Dispelling the Stigma of Bipolar Disorder

Like other forms of mental illness, bipolar disorder is often thought of as a character flaw warranting social criticism. Unlike purely physical ailments, we blame the person for their mental state, not the wiring or chemistry of their brain. 

This stigma only creates more problems: people avoid seeking help in order to avoid stigma.  Those who have received help often feel shame and guilt over their diagnosis.

We need to support each other. If you receive or hear a joke about mental illness, say something. You should know that a number of very creative and talented people have been diagnosed with bipolar disorder: Robert Downey Jr. has been described as the poster child for this illness. Read his story and you’ll know why.  The same goes for Robin Williams and a number of others.  

Please remember to be kind—everyone is broken in some way. Let’s resolve to understand, rather than judge those who struggle with this disorder.

Does my loved one have a Bipolar Disorder?

As 2.6 percent of people suffer from bipolar disorder, there is a probability that you may know someone who will experience the disorder. Given the strong genetic correlation, your chances of developing bipolar disorder increase greatly if another member of your family has been diagnosed with it.

Knowing if a loved one is presenting signs of bipolar disorders is important. Even more importantly, it’s important to know where and how to get help. A thorough evaluation by a psychiatrist, along with medication, are essential for treating mania and major depression.  Talk therapy can help manage symptoms between episodes, and offer support for families.

With good treatment and support from family and friends, people with bipolar disorders can lead productive lives. However, without treatment, the disorder can have a devastating effect on life and relationships. 

Identifying Potential Symptoms
Bipolar disorder, as it is so named, is a disorder of extremes or poles from high to low. Depression and manic states are part of the bipolar cycle. 

You may notice that your loved one is sleeping less and less, and has unlimited energy and full of ideas. This person can be pleasant and fun to be around, but it can quickly change to irritability, which can lead to verbal or physical outbursts. You may notice that your loved one is self-medicating with drugs or alcohol to offset the effects of the disorder. 

You may see increased use of bad judgment from your loved one. They may spend money recklessly and engage in risky behaviors, including casual and unprotected sex, gambling, driving at high speeds, and generally in places where bad things will happen. 
If the symptoms continue without treatment, behaviors can become progressively more threatening.

Approaching the Subject
When speaking to your loved one about their behavior, they may accuse you of being boring, oppressive, or ruining their life. You will need to approach it delicately, as pushing a person in a manic state will lead to unnecessary and potentially harmful conflict. 

Your best strategy is to use a combination of listening to your loved one and applying leverage to influence positive behavior, like meeting with a mental health professional. 

Leverage isn’t about pushing or forcing, but about providing your loved one a choice. For instance, if you are providing something they need like a car, money or something else of value, you can give them a choice about how to proceed: continue receiving these items by getting help, or choosing to live without them and not receiving help. 

Never Give Up
Managing an illness, even after receiving help from mental health professionals is a marathon, not a sprint. Your morale and determination will be tested.  As you support your loved one who struggles with the illness, don’t be afraid to ask for your own help.  Mental health professionals can assist you with finding the resources you and your loved ones need to manage this difficult illness. 

4 Types of Bipolar Disorder

5.7 million Americans or 2.6 percent of the population are affected by bipolar disorder, but their experiences are not exactly the same. Regarding bipolar disorder, there are four distinct types that help mental health care providers identify and treat patients. 

Bipolar I disorder
The one and only criterion for a diagnosis of Bipolar I disorder is having experienced at least one full manic episode. Manic episodes last at least one week or require hospitalization, and cause significant impairment in functioning. Mania is characterized by a dramatic increase in energy and a significantly reduced need for sleep.  There may be grandiosity, aggressive behavior and even a break from reality (psychosis). The manic episode may be preceded or followed by major depressive episodes. However, some people with Bipolar I disorder never experience a depressive episode.

Bipolar II disorder
There has been at least one major depressive episode lasting at least two weeks and at least one episode in which abnormally elevated mood and increased energy or irritation are experienced for at least four days (hypomania), but never at the level of the full manic episode that is characteristic for Bipolar I disorder. Major depressive episodes or the unpredictable changes in mood and behavior cause distress or difficulty in multiple areas of your life.

Cyclothymic disorder
At least two years — or one year in children and teenagers — of numerous periods of hypomanic symptoms alternating with periods of depression. During that time, symptoms occur at least half the time and never go away for more than two months. Mood symptoms don’t meet full criteria of major depression or hypomania, and cause significant distress in important areas of your life.

Other types
These include, for example, bipolar and related disorder due to another medical condition, such as Cushing's disease, multiple sclerosis or stroke. Another type is called substance and medication-induced bipolar and related disorder.

Research suggests bipolar disorder is 60 percent hereditary, and that it typically appears in adolescence or before the age of 25, but it can also emerge later in life. Biological differences in the brain and an imbalance of chemicals called neurotransmitters and hormones could also contribute. Stressors can act as triggers of an onset, like emotional or physical trauma. Bipolar I disorder is a life-long condition that requires use of medication.  Cognitive therapy can assist with early identification and management of symptoms that appear to be chronic or signal onset of a major mood episode. Family members of a person struggling with bipolar disorder often benefit from therapy as well, both in a group and individual settings.