Bipolar disorder is not classic depression. While unipolar depression is characterized by a depressed mood, patients with bipolar disorder suffer from extreme mood swings. They experience both deep depressive phases and manic episodes. Mania is characterized by euphoria and elation. Because those affected oscillate between two poles, the condition is called “bipolar.”
Here you’ll find more information as well as a selection of specialists for the treatment of bipolar disorder.
In 2008, actor Mel Gibson spoke about his diagnosis in the documentary *Acting Class of 1977*. He is a good example of how people with mental illness are also capable of great achievements. At the same time, such a condition poses a particular risk. This is because bipolar disorder is associated with an increased suicide rate of 15 percent (high comorbidity rate). (Source: Deutsches Ärzteblatt; DOI: 10.3238)
Bipolar disorder manifests very differently from person to person. For this reason, the clinical picture is not always easy to recognize.
Symptoms of a Depressive Episode
As mentioned earlier, during a depressive phase, people suffer from a depressed mood and reduced drive. They also lose interest in things that were previously important to them. You can find more details about the clinical picture of depression on our website.
If a depressive episode occurs in the context of bipolar disorder, the diagnosis according to the ICD-10 (World Health Organization’s diagnostic classification) is: F31.3. Bipolar affective disorder, currently a mild or moderate depressive episode without psychotic symptoms.
Severe depressive episodes are coded as F31.4 in this context.
During a depressive phase, the mood is low @ MP Studio /AdobeStock
Symptoms of Mania
The following key symptoms characterize manic phases:
An example of how elevated mood and irritability go hand in hand: A person experiencing an acute manic episode talks nonstop to his partner. He tells her that he wants to quit his job for good and walk the Camino de Santiago. While he’s talking, he searches the internet for a suitable flight. He’s absolutely thrilled about this idea. His girlfriend explains that she doesn’t understand his plan. He has never mentioned such desires before. She is frustrated by how recklessly he is risking his job. He reacts angrily to her objections and calls the relationship into question.
If a person shows only mild symptoms, doctors refer to this as a hypomanic phase.
During extreme manic episodes, people with bipolar disorder are exuberant, active, irritable, erratic, and restless @ LunaLu /AdobeStock
Symptoms of Hypomanic Phases
A hypomanic episode is present when the person has an unusually irritable or euphoric mood for at least four consecutive days.
At the same time, at least three of the following characteristics are present:
During such phases, the affected individuals’ performance and creativity are significantly above normal levels. The symptoms are not necessarily severe enough to cause the affected individual to experience social exclusion or job loss.
Since manic-depressive disorder can take various forms, diagnosis is difficult. A review study from Canada concludes that, on average, six years pass before a patient receives a diagnosis.
Why does it take so long? Mental illnesses, including manic-depressive disorder, cannot yet be easily measured by laboratory tests.
Many patients seek medical help during a depressive phase. When they feel better—because they enter a hypomanic phase—they discontinue treatment. They feel fine and have little insight into their condition.
Another important aspect: Between 70 and 80 percent of bipolar disorders begin with depression. Specific symptoms provide clues to a manic-depressive disorder.
The patient is:
Furthermore, the illness begins at an early age and its course changes abruptly.
About one to three percent of people suffer from bipolar disorder at some point in their lives. Men and women are affected equally often. Unipolar depression, for example, is more common in women.
The German Society for Bipolar Disorders reports on its website that people with bipolar disorder often suffer from other mental health conditions.
These include:
Bipolar disorder can affect anyone. The risk of developing the disorder varies from person to person. In most cases, the disorder first appears in early adulthood.
To date, medical science has not been able to identify a single, definitive cause for the onset of bipolar disorder. Therefore, experts assume that it results from a multifactorial process. This means that various factors, in different combinations, can trigger bipolar disorder. The technical term for this is the biopsychosocial model.
Examples of such factors include:
People with bipolar disorder typically receive psychotherapy. In some cases, additional medication may be beneficial. The goal of treatment is to reduce current symptoms and prevent relapses.
In the treatment of bipolar disorder, psychotherapeutic approaches such as behavioral therapy are considered a central pillar. The psychotherapist takes into account not only the patient’s individual problems but also their strengths.
The patient practices strategies that help them cope with their illness. This is also very important because it helps them gain self-confidence and actively work toward their recovery.
In some cases, doctors involve family members. If possible, this should happen at the start of therapy, provided the patient agrees.
Medications are frequently used to treat mania. These so-called mood stabilizers (such as lithium) cannot completely prevent a new episode. However, they reduce the risk of relapse and mitigate the severity of potential new episodes. When combined with psychotherapy, this treatment significantly lowers the risk of relapse.
The extreme mood swings are very stressful for family members and close friends. It can be helpful for family members to thoroughly familiarize themselves with the effects and symptoms of bipolar disorder. This allows them to properly interpret the person’s behavior and develop a better understanding of the person with the illness.
A Constant Tightrope Walk
If family members want to support the patient during an acute phase of the illness, they need to be attentive and calm. They find themselves in a constant balancing act between setting boundaries and providing care. On the one hand, it’s important to show compassion for the person affected. At the same time, family members must be careful not to burn out or neglect their own lives. A major challenge!
Support Group for Family Members
It can be helpful for family members to join a support group for family members. There, they can share experiences with others and receive support. This helps them feel understood and less alone.
As with all life-altering illnesses, there are regional self-help groups and online forums specifically for those affected. The German Society for Bipolar Disorders also supports healthcare professionals with bipolar disorder through specialized services. For these professional groups in particular—especially doctors, nursing staff, and psychotherapists—the diagnosis poses a major challenge.
Bipolar disorder poses an enormous challenge for those affected and their loved ones. The positive aspect is that there are various therapeutic and support services available that improve everyone’s quality of life.
