Bipolar Disorder Therapy

Through The Forest Counseling of Boston

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+1 (857) 299-1123

Through The Forest Counseling of Quincy

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+1 (617) 845-0990

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Bipolar disorder, often known as manic depression, is a continuously recurrent condition characterized by mood swings between mania and depression. Depression is by far the most common symptom of the condition. The manic phase is characterized by irritation, rage, and depression, with or without euphoria. When euphoria is present, it might appear as extraordinary energy and overconfidence, which can express as overspending or promiscuity, among other behaviors.

The disorder most commonly manifests itself in young adulthood, however, it can also manifest itself in children and adolescents. Misdiagnosis is prevalent; the disease is frequently misdiagnosed as attention-deficit/hyperactivity disorder, schizophrenia, or borderline personality disorder. Certain individuals are undoubtedly predisposed to the disorder due to biological causes, and situations such as sleep deprivation can set off manic episodes.

Bipolar disorder is classified into two types: Bipolar I and Bipolar II. A major depressive episode may or may not be associated with bipolar I, although it is associated with bipolar II. People who have bipolar I have experienced at least one manic episode, which can be severe and necessitate hospitalization. People with bipolar II often experience a significant depressive episode that lasts at least two weeks, as well as hypomania, a mild to moderate mania that does not usually necessitate hospitalization.

According to the National Institute of Mental Health, around 2.8 percent of American adults have experienced bipolar disorder in the previous year, and 4.4 percent have had bipolar disorder at some point in their life. These figures are comparable for males and women. According to the World Health Organization, the disorder affects around 45 million individuals worldwide.

Symptoms in children and adolescents are comparable to those in adults and include the condition’s characteristic mood swings. Children with bipolar disorder have significant mood and behavioral fluctuations, becoming exceptionally cheerful and lively during manic episodes and very sad and less active during depressive episodes. Manic episodes are characterized by increased energy, distractibility, grandiosity, and an inability to sleep, whereas depressive episodes are characterized by self-harm or suicidal thoughts and gestures, which should be treated seriously.

One important distinction is that bipolar disorder is episodic, whereas other disorders are chronic. Bipolar symptoms, for example, come and go with mood swings, but disorders like ADHD tend to be more stable if left untreated.

Bipolar disorder can be caused by both genetic and environmental causes. As a result, the causes differ from one individual to the next. While the disorder can run in families, no specific genes have been definitely discovered that increase the likelihood of having the ailment. There is some evidence that increased paternal age at conception increases the likelihood of new genetic variants that cause susceptibility. Imaging studies have revealed that there may be changes in the anatomy and function of specific brain regions, but no persistent abnormalities have been discovered.

Life experiences, especially different forms of childhood trauma, are likely to have a role in precipitating bipolar disorder in people who are predisposed to the condition. Researchers do know that once bipolar disorder develops, certain life circumstances might trigger its recurrence. Interpersonal conflict and abuse are the most often reported triggers for the disorder.

According to the DSM-5, “family history is the strongest and most consistent predictor for bipolar disorder.” Those who have a relative with bipolar I or bipolar II are at a tenfold increased risk. Genes that are handed down in a bipolar family appear to impact how the brain regulates mood.

When seeking to investigate a bipolar diagnosis, it is critical to examine the family history of mental health in order to determine if an individual is prone. Consider whether anybody in the family, particularly close relatives, has had strong mood swings, severely unpredictable conduct, or great irritation followed by deep grief.

Because bipolar disorder is a recurring condition, it needs long-term treatment. Mood stabilizer drugs are commonly administered to avoid mood swings. Although lithium is the most well-known mood stabilizer, newer drugs such as lamotrigine have been demonstrated to have fewer negative effects while frequently eliminating the need for antidepressant treatment. Antidepressants, when used alone, can cause mania and hasten mood cycling. Getting the whole spectrum of symptoms under control may necessitate the use of additional drugs, either short-term or long-term.

Nutritional treatments have also been discovered to be helpful. According to research, omega-3 fatty acids may help reduce the number or amount of drugs required. Omega-3 fatty acids are integrated into the structure of brain cell membranes and have a role in the functioning of all brain cells.

