Each of us has certainly had mood swings at one time or another. Just a moment ago you were happy because you offered your seat to an elderly person on the bus and only 5 minutes later you are angry because the bus is stuck in a traffic jam and you are late for your appointment. These mood changes always have a current reason, so they are immediate reactions to current life circumstances. In bipolar disorder, on the other hand, the mood changes independently of external circumstances, and the fluctuations are much stronger than described above. The disorder progresses in phases that last for different lengths of time. There are symptom-free phases, manic phases, and depressive phases. But not only the mood is affected, but also one's own drive (exaggerated or diminished), as well as feeling and thinking. Affected persons describe that these fluctuating feelings of enormous intensity are sometimes hardly bearable. They do not fluctuate between being sad and being happy, but between deep despair with suicidal thoughts and frenzied enthusiasm for life.
Classification of Bipolar Disorder
There are 3 different courses of the disorder. There is Bipolar I disorder, where violent manias and depression alternate. Then there is the Bipolar-II-disorder, where the manic phases are less violent and last shorter, one also speaks of hypomanic phases. Here, however, the depressive phases are often severe. And lastly, there is the rapid cycling type, where the phases alternate very quickly. If the words mania, depression or hypomania don't mean much to you yet, I would like to explain them to you briefly here.
In this phase, the mood is strongly elevated. The affected person feels euphoric and could literally pull out trees. Often, in this phase, they set their minds on something that is not feasible. At that moment, however, they are convinced that they can do it. They are not open to the concerns of their relatives. Also typical are unrestrained spending, partying, drinking or unprotected sex, as well as unusual behavior (for example, cheating, speeding or stealing) and a reduced need for sleep. Sufferers are also often physically very restless and talk much more than usual.
If the above-mentioned changes are only weakly pronounced, then one also speaks of a hypomanic phase.
In this phase, the affected person is depressed, listless and sad. The need for sleep is increased, but sleep is often impeded by difficulty falling asleep and staying asleep. Behavior from the manic phase is often strongly regretted, which can lead to a maelstrom of guilt and self-reproach that further depresses mood. The consequences from the manic phase, such as money problems or loss of contact with friends and family, are also now realized and trigger worries. Fears about the future may arise. Suicidal thoughts may also emerge during these depressive phases. Unfortunately, suicide rates are quite high when the disease is untreated. Yet there are now good treatment strategies to mitigate the intensity of the phases.
Are there people in your family who are already affected by bipolar disorder? Then you could try to pay attention to some things preventively to counteract a possible outbreak. We are not entirely sure about the origin of bipolar disorder, but at present, a bio-psycho-social model is assumed. This means that both a genetic predisposition and traumatic events or stressors in your past or current life can contribute to the onset of the disorder. If you already have sufferers in your family, then it can be especially important to pay attention to a regular rhythm of life without extreme stress. Permanent stress must be avoided, as well as an irregular sleep-night rhythm. Sleep deprivation, for example, can trigger mania. Talking to a psychiatrist or psychotherapist can also be helpful in recognizing any early warning signs in good time. This is not meant to scare you, but rather to give you the knowledge you need to prevent or be prepared in the event of a first illness.
But even if the disease has already broken out in you, there are good treatment strategies. The Swiss Society for Bipolar Disorders recommends a combined treatment of medication and psychosocial treatment approaches (psychotherapy individually and in groups, psychoeducation, involvement of relatives). There are different medications for the different phases and there are also so-called phase prophylactics. These are drugs that, among other things, have a mood-stabilizing effect. Drug therapy is divided into 3 stages, acute treatment, continuation therapy, and relapse prophylaxis. After the acute symptoms have been treated, the medication must not be stopped immediately. After all, the disease progresses in phases. These phases have a natural end even without medication, but these phases can last quite a long time without medication. If the medication is discontinued before the phase has reached its natural end, acute symptoms can develop again very quickly. Therefore, it is important to continue therapy for some time. For most patients, however, long-term relapse prophylaxis is still needed afterward. It is best to decide together with your psychiatrist whether this is the case for you.
But medication is only one component of treatment. Another important component is psychotherapy. Here you can learn to recognize early warning signs and to deal with the symptoms. Since the disease usually also puts a strain on professional, friendship, or family relationships, it can be relieving to look at these areas of life together with a psychotherapist. You can also learn behavioral techniques in psychotherapy that can help you to counteract the various phases, such as stress reduction and relaxation exercises. Just check out our WePractice homepage to see if a psychotherapist strikes your fancy. We have many therapists who can competently guide you on your path to living with your bipolar disorder.
The goal of combined treatment is to improve your acute symptoms, prevent or mitigate the recurrence of manic or depressive episodes, and protect your brain because if left untreated, the illness can lead not only to distress and social disadvantages but also to changes in the brain. Through treatment, you can regain a very good quality of life. The increased risk of extreme mood swings remains throughout your life, but you can have a decisive influence on the probability of the occurrence of new phases.
Here at WePractice you'll find a wide range of therapists who can support you.