The Center for Reintegration

Back to Work, Back to Life

Bipolar Disorder

Bipolar disorder is a mental illness in which a person's mood can swing dramatically from deep depression to intense highs, or "mania." In fact, the disease is often referred to as manic depression. But no matter what it's called, the disease can seriously affect the lives of everyone who encounters it, including the patients, their families and friends.

In the United States, approximately 1 in 100 people will be diagnosed with bipolar disorder. And while both men and women are equally likely to develop the disease, it tends be a combination of highs and lows for men, whereas women tend to have more cycles of depression than mania.

Bipolar disorder tends to first appear when people are in their 20s, but some show symptoms of the disease as children or adolescents, and some are diagnosed with the illness much later in life. 

Symptoms and Causes

Bipolar disorder is characterized by two different sets of symptoms, both of which can be disruptive and frightening, but can also be effectively treated and managed.

Mania Phase The symptoms of this phase may include:

  • Dramatic elation. A sensation of being on top of the world that nothing can change.
  • Grandiose delusions. Feeling of special connections with holy figures, celebrities or political leaders.
  • Excessively risky behavior. A feeling of invincibility that may also include reckless behavior, eccentric and outlandish spending, irrational business decisions, or unexpected sexual behavior.
  • Hyperactivity. An inability to rest or relax. Constant motion throughout the day and night.
  • Racing thoughts and speech. Rapid shifts in topics, loud and sometimes incoherent speech.
  • Sudden irritability or anger. Outbursts that may follow the disruption of grandiose plans and schemes.
  • Less need for sleep. Staying awake for 3 or 4 days or more.
  • Depressed Phase The symptoms of this phase may include:
  • Deep sadness or despair. An intense feeling of helplessness and worthlessness.
  • Disinterest. Ignores the people and activities they previously enjoyed.
  • Sleep difficulties. Insomnia, sleeping too much, or inability to sleep restfully.
  • Difficulty concentrating. No ability to stay focused on work, conversations or chores
  • Loss of energy. A persistent fatigue no matter how much sleep.
  • Appetite changes. A significant weight loss or a noticeable increase in appetite
  • Thoughts of death or suicide. A serious and constant risk.
  • The timing and duration of these symptom "episodes" is difficult to predict and can vary greatly from person to person. Generally, the depressive episodes last longer than the manic episodes.

Depressive episodes can last months or longer, especially if untreated, while the manic episodes are generally measured by days or weeks.

The possible causes

It's likely that both genetics and environment play a role in the development and onset of bipolar disorder.

Since the disease tends to run in families, a genetic factor is probably at the root of the disease. An overwhelming majority - as many as 90% -- of people diagnosed with bipolar disorder have a relative known to suffer from either depression or bipolar disorder.

Research has also explored other physiological factors, including irregularities in the how brain cells communicate, and an abnormal production or release of hormones.

And while genetics clearly play a role, what causes the actual onset of bipolar disorder is not well understood.

Studies have shown that both manic and depressive phases may be triggered by incidents of physical or emotional trauma, dramatic life changes, or the loss of a relationship. Physical illnesses and hormonal changes have both been linked to the onset of an episode, as well as alcohol or drug abuse.

Following the first manic or depressive episode, symptoms may occur for no clear reason, making the disease especially unpredictable.

But, with the help of physicians, caregivers, family and friends, many people with bipolar disorder are able to live satisfying and productive lives.

Hope and Help

Bipolar disorder is a persistent and life-long condition, but it can be treated and managed over time.

With the right treatment-- and with the support of physicians, caregivers, family and friends -- many people improve and lead successful and gratifying lives.

Medications are often neccessary for improvements in the reintegration process, especially when a dedicated and informed group of people are available to help both the person with bipolar disorder and their family.

Reaching out. Looking in.

Reintegration doesn't happen without help. The help may come from a caregiver, a sibling or even an employer. Often, the help comes in the form of psychotherapy as well as social and vocational training-all of which are helpful in providing support, education, and guidance to people with mental illnesses and their families.

When combined with consistent and appropriate drug therapies, these types of therapies and training can be very effective.

Individual Psychotherapy

Individual psychotherapy involves regularly scheduled sessions between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker, or psychiatric nurse. The goal of this treatment is to help people with serious mental illness understand their experiences, thoughts, and feelings. By sharing experiences with a trained, knowledgeable, and understanding person people with mental illnesses may gradually understand more about themselves and their problems.

