A story of Bipolar Disorder or Manic-Depressive Illness : Does it sound like you?

(This blog is for me to share my experiences and information I have found, or resources I have found useful. This is not a place for self-diagnosis. But if you recognize some of these signs and symptoms in yourself or your loved ones or friends, you/they may need medical attention, please consult the medical physician.)

How does one know if he or she has Bipolar Disorder of Manic-Depressive Illness? It took me 20 years to get a diagnosis. And my first diagnosis was proneness to major depression. It was after a manic episode several months after taking anti-depressant that my Doctor realized that I am actually prone to Bipolar Disorder or Manic-Depressive Illness.

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Early recognition of symptoms can lead to earlier diagnosis. And early diagnosis can lead to earlier finding helps and means to cope.

National Institute of Mental Health (NIMH) produced a very useful article on the real account of someone with Bipolar Disorder and it gives important information on the symptoms of Bipolar Disorder.

The article starts by asking "Are you feeling really “down” sometimes and really “up” other times? Are these mood changes causing problems at work, school, or home? If yes, you may have bipolar disorder, also called manic-depressive illness. "

James’ story:

“I’ve had times of feeling “down” and sad most of my life. I used to skip school a lot then I felt like this because I just couldn’t get out of bed. At first I didn’t take these feelings very seriously.

I also had times when I felt really terrific, like I could do anything. I felt really "wound up” and I didn’t need much sleep. Sometimes friends would tell me I was talking too fast. But everyone around me seemed to be going too slow.

My job was getting more stressful each week, and the “up” and “down” times were coming more often. My wife and friends said that I was acting very different from my usual self. I kept telling them that everything was fine, there was no problem, and to leave me alone.

Then, all of a sudden, I couldn’t keep it together. I stopped going to work and stayed in bed for days at a time. I felt like my life wasn’t worth living anymore. My wife made an appointment for me to see our family doctor and went with me. The doctor checked me out and then sent me to a psychiatrist, who is an expert in treating the kinds of problems I was having.

The psychiatrist talked with me about how I’d been feeling and acting over the last six months. We also talked about the fact that my grandfather had serious ups and downs like me. I wasn’t real familiar with “bipolar disorder,” but it sure sounded like what I was going through. It was a great relief to finally know that the ups and downs really were periods of “mania” and “depression” caused by an illness that can be treated.

For four months now, I’ve been taking a medicine to keep my moods stable and I see my psychiatrist once a month. I also see someone else for “talk” therapy, which helps me learn how to deal with this illness in my everyday life.

The first several weeks were hard before the medicine and talk therapy started to work. But now, my mood changes are much less severe and don’t happen as often. I’m able to go to work each day, and I’m starting to enjoy things again with my family and friends.”

Many people who have bipolar disorder don’t know they have it. This booklet can help. It tells you about four steps you can take to understand and get help forbipolar disorder.

Four steps to understand and get help for bipolar disorder:

1. Look for signs of bipolar disorder.
2. Understand that bipolar disorder is a real illness.
3. See your doctor. Get a checkup and talk about how you are feeling.
4. Get treatment for your bipolar disorder. You can feel better.

Download this Free Booklet from National Institute of Mental Health (NIMH) and read further:

A story of bipolar disorder.pdf

Read on Signs and Symptoms of Bipolar Disorder or Manic-Depressive Illness.

Read on Treatments for Bipolar Disorder or Manic-Depressive Illness.

Symptoms of Bipolar

This article is taken from the website of National Institute of Mental Health (NIMH). NIMH said "NIMH publications are in the public domain and may be reproduced or copied without the permission from the National Institute of Mental Health (NIMH). NIMH encourages you to reproduce them and use them in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated."

Introduction
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

What Are the Symptoms of Bipolar Disorder?
Bipolar disorder causes dramatic mood swings—from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.

Signs and symptoms of mania (or a manic episode) include:
• Increased energy, activity, and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, can't concentrate well
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.

Signs and symptoms of depression (or a depressive episode) include:
• Lasting sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, a feeling of fatigue or of being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleeping too much, or can't sleep
• Change in appetite and/or unintended weight loss or gain
• Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
• Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Thus even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment, however, hypomania can become severe mania in some people or can switch into depression.

