I opened my eyes today. The day seems dull, and I find myself stuck in bed. I am too tired to get out of bed and get started. I see my guitar in the corner of my room. When I look back down my memory lane, the guitar was my favourite instrument. I could play it for hours. I keep thinking back to that time till my eyes go to the clock – it is 9 in the morning. There is a sudden rise in my heartbeat as I realise that I am late for college again. I let the anxiety settle and then decide to stay in bed for the 4th day in a row. With all these muddled thoughts, I fall back asleep.
3 months later,
I open my eyes today. There is a rush of energy. My body feels like it has derived extra energy from the night before. I rush around the house, make my morning tea, change into my jogging suit, and go out for a run. I come back home, take a quick shower and change into my favourite dress. I know I look fantastic. I run out, get in my car and drive to my college. Every staff member at the office knows me well. They greet me well, and I greet them back too. They again say, “You are too early for the class.” They say, “3 months back we hardly saw you, but now you are always here, before time.” I ignore it and rush to the library. I have an endless number of projects to finish. I keep taking up assignments from my professors, and, of course, there is additional work from my part-time office. After classes, I meet my friend group. I invite all of them to my house for an impromptu house party. I run to the nearby mall, I buy 10 dresses for myself—it is my party, I should look the best. I hoard snacks for the entire party. The cashier re-checks with me, “Ma’am, are you sure you want to buy all of this at once?” I say, “sure, yes.” I come back home, I wait for my friends, we party, and then I get to clean the house. I think it is good to not feel tired at all.
This is a vignette of a person who is undergoing a depressive and manic phase that is common in bipolar disorder. At its core, bipolar disorder is a cycle of mood fluctuations characterised by emotional highs (mania) and emotional lows (depressions). The duration and intensity of each mood might vary from individual to individual. The experience is also unique to each individual, – which means that one person with bipolar disorder may not have the same experience as another person. While there is individuality in the experience of this disorder, there are two broad types of bipolar disorder: bipolar I and II.
These two phases can manifest themselves in different ways, which are as follows:
Symptoms of emotional high/mania –
Physiological Symptoms: You experience a decreased need to sleep and increased libido/sexual drive.
Affective Symptoms: You feel euphoric, are easily distracted, and have a high sense of confidence and efficacy.
Cognitive Symptoms: You have racing thoughts, lack of insight, poor judgment and decision-making.
Behavioural Symptoms: You have a higher tendency to engage in risk-taking (having sexual relations without using protective measures, engaging in extreme sports), increased talkativeness, speaking fast, increased use of alcohol, etc.
When symptoms of mania occur with less severity, and intensity and have a lower impact on functioning, it is called hypomania.
Symptoms of emotional low/depression –
Physiological symptoms: There is a change in sleeping and eating patterns, physical pain that doesn’t respond to treatment, and significant weight changes.
Affective symptoms: You experience persistent sadness, restlessness, fatigue, hopelessness, helplessness, extreme guilt, and lack of pleasure in previously pleasurable things.
Cognitive symptoms: You have difficulty concentrating, making decisions, and have a reduced ability to focus and remember things.
Behavioural symptoms: You find it hard to go to school/work, difficulty performing well at school/work, low interest to engage in pleasurable activities, and slowed behaviour.
The difference in the combination, intensity, and cycle of mania, hypomania, and depression leads to the distinction in the diagnosis of bipolar I and bipolar II.
Bipolar I
For a diagnosis of bipolar I, there needs to be at least one episode of mania lasting for a minimum of one week. This must be followed or preceded by depressive episodes. The mania might at times come with severe symptoms leading to a break from reality. These episodes and cycles cause disruptions in functioning and are not related to the use of medication and substances.
Bipolar II
In bipolar II, there are major depressive episodes along with hypomania. For the diagnosis of bipolar II, there needs to be at least one episode of depression and one episode of hypomania. Hypomania must last for at least 4 days for the diagnosis to occur. Similar to Bipolar II, there is impairment in functioning and the symptoms are not related to the use of medication and substances.
Cyclothymia
You may experience the emotional highs and lows that are experienced in Bipolar I & II, but this form of the condition is less severe but chronic. You may face some difficulty in functioning because of the changes in your mood, but you may be relatively high functioning despite the fluctuations.
While the symptoms of bipolar disorder can be identified by you, the diagnosis and treatment are tricky. If you suspect the presence of this disorder in anyone around you, please seek the help of a trained clinician. Self-diagnosis might lead you to miss some aspects of the disorder and may delay treatment opportunities! With adequate clinical intervention, bipolar disorder can be managed, and we are here to support you through your journey!
For more information, visit our website: https://www.amahahealth.com
References:
Bipolar disorder – Symptoms and causes. (2021, February 16). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
Holland, K. (2021, November 29). Everything You Need to Know About Bipolar Disorder. Healthline. https://www.healthline.com/health/bipolar-disorder#in-children-and-teens
Newman, T. (2020, July 22). What to know about bipolar disorder. MedicalNewsToday. https://www.medicalnewstoday.com/articles/37010#types
Roland, J. (2019, November 6). Understanding Bipolar Disorder Episodes. Healthline. https://www.healthline.com/health/bipolar-disorder/episodes#Diagnosing-bipolar-disorder