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Heaven and hell, in a single brain | All the things you need to know about Bipolar Disorder

March 5, 2018

“She is sometimes a ranged shrew, with shrieks pierced my ears and frightful expressions in her eyes; standing on the stage, she forgets her lines, sings the wrong words, assaults other actors and falls into frustration from time to time. While she comes to a silence, her suffering martyrdom reveals her facet of a child.”

 

Vivien Leigh may leave us with an impression of the sprightly, shining Scarlet in Gone with the Wind. However, the fact that she suffered from bipolar disorder is not a secret. Swinging in this bi-polar state, she exchanged for a dazzling but brief life at the expense of her health.

 

So today, let us talk about all things related to bipolar disorder.

 What is bipolar disorder?

 

Bipolar disorder, also called manic-depression, is a severe mental illness characterized by alternating periods of mania and depression.

 

Mania is a remarkable characteristic of bipolar disorder, which commonly features:

  • A heightened state of mind: an individual’s mind is extremely high but easily enraged.

  • Racing thoughts: an individual’s pace of thinking is much faster than the frequency of language expression; individuals may speak very quickly often making quick changes between different topics. Sometimes individuals even find it hard to express themselves as their brains are too full of ideas.

  • Increased activity: an individual becomes extremely talkative, fast-talking, and exaggerated in their words and content.

  • Elevated self-esteem with impulsive behavior.

  • Little need for sleep: the individual never gets tired even after prolonged activity and after working for a long time; they do not need to sleep, or only sleep a little.

 

The main character of Skam — the Norwegian TV series, suffers from bipolar disorder. When he is in a manic episode he never sleeps at night and runs around naked at midnight. He, on a whim, breaks into other people’s houses to swim, and speaks unceasingly in an unconstrained style.

 Depression is the second characteristic of bipolar disorder. Depressive episodes of bipolar disorder tend to be very similar to single-phase depression (major depressive disorder) and they are difficult to distinguish clinically. Low state of mind, loss of interest, and decreased activity also appear when patients enter episodes of depression. Only when they feel depressed, do people with bipolar disorder tend to seek help. In fact, it is exactly because they only go to the doctor when they feel depressed that many people suffering from bipolar disorder are wrongly diagnosed as having depression. So, if you notice symptoms of depression in your family or friends, you had better pay attention to if they show manic behavior as well.

 

The most painful truth for bipolar disorder patients is that they are alternately attacked by mania and depression. Sometimes you may see them living in an extreme high state of mind — so high that they feel like they are the master of the universe. In contrast, they sometimes get so depressed that they no longer want to carry on living.

 

One bipolar disorder sufferer said to us, “Someone bleeds all his energy to keep living — that person is me.”

 Some misconceptions about bipolar disorder:

 

Those who experience the pain will feel empathy towards those people suffering it. People without such experiences may easily have some misunderstandings and confusion about mental illness. This is especially true for bipolar disorder, which may give people a large space for imagination, and leads many misconceptions to arise.

 

1) Bipolar is just the normal ups and downs of moods.

Many people may simply regard bipolar disorder as a state of “sometimes happy, sometimes sad”. Some people may put the label of “bipolar” on themselves and others at their will.

 

This is very unfair for those who are actually suffering from bipolar disorder — just as some wrongly believe that patients with depression will get better merely by “being more positive”. It minimizes what it is actually like to live with bipolar.

 

Sufferers of bipolar disorder are always swinging between heaven and hell in their lives. The feelings of surging and falling follow them, along with the struggle through day and night. As people who have not experienced bipolar, we may seek excitement by playing Mega Drop. But what if you imagine that you spend your entire life on the Mega Drop? This would probably be somewhat like the reality of a bipolar disorder patient.

 

2) Bipolar disorder favors genius (maybe I want some too)?

Some people think that bipolar disorder is a kind of “genius disease”, which is the price people pay in exchange for intelligence and creativity. Many anecdotes and biographies show a tendency for people suffering from bipolar disorder or schizophrenia to show signs of genius and of being in possession of an “incomparable vision of world.” Some believe that an abundant imagination and creativity are the silver lining that keeps sufferers alive in the darkness of the disease.

 

In the book Bipolar Disorder and Temperaments of Artists by American psychologist Kay Redfield Jamison, a list of celebrities who may suffer from bipolar disorder is shown. Writers, artists, and composers make up the majority..

