Bipolar Disorder Balanced with Wellness: PT-I About Bipolar Disorder

Personal: This is a ‘green’ article, which will be several parts – added too, updated, and revised with new information. The purpose is giving insight to bipolar disorder as a mental illness from a personal perspective, the treatment of the bipolar patient’s moods swings, providing an understanding of today’s wellness principals, and touch on alternative medicine choices. Most of this series of internet articles will be informational, though as it progresses personal experience choices will be used to emphasize my learning process / experience.

Disclaimer: This series of articles, blog posts, or other published works is not intended to replace legal, medical, or any other professional service. The information provided is not a replacement for professional advice or care. If you require nutritional, medical, or expert services, please seek appropriate professional care. The author, contributors, publisher and their employees are not liable or held accountable for any damages arising from or in association with the application of any information contained in them. Statements about the efficacy of treatments may not have been evaluated by the U.S. Food & Drug Administration nor been evaluated to diagnose, treat, cure, or prevent any disease.

Bipolar disorder as a mental illness can be a mystery to those diagnosed with it. Thought on the symptoms, observations, treatment, and diagnosis of bipolar disorder has changed with history, although it has always been a mental health issue. Even though the terms have changed – madness, psychosis, reaction, illness, and disorder, the observable symptoms remain the same. Treatment has always been an earnest effort by healers, or those seeking to give comfort, with alleviating the symptoms, though it remains without a cure. Ranging from electroconvulsive therapy to alternative medicine varying treatments is used to this end.

Wellness has grown extensively in modern thought and is a cornerstone of today’s education system, workplace environment, and home life. Wellness goes beyond fitness and health principals taking it toward a holistic lifestyle choice. Supported by the U. S. Surgeon General’s Office, taught on most high school and collegiate campuses, promoted by local, state, and federal Government programs, and accepted in the private sector there is opportunity for learning these principals. Balancing bipolar disorder with sound principals of wellness has the propensity to lead to a productive, fulfilling life while presenting opportunity to insights of meaning.

Dating back as far as the second century, Aretaeus of Cappadocia (ancient Greece) documented symptoms while linking them together. The author of The Canon of Medicine , written in 1025, Avicenna, who was a Persian Physician and psychological thinker, distinguished manic-depression from other forms of madness – mania, rabies, and schizophrenia, as a manic-depressive psychosis. In 1650, Dr. Richard Burton wrote a book The Anatomy of Melancholia focusing on depression. Being credited as the father of depression of mental illness his works are still used today.

During the year of 1854, Jules Baillarger presented to the French Imperial Academy of Medicine "folie à double forme " (‘dual-form insanity’), which was described as a biphasic mental illness causing recurrent oscillations between mania and depression. Linking suicide and depression, Jeane-Pierre Farlet coined the term “folie circulaire ” (circular insanity) from observations of a distinction between depression and heightened moods of elation. His associating this disease to connections with family links an early connection with genetic predisposition.

Using the concept of cyclothymia the German psychiatrist Emil Kraepelin developed those concepts further. His study of the natural course of untreated patients of these manic-depressive symptoms noted periods of symptom free intervals. These followed varying length periods of mood swings as an acute illness – mania or depression, leading to the coined term manic-depressive psychosis .

After WWII, Australian psychiatrist Dr. John Cade worked with veterans with this diagnosis. Using various compounds he discovered in 1949 Lithium Carbonate could be used successfully as a treatment. The current thought feared the toxicity of substituting table salts, so his findings did not lead immediately to treatments. U.S. hospitals in the 1950’s began experimenting with lithium as an alternative medicine , which was followed by the mid 60’s with medical journal reports of its effectiveness. It wasn’t until 1970 the FDA approved it as a medical treatment. Today, bipolar medications are foundational to the treatment of mood swings of the bipolar patient.

Appearing in the American Psychiatric Association Diagnostic Manual in 1952 the term "manic-depressive reaction" was introduced. Adolf Meyer had introduced the paradigm illness as a reaction of biogenetic factors to psychological and social influences. German psychiatrist Karl Leonhard in 1957 was the first to introduce the terms bipolar (for those with mania) and unipolar (for those with depressive episodes only).

