Bipolar disorder is not a classic depression. While unipolar depression is associated with a depressed mood, patients with bipolar disorder suffer from extreme emotional fluctuations. They experience both deep depressive phases and manic episodes. Mania is characterized by euphoria and elation. As sufferers oscillate between two poles, the disorder is called "bipolar".
Here you will find further information and selected 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 the fact that people with a mental illness are also capable of great achievements. At the same time, an illness like this means a particular risk. This is because bipolar disorder has an increased suicide rate of 15 percent (high comorbidity rate). (Source: Deutsches Ärzteblatt; DOI: 10.3238)
The course of bipolar disorder varies greatly from person to person. For this reason, the clinical picture is not always easy to recognize.
Symptoms of a depressive episode
As already mentioned, people suffer from a depressed mood and reduced drive during a depressive phase. They also lose interest in things that were previously important to them. You can find out more about the clinical picture of depression on our pages.
If a depressive episode occurs in a bipolar disorder, the diagnosis is according to ICD-10 (diagnostic catalog of the World Health Organization): F31.3. bipolar affective disorder currently mild or moderate depressive episode without psychotic symptoms.
Severe depressive episodes are given the code F31.4 in this context.
During a depressive phase, the mood is depressed @ MP Studio /AdobeStock
Symptoms of mania
The following main symptoms characterize manic phases:
An example of how elevated mood and irritability go together: A sufferer with an acute manic phase talks incessantly to his partner. He tells her that he now wants to quit his job for good and walk the Camino de Santiago. While he talks, he searches the internet for a suitable flight. He is all for the idea. His girlfriend explains that she doesn't understand his plan. He has never told her about this kind of wish before. She is irritated at how recklessly he is risking his job. He reacts angrily to her objections and questions the relationship.
If a sufferer only shows mild symptoms, doctors speak of a hypomanic phase.
In extreme high phases (mania), people with bipolar disorder are exuberant, active, irritable, erratic and restless @ LunaLu /AdobeStock
Symptoms of hypomanic phases
A hypomanic episode occurs when the person affected has an unusually irritable or euphoric mood for at least four days in a row.
At least three of the following characteristics occur at the same time
During such phases, the performance and creativity of those affected are considerably higher than normal. The symptoms are not necessarily so severe that the affected person experiences exclusion or loss of employment.
As manic-depressive disorder has different forms, it is difficult to diagnose. A survey study from Canada came to the conclusion that it takes an average of six years for a patient to receive a diagnosis.
Why does it take so long? Mental illnesses, including manic-depressive disorder, cannot yet be measured simply by laboratory values.
Many patients consult a doctor during a depressive phase. If they feel better because they fall into hypomania, they discontinue treatment. They feel good and there is hardly any insight into the illness.
The other important aspect is that between 70 and 80 percent of bipolar disorders begin with depression. Specific aspects provide indications of a manic-depressive illness.
The patient is:
In addition, the illness begins at an early age and the course changes abruptly.
Around one to three percent of people suffer from bipolar disorder in the course of their lives. Men and women are affected equally often. Unipolar depression, for example, occurs more frequently in women.
The German Society for Bipolar Disorders reports on its website that manic-depressive people often suffer from other mental illnesses.
These include
In principle, bipolar disorder can affect anyone. The risk of developing the disorder is individual and varies. In most cases, the illness breaks out in early adulthood.
To date, medicine has not been able to identify a clear cause for the onset of bipolar disorder. Experts therefore assume that it is multifactorial. This means that various factors in different combinations can trigger bipolar disorder. The technical term for this is the bio-psycho-social model.
Examples of such factors are
People with bipolar disorder usually receive psychotherapy. In some cases, additional medication may be useful. The therapy should reduce the current symptoms and prevent relapses.
Psychotherapeutic methods such as behavioral therapy are a central pillar in the treatment of manic-depressive illness. Together with the psychotherapist, individual problems as well as the patient's strengths are taken into account.
The person affected practises strategies that help them to deal with their illness. This is also very important because they gain self-confidence and actively work on their recovery.
In some cases, relatives are involved. If possible, this should be done at the start of treatment, provided the patient agrees.
Medication is often used for mania. These so-called phase stabilizers (e.g. lithium) cannot completely prevent a new episode. However, they reduce the risk of relapse and alleviate possible new episodes. In combination with psychotherapy, the treatment reduces the risk of relapse enormously.
The extreme mood swings are very stressful for relatives and loved ones. It can be helpful if relatives deal with the effects and symptoms of bipolar disorder in detail. This enables them to correctly classify the affected person's behavior and develop a better understanding of the patient.
A constant balancing act
If relatives want to support the patient during an acute phase of the illness, they need to be attentive and calm. They are in a constant balancing act between distancing and caring. On the one hand, it is important to show compassion for the patient. At the same time, family members must be careful not to overdo it or neglect their own lives. A major challenge!
Support group for relatives
It can be useful for relatives to join a self-help group for relatives. There they can talk to others and receive support. This makes them feel understood and less alone.
As with all serious illnesses, there are regional self-help groups and internet forums for those affected. The German Society for Bipolar Disorders also supports healthcare professionals with bipolar disorder with special services. For these professional groups in particular (especially doctors, nursing staff and psychotherapists), the diagnosis represents a major challenge.
Bipolar disorder is an enormous challenge for those affected and those around them. The positive aspect is that there are various therapeutic and support services that improve everyone's quality of life.
