Manic depressive disorder | Bipolar Affective Disorder

Although a bipolar disorder is a very serious condition, coping with bipolar disorder is something you can achieve as long as you have a proper treatment plan. Dealing with symptoms like mania, hypomania and depression seems like a very hard task but with the right support you are very well able to live a ‘normal life’.

Probably the most important thing to do when you have to cope with bipolar disorder is making a good treatment plan.  A treatment plan consists of good contact with a doctor and good contact with a therapist. You should be able to regular visit your doctor to talk about how you feel and if the medication is till doing it’s job. Talking to a psychotherapist is also a very important thing to do. He will guide you how to cope with the symptoms of bipolar disorder and how to recover from episodes of mania, hypomania or depression.

If you don’t have a treatment plan there is a very good chance that coping with bipolar disorder | manic depressive disorder will be a lot harder. You really need to know if the medicines you are taking are still working, and what triggered the depression or the mania. Although you are probably quite well to notice when you feel depressed, it is almost impossible to notice if you are in an episode of mania. When you have an episode of mania you will feel so good that you think medicine is not needed anymore and this will trigger the mania. When you don’t talk to a psychotherapist, you will not get the insight on how you can deal with the symptoms and how to recover. The sooner you notice a new episode coming, the bigger the chance you might prevent it.

A very good idea in dealing with bipolar disorder | manic depressive disorder is keeping a journal. If your regularly write down how you feel and keep track of your progress, you might notice possible triggers sooner. It could also help you sustaining your treatment plan and help you remember when to take your medicine or go to appointments.

Probably the most important thing in coping with bipolar disorder is keeping some kind of daily schedule for your self. You need to keep a tight schedule from the moment you wake up until the moment you go to bed. A disruption of your daily rhythm might be a trigger for a new episode of mania or depression. keeping a schedule will help you maintaining a healthy lifestyle and decrease the chance of a new episode.

There are some common triggers out there that might cause a new onset of an episode. One of them is stop taking your medicine because you feel better. Another one is when you notice you don’t need as much sleep as normal and you don’t want to go to bed. Other triggers might be drugs and alcohol abuse or abnormal flirting with the opposite sex.

Bipolar disorder is a disease you have to life with for the rest of your life. Coping with bipolar disorder will be very hard but the advice mentioned here might get you on track in organizing your life and live a ‘normal life’.

In other posts I have already explained what a bipolar disorder is and what different subtypes there are. Sometimes we will see a bipolar disorder with psychotic features. The term psychosis is not always well explained and I will do my best to give a good explanation what it is and how it effect daily life for someone with bipolar disorder.

There are different types of bipolar disorder and some of them will have features of mania or hypomania. In extreme cases of mania and very rare in heavy depressive episodes, someone will get psychotic features. Psychotic features of mania and heavy depressive episodes are delusions and hallucinations. A person who is psychotic will loose all concept of reality and will not see the world as you and I see it. Delusions are false beliefs.Ffor instance, a person could believe that god himself has send him to be the new messiah. These delusions are often seen in mania and are truly absurd. Sometimes people believe they have super powers or that aliens have invaded earth. These extreme delusions are also seen in Schizophrenia  and schizo-affective disorder. Milder delusions are often seen in people with dementia. Delusions in a major manic depressive disorder are not the same as the ones in mania. They are often more negative as their mood is also very negative. Delusions are related to your negative or positive mood. For this reason, some patients with bipolar disorder are diagnosed with Schizophrenia.

Next to delusions, hallucinations are also frequently seen in a psychotic episode. The main difference between a delusion and a hallucination is that a delusion is something you belief and a hallucination is something you see or hear. There are auditory hallucinations which are often seen in Schizophrenia, patients hear voices in their head telling them to do things. In extreme cases like a psychotic event, patients can see little bugs crawling on their own body or see dead people walking as if they never died. A very good example of such is seen in the movie: A beautiful mind.

When a patient is psychotic he can be in any state and even be a danger to you or himself. The patient is often placed in a room where he can not hurt himself. In psychotic events, only anti-psychotic medicine will help the patient to get out of his psychosis. Often Haloperidol or Risperidone is used to tranquilize the patient and reduce the psychotic effect. Off course only a doctor will subscribe these medicines as the effect should always be monitored.

Bipolar disorder with psychotic features is not seen very often and also wrongly diagnosed with schizophrenia. The chance on a new psychotic event will rise with every new episode of psychosis. Anti-psychotics will reduce the episodes but often not prevent entirely. Another disadvantage is that when people start to feel good they believe they don’t need the medication anymore and without medication the chances on a new psychosis will only rise more.

What is an atypical bipolar disorder? It is actually not a term that is used very often. In psychology language it is referred to a diagnosis bipolar disorder nos. Nos stands for ‘not otherwise specified and is used as a diagnosis when the symptoms of a person don’t fit any other diagnosis in the same spectrum.

Every depression, if it is a unipolar depression or a bipolar manic depression, will start with a period of depression. Even a bipolar disorder will always start with a few cycles of depression. Therefore there is always first a diagnosis of depression before there is a diagnosis of bipolar disorder. Almost 20% will eventually get a mania or hypomania episode and move to the diagnosis spectrum of bipolar disorder.

There are a few different types of manic depressive disorder. It nis not exactly clear how many different types there are but we must consider it as a continuum. We speak of a bipolar disorder 1 when someone has had different reoccurring episodes of mania without major depressive episodes. Depressive episodes are evident but are not required for a diagnosis bipolar disorder 1.

We speak of bipolar disorder II if the disorder is characterized by hypomanic episodes rather than manic episodes and at least one major depressive episode. The criteria for this disorder is that one should not have had an episode of mania. However, this does not guarantee that this person will not eventually get an episode of mania and therefore another diagnosis. The big difference between mania and hypomania is that a hypomania will not go to the extreme. This period is often seen as a productive period where there is nothing wrong with the person as in a mania someone will feel more than good. He feels great and can not see disadvantages of some of his own actions. The normal functioning in a hypomania makes it very difficult to diagnose a bipolar II disorder.

Cyclothymia is defined by periods of hypomania and depression that is not a major depressive disorder. The hypomania and depressive episode will frequently cycle in episodes. Both will not met the criteria for a mania or a major depressive disorder.

an atypical bipolar disorder or also called bipolar nos is given as a diagnosis when someone fits a bipolar disorder but does fit any of the specific diagnosis mentioned above. Although one is not meeting the criteria for a full diagnosis, this does not mean that these people suffer less or function better than people with another diagnosis of bipolar disorder. Atypical bipolar disorder is often a catch-it-all diagnosis but also a disorder that is very well present.