With the ever increasing biological thought as the driving force in 1968, both the newly revised classification systems ICD-8 and DSM-II termed the condition "manic-depressive illness." Today the term bipolar disorder is used and the DSM-IV-TR, (Diagnostic and Statistical Manual – Version IV-TR), give it two distinct classifications – Bipolar Disorder Type I and Bipolar Disorder Type II, along with the associated identifiers, cyclothymic disorder and “not otherwise specified .”

Today’s thought is bipolar disorder is a mental illness, a biologically driven disease causing mood swings ranging from the lows of depressions to the highs of mania. There are two main types of bipolar disorder – Type I and Type II. And, an associated disorder closely related to it is known as cyclothymic disorder.

The process of diagnosing is not as simple as a blood test or imaging. Only experienced professionals should be consulted. Most of the diagnostic procedure is from an interview process where the professional hears the symptoms revealed while sharing / talking about your mood swings, behaviors, and lifestyle habits. Some symptoms for the swinging pendulum of bipolar disorder are listed below:

Bipolar mania or hypo-mania

• · euphoria or irritability
• · excessive talk; racing thoughts
• · inflated self-esteem
• · unusual energy; less need for sleep
• · impulsiveness, a reckless pursuit of gratification (shopping sprees, impetuous travel, more and sometimes promiscuous sex, high-risk business investments

Bipolar depression/major depression

• · depressed mood and low self-esteem
• · low energy levels and apathy
• · sadness, loneliness, helplessness, guilt
• · slow speech, fatigue, and poor coordination
• · insomnia or oversleeping
• · suicidal thoughts and feelings
• · poor concentration
• · lack of interest or pleasure in usual activities

These symptoms may endure over long periods of time or cycle one or more times within a short period of time or concurrently, termed mixed bipolar. Cycles of bipolar disorder may be plotted over time. Rapid cycling bipolar disorder is diagnosed after four episodes of depression, mania, or hypomania occur within one year. Rapid cycling can be difficult to diagnose, since the majority of symptoms may be depression leading the medical professional to a misdiagnosis of depression. Research has shown many bipolar II patients spend 35 times the amount of time depressed while their experience of mania or hypomania is interpreted as “feeling good .”

The distinguishing differences between bipolar I and bipolar II is the experience of the symptom of mania. To receive a bipolar I diagnosis a manic episode must be experienced. According to the definition in the DSM-IV, bipolar II is "characterized by one or more major depressive episodes accompanied by at least one hypomanic episode." The key difference between these two is bipolar II has hypomanic but not manic episodes. Also, while those with bipolar I disorder may experience additional psychotic symptoms such as delusions and hallucinations, bipolar II by definition cannot have psychotic features. The definitions of these two are;

Hypomania: “A condition similar to mania but less severe. The symptoms are similar with elevated mood, increased activity, decreased need for sleep, grandiosity, racing thoughts, and the like. However, hypomanic episodes differ in that they do not cause significant distress or impair one's work, family, or social life in an obvious way while manic episodes do.” (MedNet.com)

Mania: “An abnormally elevated mood state characterized by such symptoms as inappropriate elation, increased irritability, severe insomnia, grandiose notions, increased speed and/or volume of speech, disconnected and racing thoughts, increased sexual desire, markedly increased energy and activity level, poor judgment, and inappropriate social behavior.” (MedNet.com)

Today, the most common treatment is an eclectic approach – biological, which commonly is bipolar medications, behavior within varying therapeutic models, and sociological approaches. Some keys to living with bipolar disorder successfully is its acceptance, willingness to learn from teachers – doctors – counselors, and acknowledgment of responsibility as a self-healer.

