Recognizing and Coping with Bipolar Depression and Mania

Popularly known as bipolar depression or manic depression, bipolar disorder brings in double trouble as the names suggest.

If you are reading this now, based on your media exposure, various images might pop up in your mind. Mental health issues almost always have a demonised representation in movies.

For example, in the movie Silver Linings Playbook, the protagonist is diagnosed with bipolar disorder. The movie heavily places importance on how his romantic relationship can fix his mental illness. We are now aware that while social support is important for someone with a mental health disorder, professional treatment is vital.

The word bipolar denotes the polarities that an individual may experience after being diagnosed with this condition. At one pole, is the depressive episode where they may experience intense sadness, depletion of energy, hopelessness, and helplessness. At the other pole is the manic episode they may feel ecstatic, full of energy, and engage in impulsive behaviours.

While these may be terms that you are familiar with, it comes down to individual experiences of a mental health condition. How you experience it may be different from how someone with the same condition experiences it. Bipolar disorder can be difficult to diagnose as everyday experiences of sadness and happiness need to be distinguished from clinical concerns of depression and mania.

If you are suspecting that you might be experiencing it, consider meeting a professional such as a Psychiatrist or a Clinical Psychologist for a detailed assessment. Recognizing the signs, causes, and treatments for bipolar depression can be helpful in managing the disorder if you have received the diagnosis.

What are the types of bipolar depression?

Before getting into the types of bipolar depression, it is essential to know about the two types of manic episodes and depressive episodes that one may experience in this disorder. If they are going through a depressive episode, they may display the following signs:

• Lose energy and may not be motivated to engage in their everyday work/ chores
• May feel stuck and hopeless about their current situation
• Sleep too little or sleep excessively, even through their working hours
• Eating pattern and appetite may also be influenced; they may eat too much or eat too little
• May experience difficulties with attention and focus

A person diagnosed with bipolar disorder may experience two types of manic episodes: hypomania and mania. While they share a lot of similarities, there are distinguishing features between the two.

1. Mania

A manic episode can last for up to a week. Imagine a person who becomes extremely excited and appears to have excessive energy. This episode often has an impact on their everyday functioning. When they experience this, you may notice that they:

• May talk really fast and may feel that they can do anything.
• Take risks without thinking of the consequences
• Sleep very little or none at all
• May be irritable and aggressive

2. Hypomania

Hypomanic episodes are different in intensity, duration, and awareness from manic episodes. In a hypomanic episode, you may be able to go about your day, but others may notice a difference in your mood and behavior. It typically lasts at least for 4 days. Some signs of hypomania can include:

• Energy will be higher than usual
• Daily functioning may not be disrupted
• Take impulsive actions but may be less risky
• Decreased need for sleep
• Restlessness and feel that your thoughts are racing

Mood episodes or phases can be unpredictable. Based on these phases, there can be four  types of bipolar disorders:

3. Bipolar I disorder

Characterized by at least one manic episode and depressive episodes may also occur. They may also experience mixed symptoms i.e. they may notice intense shifts in their mood. They generally go through intense highs and lows.

4. Bipolar II disorder

Characterized by hypomanic episodes and depressive symptoms. Since the individual experiences hypomania, the impact of this condition is less severe than that of bipolar I. A person may display heightened energy levels, but may not be out of control.

4. Cyclothymic disorder

This condition is generally considered to be less severe than the ones mentioned above. You may experience a mix of these symptoms over the course of two years. Milder doesn’t necessarily mean better. They may experience mood swings more frequently.

Am I prone to developing bipolar depression? Understanding the causes

You get malaria when a type of mosquito bites you. You develop a cold due to allergies or changes in temperature. What differentiates physical health conditions from mental health issues is that for the latter, there is no single or simple explanations for a cause. There are numerous potential causes of bipolar depression that operate together in complex interactions. It is important to note that no single factor solely causes bipolar depression.

Potential contributing factors of this condition can be:

• Family history of mental illness : If a parent or sibling has been diagnosed with bipolar disorder, it increases the likelihood of a genetic component.
• Significant changes/ shifts in your life: Divorce in the family, death of a loved one, or a personal loss can create significant shifts in your mood.
• Imbalances in hormones: Imbalances in our body’s chemicals can influence how we feel and behave.

Seeking help for your mood disorder

Did you know that the total number of people with mood disorders in India is estimated to be 78 per 1,000 people? This is perhaps the number of reported cases that we have accounted for and there may be many who are not able to access mental health services, often because of stigma. 

Bipolar depression can keep you confused and influence your interactions. While there are various therapeutic approaches, your mental health professional will tailor the healing process for you. When you reach out to a psychologist, try to understand their qualifications and areas of expertise. The following are professionals you can reach out to:

1. Counsellor

If they are a counselling psychologist, they can help you with therapy. However, they are not authorised to provide medications or diagnoses. They have a masters in Counselling or Clinical Psychology.

They can help you understand your mood dysregulations and also help you learn healthy coping strategies to regulate your mood through talk therapy.

2. Clinical Psychologist

Apart from a Masters, clinical psychologists additionally hold an MPhil degree in psychology. They are trained in testing and assessment, and aid in the diagnosis process.

3. Psychiatrist

In cases of severe dysfunction, you may be advised to seek medication. A psychiatrist is a doctor with an MBBS degree. Their primary method of treatment is medication.

If you are experiencing the symptoms of bipolar depression, here are a few things that you can start doing and implementing now:

• Talk to someone in your trusted circle. Tell them about your experience and how the symptoms may be impacting your everyday routine. If you feel ready, you can try reaching out to a mental health professional.
• Try to prioritize your routine. Bipolar depression can affect how you eat and sleep. Ensure that you get enough meals and eat meals regularly.
• Be compassionate with yourself. It can be difficult to recognize that you have a mental health conditions. Try to be kind and empathetic towards your experience.

Ending Note

Often people ask  whether  our concerns are severe enough to seek professional help. Unlike physical health, we can’t ‘see’ our mental health, but that does not mean it doesn’t exist. Bipolar depression is a serious mental health condition that requires professional support. Remember that your emotional landscape needs to be taken care of as much as your physical body!

References:

Arvind, B. A., Gururaj, G., Loganathan, S., Amudhan, S., Varghese, M., Benegal, V., ... & Shibukumar, T. M. (2019). Prevalence and socioeconomic impact of depressive disorders in India: multisite population-based cross-sectional study. BMJ open, 9(6), e027250.