Sometimes, severe episodes of mania or depression include symptoms of psychosis (or psychotic symptoms). Common psychotic symptoms are hallucinations (hearing, seeing, or otherwise sensing the presence of things not actually there) and delusions (false, strongly held beliefs not influenced by logical reasoning or explained by a person's usual cultural concepts). Psychotic symptoms in bipolar disorder tend to reflect the extreme mood state at the time. For example, delusions of grandiosity, such as believing one is the President or has special powers or wealth, may occur during mania; delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed some terrible crime, may appear during depression. People with bipolar disorder who have these symptoms are sometimes incorrectly diagnosed as having schizophrenia, another severe mental illness. It may be helpful to think of the various mood states in bipolar disorder as a spectrum or continuous range. At one end is severe depression, above which is moderate depression and then mild low mood, which many people call "the blues" when it is short-lived but is termed "dysthymia" when it is chronic. Then there is normal or balanced mood, above which comes hypomania (mild to moderate mania), and then severe mania.

In some people, however, symptoms of mania and depression may occur together in what is called a mixed bipolar state. Symptoms of a mixed state often include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. A person may have a very sad, hopeless mood while at the same time feeling extremely energized.

Bipolar disorder may appear to be a problem other than mental illness—for instance, alcohol or drug abuse, poor school or work performance, or strained interpersonal relationships. Such problems in fact may be signs of an underlying mood disorder.

Diagnosis of Bipolar Disorder
Like other mental illnesses, bipolar disorder cannot yet be identified physiologically—for example, through a blood test or a brain scan. Therefore, a diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and, when available, family history. The diagnostic criteria for bipolar disorder are described in the Diagnostic and Statistical Manual for Mental Disorders, fourth edition (DSM-IV).2

Descriptions offered by people with bipolar disorder give valuable insights into the various mood states associated with the illness:

Depression: I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless…. [I am] haunt[ed]… with the total, the desperate hopelessness of it all…. Others say, "It's only temporary, it will pass, you will get over it," but of course they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think or care, then what on earth is the point?

Hypomania: At first when I'm high, it's tremendous… ideas are fast… like shooting stars you follow until brighter ones appear…. All shyness disappears, the right words and gestures are suddenly there… uninteresting people, things become intensely interesting. Sensuality is pervasive, the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, euphoria… you can do anything… but, somewhere this changes.

Mania: The fast ideas become too fast and there are far too many… overwhelming confusion replaces clarity… you stop keeping up with it—memory goes. Infectious humor ceases to amuse. Your friends become frightened…. everything is now against the grain… you are irritable, angry, frightened, uncontrollable, and trapped.

This publication, written by Melissa Spearing of NIMH, is a revision and update of an earlier version by Mary Lynn Hendrix. Scientific information and review were provided by NIMH Director Steven E. Hyman, M.D., and NIMH staff members Matthew V. Rudorfer, M.D., and Jane L. Pearson, Ph.D. Editorial assistance was provided by Clarissa K. Wittenberg, Margaret Strock, and Lisa D. Alberts of NIMH. NIH Publication No. 3679
Printed 2002
NIMH publications are in the public domain and may be reproduced or copied without the permission from the National Institute of Mental Health (NIMH). NIMH encourages you to reproduce them and use them in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated. However, using government materials inappropriately can raise legal or ethical concerns, so we ask you to use these guidelines:
• NIMH does not endorse or recommend any commercial products, processes, or services, and publications may not be used for advertising or endorsement purposes.
• NIMH does not provide specific medical advice or treatment recommendations or referrals; these materials may not be used in a manner that has the appearance of such information.
• NIMH requests that non-Federal organizations not alter publications in a way that will jeopardize the integrity and "brand" when using publications.
• Addition of Non-Federal Government logos and website links may not have the appearance of NIMH endorsement of any specific commercial products or services or medical treatments or services.

If you have questions regarding these guidelines and use of NIMH publications, please contact the NIMH Information Center at 1-866-615-6464 or at nimhinfo@nih.gov.

Updated: 01/24/2007