Work and interpersonal issues may be both a cause and a consequence of bipolar episodes, emphasizing the importance of psychotherapy treatment. According to research, this type of treatment minimizes the frequency of mood episodes that patients encounter. Psychotherapy is also useful in teaching self-management techniques, which can help prevent ordinary ups and downs from escalating into full-blown episodes.

People with bipolar disorder often require medication, but selecting the proper drug or drug combination sometimes takes some trial and error. To find the best treatment for the patient, the psychiatrist may begin with a low dose and progressively raise it based on the patient’s reaction and tolerance. They will solicit patient input and prescribe one medication at a time to determine the greatest fit.

Bipolar disorder can have a negative impact on a person’s aspirations and relationships. Sufferers, however, may develop coping skills and techniques to keep their life on track in conjunction with good medical care. Bipolar disorder, like many other mental disorders, may be difficult to diagnose. While most patients believe the disorder to be a burden, some value its role in their life, and some even associate it with increased creative productivity.

While bipolar disorder depression is difficult to treat, mood swings and recurrences may frequently be postponed or prevented with a mood stabilizer, either alone or in combination with other drugs. Psychotherapy is a useful supplement to medicine, particularly for coping with the job and relationship issues that frequently accompany the disorder. Clinicians are well aware that there is no one-size-fits-all cure: a person experiencing their first manic episode will not be the same as someone who has lived with bipolar disorder for a decade.

During mania, many people with bipolar disorder develop hyperreligiosity. In the United States, 15 to 22% of people with bipolar mania have religious delusions, such as believing that devils are monitoring them or that they are Christ reincarnated.

Spirituality is a complicated experience that includes networks of different brain areas. Parts of the parietal lobe are associated with feelings of spiritual transcendence, parts of the temporal and frontal cortices are involved in the storage and retrieval of religious beliefs in memory, and other frontal lobe and limbic structures are responsible for the rational and emotional aspects of religious beliefs. Dopamine levels in bipolar disorder patients may have a role in enhancing religious and spiritual experiences.

One widespread misunderstanding concerning bipolar disorder is that mania is always “positive” since it is preferable to depression. However, during a manic episode, people frequently do stupid or ignorant things, make blunders, and do harm to others. Another common misconception is that activities taken during manic episodes are entirely choice, yet the individual does not have complete control over their faculties.

Another common misconception is that treatment ceases when a person is stable. Because bipolar disorder is a chronic condition, it is necessary to maintain stability, incorporate lifestyle adjustments, and be aware of triggers on an ongoing basis.

Mania is the distinguishing trait of bipolar disorder. It might be the disorder’s triggering episode, followed by a depressive episode, or it can appear after years of depressive episodes. The transition from mania to depression can be sudden, and moods might fluctuate fast. However, while mania is what defines bipolar disorder from depression, a person may spend significantly more time in a depressed condition than in a manic or hypomanic state.

Hypomania may be deceiving; it is frequently felt as an increase in energy, which can feel wonderful and even boost productivity and creativity. As a result, a person suffering from it may deny that anything is wrong. Manic symptoms vary greatly, but characteristics may include increased energy, activity, and restlessness; euphoric mood and extreme optimism; extreme irritability; racing thoughts, unusually fast speech, or thoughts that jump from one idea to the next; distractibility and lack of concentration; decreased need for sleep; an unrealistic belief in one’s abilities and ideas; poor judgment; reckless behavior, including spending sprees and dangerous driving, or risky impulsive behavior.

The length of high moods and the regularity with which they alternate with depressive moods can vary greatly between people. Rapid cycling, or frequent fluctuation, is not rare and is characterized as at least four episodes each year.

The degree and duration of depressive symptoms in bipolar disorder vary greatly, just as there is substantial variety in manic symptoms. Symptoms include a persistently sad, anxious, or empty mood; feelings of hopelessness or pessimism; feelings of guilt, worthlessness, or helplessness; a loss of interest or pleasure in previously enjoyed activities, including sex; decreased energy and feelings of fatigue or being “slowed down”; difficulty concentrating, remembering, or making decisions; restlessness or irritability; oversleeping or an inability to sleep or stay asleep; change in appetite and/or

Mania and depression symptoms frequently coexist in “mixed” episodes. Agitation, difficulty sleeping, a major change in appetite, psychosis, and suicidal ideation are all symptoms of a mixed condition. At certain times, a person may feel both melancholy and energetic.