Psychoeducation

Psychoeducation involves teaching people about their illness, how to treat it, and how to recognize signs of relapse so that they can get necessary treatment before their illness worsens or occurs again. Family psychoeducation includes teaching coping strategies and problem-solving skills to families (and friends) of people with mental illnesses to help them deal more effectively with their ill relative. Family psychoeducation reduces distress, confusion, and anxieties within the family, which may help the person, recover.

Social skills training

This training, which can be provided in group, family or individual sessions, is a structured and educational approach to learning social relationship and independent living skills. By using behavioral learning techniques, such as coaching, modeling and positive reinforcement, skills trainers have been successful in overcoming the cognitive deficits that interfere with rehabilitation. Research studies show that social skills training improves social adjustment and equips patients with means of coping with stressors, thereby reducing relapse rates by up to 50 percent.

Self-help and Support Groups

Self-help and support groups for people and families dealing with mental illnesses are becoming increasingly common. Although not led by a professional therapist, these groups may be therapeutic because members give each other ongoing support.

Members of support groups share frustrations and successes, referrals to qualified specialists and community resources, and information about what works best when trying to recover. They also share friendship and hope for themselves, their loved ones, and others in the group

FAQ

What is bipolar disorder?

Bipolar disorder is a mental illness in which a person's mood can swing dramatically from deep depression to intense highs, or "mania." In fact, the disease is often referred to as manic depression.

In the United States, approximately 1 in 100 people will be diagnosed with bipolar disorder. And while both men and women are equally likely to develop the disease, it tends be a combination of highs and lows for men, whereas women tend to have more cycles of depression than mania.

Bipolar disorder tends to fist appear when people are in their 20s, but some show symptoms of the disease as children or adolescents, and some are diagnosed with the illness much later in life.

How is bipolar disorder diagnosed?

Only a trained mental health professional can make a diagnosis of bipolar disorder. They will look for periods of persistent depression along with periodic episodes of mania.

What are the symptoms of bipolar disorder?

Bipolar disorder is characterized by two different sets of symptoms, both of which can be disruptive and frightening, but can also be effectively treated and managed.

In the mania phase, the symptoms may include:

  • Dramatic elation
  • Grandiose delusions
  • Excessively risky behavior
  • Hyperactivity
  • Racing thoughts and speech
  • Sudden irritability or anger and less need for sleep

In the depressive phase, the symptoms may include:

  • Deep sadness or despair
  • Disinterest
  • Sleep difficulties
  • Difficulty concentrating
  • Loss of energy
  • Appetite changes
  • Thoughts of death or suicide

The timing and duration of these symptom "episodes" is difficult to predict and can vary greatly from person to person. Generally, the depressive episodes last longer than the manic episodes.

Depressive episodes can last months or longer, especially if untreated, while the manic episodes are generally measured by days or weeks.

What causes bipolar disorder?

Scientists believe that both genetics and environment play a role in the development and onset of bipolar disorder.

Since the disease tends to run in families, a genetic factor is probably at the root of the disease. An overwhelming majority - as many as 90% -- of people diagnosed with bipolar disorder have a relative known to suffer from either depression or bipolar disorder.

Research has also explored other physiological factors, including irregularities in the how brain cells communicate, and an abnormal production or release of hormones.

The actual onset of bipolar disorder is not so well understood.Studies have shown that both manic and depressive phases may be triggered by incidents of physical or emotional trauma, dramatic life changes, or the loss of a relationship. Physical illnesses and hormonal changes have both been linked to the onset of an episode, as well as alcohol or drug abuse.

Is there a cure?

There is no cure for bipolar disorder. With the causes rooted in a complex combination of genetics, brain chemistry and environmental factors, an outright cure is unlikely for the immediate future.

How is bipolar disorder treated?

The treatment of bipolar disorder has advanced dramatically in recent years. Using   mood stabilizing medication and SGA's especially when psychotic synptoms coincide is essential for many patients. Together with the intervention of concerned and informed caregivers and family members, people with bipolar disorder are reaching higher levels of reintegration than ever before.

Is a complete recovery possible?

Bipolar disorder is a disease that will likely affect a person for the rest of their life. But there are more and more people who, through skillful treatment, are finding satisfying work, living independently and forming meaningful relationships. Helping people and their families achieve this level of reintegration is the mission of the Center of Reintegration, and reintegration.com.

Where can someone turn for help?

There are many organizations and other information resources that are available to help people with serious mental illness, their families and concerned caregivers. They include both local organizations and national advocacy groups. Many states have created programs specifically to help people reintegrate.