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Bi-Polar, what is it?  How does it feel like to live with?

Bi-polar disorder is sometimes known as 'depression' or Bi-polar affective disorder.  With the condition patients may have periods where their moods can go from one extreme to another; One extreme is known as depression, where a patient feels low and may have other symptoms.  The other extreme is called 'mania' (or hypomania where symptoms are less severe), where the patient feels high or elated along with other symptoms.

The amount of time you experience each extreme can vary.  It is usually for several weeks at a time or longer.  Bi-polar is quite different from the mood swings other people may experience which may only last for a few moments or for several hours.

Patients can experience any number of episodes of highs and lows throughout their life.  There may be short or prolonged gaps between each episode.  In which case the patient will experience times when their mood is 'normal'.  However, some patioents experience the change in highs and lows quite quickly without a period of normal mood in between. This is called 'rapid cycling' and if you experience the rapid cycling you can have at least four mood swings per year.

Also, some people with Bi-Polar can have periods of time with mixed symptoms where they may quickly alternate between depressive symptoms and manic symptoms (usually within a few hours).  This is known as a mixed bi-polar episode.

Who gets Bi-Polar?

About 1 in every 100 of people can get Bi-polar.  It can occur at any age but most commonly occurs between the age of 17-29 years.  It can happen to the same number of men as well as women.  The 'rapid cycling' form of the condition can happen in 1 in 6 cases.  Mania or hypomania can happen in only a small number of people who suffer from depression.  It is more common to just have depression without episodes of mania or hypomania.

What causes Bi-Polar?

The exact cause is not yet known.  However, it can be genetic as there is a higher chance of developing the condition if any one of your family members have been affected.  Stressful situations may trigger an episdode of mania or depression in people prone to this condition.  It is thought that it is to do with an imbalance of the chemicals in the brain which maybe present in people with Bi-Polar Disorder.

What are the symptoms of mania and depression?

Extreme mania may also cause psychotic problems where you lose touch with reality.  For example, you may hear voices, which are not real, experience hallucinations or have false beliefs (delusions).  These tend to be delusions of importance (such as believing that you are a famous celebrity).

Symptoms of Depression:-

What is the treatment for Bi-Polar Disorder?

Treatments include medicines that aim to prevent episodes of mania, hypomaia and depression.  These are called 'mood stabilisers'.  They are taken every day and are long term.  Mood stabilisers are not needed by everyone who suffers Bi-Polar.  They maybe considered if you have had more than 2 episodes of mania, or if you have had suicidal thoughts, or attempted suicide, or if the condition is severely affecting your life.  You will normally continue treatment for at least 2 years but often longer.

Lithium is the most commonly used medicine for Bi-Polar Disorder in the UK.  It is normally taken in tablet form. However, it is not clear exactly how it works.  Anticonvulsant medicines such as sodium valproate, carbamazepine and lamotrigine are used to treat episodes of mania.  They are also used as long term mood stabilisers.

Self-help for Bi-Polar Sufferers:-

Family and Friends

Episodes of mania and depression can be very distressing for family and friends, particularly if they don't really know how to support you and may feel somewhat inadequate.  Letting your family know what is happening to you and how you are feeling, will help them to understand your condition better.  People with mania often do not realise they are ill.  Therefore, it would help family and friends if they knew when it would be appropriate to contact your doctor or other health care worker if symptoms of a new episode of illness develop.

Pregnancy & Bi-Polar

If you are planning to start a family, then it is important to contact your GP or health care worker as soon as possible.  You may require a change in your medication due to it being a risk to your underdeveloped baby.  However, it's important not to stop medication immediately if you find out you are pregnant.  Speak to your GP.

The following is a case study based on a young woman (her name has been changed for confidentiality reasons) who I have worked with and who was diagnosed with Bi-Polar disorder several years ago:-

Laura's story:-

Laura (pseudonym) was diangosed with Bi-Polar disorder 7 years ago.  Up until then she had suffered many bouts of depression, some of which were mild and some of which were very bad.  When Laura was finally diagnosed with Bi-Polar Disorder she could'nt help but feel relieved.  At least she knew what she was dealing with and was able to start to get to know more about the condition.

Although most of her family endeavoured to support Laura, her late Father who passed away last year, often found her condition very frustrating to cope with.  Laura said, "it was because he always had a laid back attitude to life and thought if you had a problem you sorted it or just got on with it."

Laura added, it's not easy to hide your feelings when you are feeling really low.  My Mother has always been relatively empathic but some of my other family members found it difficult to deal with.  Therefore, sometimes I felt isolated.  Applying for a job can also be somewhat daunting because you have to tell your prospective employer about your condition and what that entails.  Consequently, it is not always easy to get a job with the relevant support, or even hold down a job, depending on how often you become ill.

Relationships can also be challenging.  When I met my current partner, I found it very idstressing when I thought about how I was going to tell him about my mental health issues.  My health worker said I did'nt have to tell him anything about my condition if I did'nt want to, but being an open and honest person I didn't want to hide it from him either.  As it happened he guessed, and we discussed it, and he has been very supportive.  We are very happy and I am pleased I have finally met someone who understands me and my condition.

The medication I take is helpful, but it can take years to find the right medication that suits you.  Any new drug they put you on can take between 3-6 weeks before taking effect, which can seem a long time when you are ill.

I have a mental health team, which provide support and I see my psychiatrist every 3 months. I also do CBT with a psychotherapist whom I see monthly and a community psychiatric nurse visits me at home once a fortnight.  I find it most useful having this support in place, as they are all impartial and easy to talk to.  I have also attended support groups in the past.

In my case I believe my condition is genetic as my Great Grandmother suffered with her nerves, and my biological Father's sister suffered with the same condition.  I am also aware it is due to a chemical imbalance in my brain, as well as having experienced trauma in the past, which triggered my depressive and manic episodes.

It has taken me many years to manage my illness and only now do I feel in control of my life due to the level of support I have.  When all else fails, I can also tap into the love and support I get from family and friends.

If you think you may be suffering from Bi-Polar disorder or maybe close to someone who is experiencing any of the symptoms described, then contact your GP immediately to seek advise.


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