Bipolar disorder often manifests itself in persons in their late teens or early twenties, while symptoms can arise in toddlers as young as six years old. According to the DSM-5, the typical age of the first episode of mania, hypomania, or depression is 18 years old for bipolar I and the mid-20s for bipolar II.

People frequently battle for years with undiagnosed and untreated bipolar disorder. In fact, almost two-thirds of persons with bipolar disorder are misdiagnosed before bipolar is recognized.

The majority of these people have been misdiagnosed with depression. When deciding between the two, patients and physicians might examine family history owing to the disorder’s genetic underpinnings, as well as a personal history of inexplicable excitability and euphoria or wrath, self-harm, and suicidality. In certain situations, antidepressants can cause mania; it is crucial to observe if a patient becomes more agitated, irritated, aggressive, or hyperactive after starting medication.

Manic episodes in schizophrenia can involve or resemble psychosis, whereas depressive episodes mimic the negative symptoms of schizophrenia. (These people may be diagnosed with bipolar schizoaffective disorder.)

Some persons who have suffered traumatic brain injuries (TBI) as a result of a vehicle accident or a sports injury, for example, exhibit increased anxiety, depression, and mood swings. According to Danish research of over 100,000 persons with brain injuries, those who have suffered a TBI are four times more likely to acquire a mental disease. TBI patients are 28% more likely to have bipolar disorder, 59% more likely to get depression, and 65% more likely to develop schizophrenia.

Although bipolar disorder has biological underpinnings, living circumstances can either trigger or aggravate it. Many patients attribute their initial episode of bipolar disorder to a specific psychosocial trigger, such as a breakup, family trauma, substance abuse, or a stressful period. Being aware of these variables is critical for detecting and treating bipolar disorder.

Therapy, in addition to drug management, is an important part of treating bipolar disorder. Cognitive Behavioral Therapy (CBT), which helps patients reframe harmful or illogical thinking in order to modify mood and behavior, as well as Interpersonal Therapy, Family-Focused Therapy, and psychoeducational methods, are examples of evidence-based treatments. Family-Focused Therapy may be especially beneficial for children and teenagers suffering from bipolar disorder.

Therapy aids in the treatment of bipolar disorder in a variety of ways. Therapy provides psychoeducation to enhance medication adherence, skills to cope with the problems of living with the disease, lifestyle cures, connections to loved ones for increased support, and rapid assistance for situations that may trigger a manic or depressive episode. Patients come to treatment with varying goals; thus, a therapist should encourage patients to express their goals and collaborate to identify the best strategy.

Patients may encounter unpleasant side effects as weariness, weight gain, and nausea. Patients can control their symptoms by exercising, eating a balanced diet, sleeping on a regular schedule, and seeking social support.

It is critical for patients and doctors to discuss medication concerns throughout therapy so that the appropriate course of action may be determined. If one medication has not been effective, there may be alternative options to consider. A therapist can give clarity and support if there are worries about the stigma of psychiatric medication or anxiety about keeping one’s sense of self.

People may avoid receiving treatment because they are afraid of losing their creativity, productivity, and sense of identity. However, ignoring treatment in order to retain manic energy frequently results in a crash that threatens every element of the person’s well-being.

A therapist can ease these fears and help you rediscover your creativity. The strong increase of manic energy is frequently mistaken for creativity rather than chaotic and irresponsible production; mania can fool the person into feeling their talents are better than they actually are. A therapist can assist a bipolar patient in gradually harnessing their creative potential after mood stability and developing an orderly approach and timeframe to reach their goals.

People’s experiences with bipolar disorder might vary. While acknowledging the enormous toll the disorder has on many people’s lives, some persons with bipolar disorder think the condition gives certain benefits, such as creativity, motivation, and leadership. Famous people such as Vincent van Gogh, Winston Churchill, and, more recently, Kanye West are frequently used to demonstrate the link between talent and mental illness.

What is the next step?

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