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Diagnosing and Treating Bipolar Disorder

“I feel like I'm a snow globe and someone shook me up and now every little piece of me is falling back randomly and nothing is ending up where it used to be.”  ― Amy Reed, Crazy

Having bipolar disorder can feel like living on a roller-coaster ride as mood, energy, and activity levels swing between extreme highs and lows. Some people experience each mood for a predictable period of time, while others find it difficult to determine when their overall mood will change. In some cases, moods may alternate several times per year. This can leave those who suffer from bipolar disorder feeling hopeless—struggling to function in life.  

According to the National Institute of Mental Health (NIMH), 2.8 percent of the United States population suffers from bipolar disorder each year. These are simply the cases that are treated and diagnosed. Dr. Wes Burgess, in his book The Bipolar Handbook, estimates this statistic could be as high as 7 percent of the population. He states that nearly 10 million will face this disorder during their lifetime, but that over half will fail to receive the correct diagnosis or treatment. On a global scale, bipolar disorder is the sixth leading cause of disability recognized by the World Health Organization (WHO).

If you're wondering whether you or someone close to you suffers from bipolar disorder, we'll go over the symptoms and diagnosis of this mood disorder as well as the treatment options available.

Diagnosing Bipolar Disorder

Bipolar disorder can be difficult to diagnose. In fact, some will suffer for as long as ten years before receiving the correct diagnosis. This is due to the nature of the mood swings that define bipolar disorder. Oftentimes when a person is manic or hypomanic, he/she feels great and doesn't think there is a need to seek treatment. It's typically when a person is going through the depressed period associated with bipolar disorder that treatment is sought, with only symptoms of depression being reported. It's fairly common for someone with bipolar disorder to be incorrectly diagnosed as experiencing depression.

So what does constitute a bipolar diagnosis exactly anyway?

The basic identifier in diagnosing bipolar disorder is the changing of moods from one extreme to the next. A person who is experiencing major depression (MDD) will not swing back and forth between feeling well and having heightened levels of functioning like a person with bipolar disorder will. This heightened state presents as mania, hypomania, or as a mixed episode (symptoms of depression and mania).

The symptoms of mania that differentiate bipolar disorder from depression as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) include:

  • Elevated mood
  • Racing thoughts
  • Increased energy/creativity
  • Lack of sleep
  • Easily becoming distracted
  • Increased interest in activities and/or goals
  • Rapid speech
  • Psychomotor agitation (pacing, repetitive limb movements, etc.)
  • Dangerous behaviors (overspending, reckless driving, risky sexual behavior, etc.)
  • Beginning many projects that are left unfinished
  • Psychosis in the form of hallucinations (audio, visual, etc.) or delusional thoughts/beliefs

Bipolar disorder can be categorized into 5 different categories. These are:

Bipolar 1

Experiencing at least one manic or mixed episode is necessary for a Bipolar 1 diagnosis. This may or may not include an episode of major depression (MDD). Mania is intense for a person with Bipolar 1 and may include psychotic features (hallucinations or delusions).

Bipolar 2

The presence of one major depressive episode, as well as one hypomanic episode (a milder form of mania with the absence of psychosis), or a mixed episode (mania and depression symptoms present together) constitutes a Bipolar 2 diagnosis. This form of bipolar disorder is milder than Bipolar 1, and often less disruptive toward a person's ability to function in life. Sometimes it is possible for a person with this diagnosis to forget about the hypomanic episodes. It is also possible for a person with this diagnosis to suffer from irritability.

Cyclothymia

This is a milder form of bipolar disorder characterized by low-level depression paired with hypomanic states over the course of two years for adults, and one year for children. It's possible to have periods of time without any symptoms for up to two months in adults, and one month in children.

Rapid Cycling

This is a more intense form of bipolar disorder, as there must be four episodes of mania, MDD, hypomania or mixed episodes within one year. This form of bipolar disorder is found in more women than men.

Not Otherwise Specified (NOS)

This diagnosis is given when a person presents some of the symptoms of bipolar disorder without enough to constitute a diagnosis for the aforementioned. It's also given when a person demonstrates rapid mood changes that do not last long enough to be diagnosed as an episode of hypomania or MDD, or when a person experiences several hypomanic episodes in the absence of an MDD episode.

*These episodes cannot be attributed to a medical condition or be substance induced.

Age of Onset

The symptoms of bipolar disorder show up any time from childhood into adulthood. Children who suffer from bipolar disorder are oftentimes misdiagnosed as having ADHD due to the similarity of symptoms, as bipolar disorder in children can present with episodic cycles of:

  • Sadness
  • Irritability
  • Emotional Outbursts
  • Hyperactivity
  • Lack of Impulse Control
  • Aggressive Behavior

These children typically do not respond to ADHD medications.

Treatment for Bipolar Disorder

Treating bipolar disorder can be difficult due to the various episodes a person faces, often with unpredictability. There are antidepressant medications that may be used for MDD episodes, as well as mood stabilizers that help reduce mania. It often takes some time to find the right balance of medications per each unique case, and nearly 50% of people who experience episodes of depression do not respond to antidepressants. It is also difficult for a person who experiences mania to consistently take medication, as they often enjoy the elated feelings being manic brings. Oftentimes it's possible for a person with Bipolar I to induce mania by taking antidepressant medications as well as holistic options. It is best to consult a psychiatrist and licensed therapist when seeking treatment for Bipolar I. 

Studies ultimately show that an integrative approach combining therapy, a healthy diet, the right balance of vitamins, amino acids, minerals, essential fatty acids, exercise, sleep, social support, etc. to be the best defense toward overcoming most bipolar disorders, especially bipolar II. There's been a considerable amount of research conducted on the effectiveness of micronutrients, such as those found in the Focus Essentials formula, for treating certain bipolar II. While research has found micronutrients to be effective at treating bipolar II, more research must be conducted on the effectiveness of micronutrients for treating bipolar I, and many are of the belief that certain ingredients in micronutrients may hold the power to induce mania in those who suffer from bipolar I. Researchers have found that this holistic form of treatment, which includes every vitamin, mineral, amino acid and essential fatty acid our brains need to function optimally, to be an effective method for managing symptoms of not only bipolar II, but also trauma, MDD, anxiety, depression, psychosis, and ADHD.

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