults. Treatment for Bipolar Disorder in Adults: A Systematic Review [Internet]. https://www.ncbi.nlm.nih.gov/sites/books/NBK532193/table/ch2.tab1/. 

Hurley, K. (2020, November 24). Bipolar Disorder and Depression: Understanding the Difference. Psycom.net – Mental Health Treatment Resource Since 1996. https://www.psycom.net/depression.central.bipolar.depression.html#:~:text=Bipolar%20disorder%20is%20easily%20confused,disorder%20includes%20symptoms%20of%20mania. 

Hurley, K. (2020, November 24). Bipolar Disorder and Depression: Understanding the Difference. Psycom.net – Mental Health Treatment Resource Since 1996. https://www.psycom.net/depression.central.bipolar.depression.html 

Miklowitz DJ, Otto MW, Frank E, et al. Psychosocial Treatments for Bipolar Depression: A 1-Year Randomized Trial From the Systematic Treatment Enhancement Program. Arch Gen Psychiatry. 2007;64(4):419–426. doi:10.1001/archpsyc.64.4.419 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210013 

Miklowitz , D. J. (2019, April 12). Different Types of Therapy for Bipolar Disorder. NAMI. https://www.nami.org/Blogs/NAMI-Blog/April-2019/Different-Types-of-Therapy-for-Bipolar-Disorder. 

NAMI (2021, June 28). What Is Mania, and What Does It Mean to Have a Manic Episode? Here’s What Experts Say. What Is Mania, and What Does It Mean to Have a Manic Episode? https://www.nami.org/Press-Media/In-The-News/2021/What-Is-Mania-and-What-Does-It-Mean-to-Have-a-Manic-Episode-Here-s-What-Experts-Say?feed=In-the-news. 

U.S. Department of Health and Human Services. (2017, November 17). Bipolar Disorder: Statistics about Bipolar Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/bipolar-disorder. Retrieved July 18th, 2021

U.S. Department of Health and Human Services. Bipolar Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml. Retrieved July 18th, 2021

What are hypomania and mania? Mind. (n.d.). https://www.mind.org.uk/information-support/types-of-mental-health-problems/hypomania-and-mania/about-hypomania-and-mania/. Retrieved July 24th, 2021

 

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