Today’s medical model for the treatment of bipolar disorder has its cornerstone in biopsychology. After careful evaluation by a trained and experienced professional, which usually is a psychiatrist, medication will be prescribed. Many times multiple bipolar medications are used called a med cocktail. Most cases a mood stabilizer is prescribed, though an anti-depressant, anti-psychotic, or anxiety bipolar medications are also prescribed or any combination of one or more bipolar medications. Discovering the best combination of bipolar medications may vary from individual to individual. And, sometimes it takes months to years to arrive of the best overall prescription. However, the efficacy of the medication may fade with time and then the process may begin again.

Next, therapy or counseling dealing with the havoc of bipolar disorder may be entered. Essential for dealing with the problems it may cause in life, working with a therapist learning how to cope – uncomfortable feelings, relationships, stress, and mood swings, assist the bipolar patient/client on their journey learning. There are many different types of successful therapy, yet the most common and widely practiced is cognitive-behavioral therapy. Following that would behavioral therapy. Also, today’s thought places more emphasis on the sociological factors contributing to the success of a bipolar patient.

Education is an important key component to success with the individual’s treatment. Learning to recognize and manage symptoms and wide swings of the bipolar pendulum begins with thorough and at times comprehensive knowledge. The more the patient/client and family members understand and know about bipolar disorder the better it becomes to handle setbacks and avoid ‘trigger’ situations and problems, (Triggers – external environmental and psychological factors can set off new episodes of mania or depression or make existing symptoms worse).

Lifestyle choices can help to maintain and keep episodes to a minimum. A regular sleep schedule, avoiding alcohol and drugs, following a consistent exercise program, minimizing stress, keeping your sunlight exposure stable year round, a balanced nutrition / menu plan, and choosing the correct vitamins/supplements all help. Having a positive outlook and strong motivation aided by self-discipline practices reinforces these healthy practices of wellness.

The day to day life having bipolar disorder is challenging. Having a solid support system in place can make all the difference to maintaining a healthy outlook while staying motivated in the ongoing treatment process. The support and communication with family members and close friends is invaluable. Participation in local support groups and online chat rooms – forums give opportunity to share with others who recognize, acknowledge and understand like experiences and the daily grind of having this diagnosis.

Lastly, there are other treatments - alternative medicine practices, homeopathic practices, and spiritual awareness, to name a few, that exist today. Many have sound principals based on both historical and scientific evidence and others may not have much credibility. However, those affected by manic-depressive disorder or bipolar disorder may become desperate to alleviate the constant return of symptoms or disarray caused by a bipolar episode. Many have found some success from the exploration of these or at least discovered valuable information to assist in the continued journey of life with a bipolar diagnosis. Sound principals in nutrition, sleep, and exercise as alternative medicine practices are widely acceptance by many professionals today.

One of the keys to anyone’s journey in life is wellness. Balancing the elements of wellness becomes crucial with the highs and lows of life along with modern day stresses, yet presents opportunity for the enjoyment of life.

Although this series of articles is not on happiness, it too becomes an element of the spectrum or rainbow. Pursing the balance of wellness in the bipolar patient’s life with its many factors – symptoms, associated stigma, bipolar medications, comorbid and dual diagnosis, and life history to name a few, offers the best overall probability of experiencing a productive and happy lifestyle, in my view.

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Part-II of this series of articles will look at wellness in religion and philosophies influence, then Part III will be a historical perspective in western civilization. Following will be Part IV on modern thought on its principals, its realization both in today’s United States general society, and touching on the global perspective. Todays accepted principals both taught and practiced will be explained. Emphases from a personal perspective running through it will be the ever constant thread for finding balance with these principals. (Edited 09/17/2011)

Additional articles will be sharing personal experiences with these principles and with alternative practices sought for the alleviation of symptoms and the constant desire to be cured. Psychological, physiological, and sociological experiences will be shared while looking into the why, where, when, who, what and how much, of these turns and twists on a journey to wellness.

The adverse effects of the bipolar experience also will be shared hoping to enlighten the curious as well as hopefully guide others with this diagnosis. Along with adversity comes triumph too! The positive affect will be pointed out with a careful eye of personal examination comparing / contrasting with modern and historical thought on bipolar disorder from a holistic and social approach.

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