 

In reality, bipolar disorder is a severe mental illness; the pain brought by it is strong enough to beat a man down. The “genius patients of bipolar disorder” reported by the media is a survivor bias. Though the ability to create incomparable arts sounds really captivating, bipolar is definitely not worth looking for. There are also many sufferers of bipolar disorder who do not demonstrate any exceptional genius or creativity – this expectation is simply false.

 3) Is there a switch to alter the moods?

Many people think it incredible that bipolar disorder patients can switch between mania and depression. Actually, some patients themselves can dimly perceive a “switch” in their brains, by which they can choose to turn on the manic state.

In fact, the “switch” does not exist. Only in some conditions when the patients are doing certain activities, hormone secreted in their brain affects neural activities and accordingly trigger the mania. It is actually a switching process.

Normally, patients are not able to anticipate the state in the next few seconds. Mood swings cannot be absolutely controlled.

 The road after bipolar disorder

 

Bipolar disorder cannot be completely cured. Patients treated by medication have a quite high recurrence rate one year after treatment.

In addition to the physical treatment by medication, psychological therapy plays an important supporting role during the rehabilitation period. In the case of emotional stability, the corresponding psychological counseling and treatment can greatly decrease the rate of recurrence. Mindfulness techniques and cognitive behavior therapy have proved to be effective measures for the treatment of bipolar disorder.

 

For the family and friends of patients, their symptom of swinging between mania and depression is a heart-breaking and grievous problem. This situation seems “unreasonable” to them and it may consume all of their care and patience.

 Above all, for the patients themselves, the tolerance from both their families and the society in which they live is a crucial factor to alleviate the illness. Support, comprehension, and companionship from family and friends will provide the patients with a better environment for their recovery, and they are also useful indicators for predicting patients’ emotional stability.

 

All the changes start from understanding

 

All changes start from understanding. We participate in the MoodLaB-Bipolar Awareness Raising Project initiated by CandleX. We hope that this project is able to raise people’s awareness of bipolar disorder and also reduce the social stigma attached to it.

 

Being devoted to a charity project related to psychology requires a lot of courage. People’s disdain, misunderstanding and so on can turn into significant obstacles for the project. We are very excited that CandleX is willing to make efforts, together with 简单心理, to eliminate the social stigma surrounding bipolar disorder. We know this stigma exists and we are determined to change it.

 Pere Ibañez, a renowned photographer, is now working with the project and exhibiting his photos, each of which shows a single man expressing their bipolar moods through facial expression and gesture.

 Perhaps not everyone can understand what these photos stand for, but for those who are getting troubled by bipolar, they are very impressive.

 

We want to send people experiencing bipolar disorder the message that they are not alone; some people are caring about them, and ready for help.

 

Hope you will stand by us and CandleX, to raise the public awareness of bipolar disorder, and eliminate the social stigma of it.

 

References:

 

American Psychiatric Association (2013). DSM-5.

Andreasen, N. C. (1987). Creativity and mental illness. American journal of Psychiatry, 144(10), 1288-1292.

Ball, J. R., Mitchell, P. B., Corry, J. C., Skillecorn, A., Smith, M., & Malhi, G. S. (2006). A randomized controlled trial of cognitive therapy for bipolar disorder: focus on long-term change. The Journal of clinical psychiatry, 67(2), 277-286.

Gale, C. R., Batty, G. D., McIntosh, A. M., Porteous, D. J., Deary, I. J., & Rasmussen, F. (2013). Is bipolar disorder more common in highly intelligent people? A cohort study of a million men. Molecular psychiatry, 18(2), 190-194.

Salvadore, G., Quiroz, J. A., Machado-Vieira, R., Henter, I. D., Manji, H. K., & Zarate Jr, C. A. (2010). The neurobiology of the switch process in bipolar disorder: a review. The Journal of clinical psychiatry, 71(11), 1488-1501.

Zammit, S., Allebeck, P., David, A. S., Dalman, C., Hemmingsson, T., Lundberg, I., & Lewis, G. (2004). A longitudinal study of premorbid IQ score and risk of developing schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses. Archives of general psychiatry, 61(4), 354-360.

 

 

 

 

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