Bipolar Disorder

The “Blessing” of Bipolar?

I’ve been blessed haven’t I? … because I’m able to experience life in sort of what some people describe as kind of extremes, it just gives me an opportunity to feel things and experience things that I wouldn’t otherwise do, simple as that.”  If someone you just met were to tell you they were diagnosed with bipolar disorder, most likely the first thoughts that would come to your mind would not be to make a remark congratulating them on their diagnosis; you would probably say something along the lines of, “I’m sorry, that must be difficult to deal with.” While the 2.6% of the population diagnosed with bipolar disorder would almost certainly have their share of devastating stories to tell recounting depressive episodes or suicidal ideation, many people with bipolar also learn to view their illness as an asset to them. The unique perspective their illness gives them allows many people to not only accept the illness as a part of their individual identity but to embrace it for what it contributes to their life as a whole, struggles and setbacks included.  

While it is now a well-circulated fact that there is a link between bipolar and creativity, as there also seems to be with other mental illnesses, the reasons bipolar can be an important part of a patient’s identity extend well beyond creative advantages. Bipolar patients claim their illness allows them greater empathy for others going through similar situations, gives them a tenacity lacking in others who do not have to experience the same struggles and gives them the motivation to focus on all parts of their overall health and well-being, including their physical health. One patient who wrote an article on her experience with bipolar as a mother of three implied that her bipolar has actually provided her with several advantages as a parent. Though she used to feel guilt over how her children would perceive her as they grew older and became more aware of her depressive episodes, she worked to change her own perspective of her illness and used her bipolar and her openness in discussing it with her children as a way to encourage them to examine their own emotional health and freely express how they feel.

The experts also have things to say about why a bipolar diagnosis does not need to be viewed as something that will only cause harm and suffering to the individual. Dr. Nassir Ghaemi, MD and author of the book A First-Rate Madness: Uncovering the Links between Leadership and Mental Illness, claims that the traits inherent in those with bipolar diagnoses could also be linked to greater leadership capabilities. According to Dr. Ghaemi, “Depression enhances empathy and realism and the mania enhances creativity and resilience … so when people have bipolar disorder, they have the full gamut of benefits.” Distinguished historical figures, like Winston Churchill and Florence Nightingale, both known for their tenacity, their wit, and their leadership capabilities, were also plagued by both depressive episodes and periods of enhanced drive and motivation that were rumored to be signs of bipolar disorder. “A lot of the reason we can do what we do is not necessarily in spite of [having bipolar], it’s because of,” explains one bipolar patient.

While bipolar disorder is certainly a difficult diagnosis to deal with and the illness does not come without a very challenging set of trials and setbacks, bipolar does not need to be thought of as a life-ending diagnosis. Many patients learn to view bipolar as an important part of their identity and their personage, learning to cope with the illness by embracing all the parts that come with it, the wild manic episodes, the devastating depression, and the periods in between. And just as patients learn to cope with their bipolar symptoms by viewing them as more than simply a disadvantage or a disability, the same can be said for people with a whole range of mental illnesses, from anxiety to personality disorders to depression, that are just as stigmatized as bipolar.  Learning to embrace this mindset can be helpful in dealing with their diagnosis, and in managing their mental and physical symptoms.


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Bipolar Disorder

Sleeplessness, the Manic Trigger?

What does the word “mania” sound like to you? Does it sound like a high that some people spend large sums of money, energy, and sanity to attain? Does it sound like an adrenaline rush? The peak of a roller coaster, or a sort of euphoria perhaps? While our mind’s eye pictures “highs” in this sort of way, a bipolar manic high can be completely devastating to the person experiencing it. Its effects may include “elevated mood, inflated self-esteem, decreased need for sleep, racing thoughts, difficulty maintaining attention, increase in goal-directed activity, and excessive involvement in pleasurable activities.” While a manic episode may sound a little like an amped up version of your morning caffeine rush, its effects may greatly impact not only the individual diagnosed with bipolar but also have lasting effects on the family members and friends who may be affected by actions taken during this time when one exhibits little control over their actions and their related consequences. While manic episodes are an unfortunate reality for most bipolar patients, new research suggests that these extended euphoric episodes could actually be naturally triggered by extended periods of sleeplessness.

It is commonly known today that sleep deprivation affects many aspects of our physical health and our cognition. Insufficient sleep can make it difficult to concentrate, remember, and retain information and even to regulate your emotions. It also contributes to obesity and cardiovascular problems and has also been linked to a much faster rate of developing dementia as one ages. One University of California professor, Matthew Walker, who has spent the last 20+ years of his life researching sleep and its effects on people and their cognition, even goes as far as to suggest that sleep should be thought of like work or any other mandatory responsibility because of its importance to how we function and our longevity. “[Sleep] needs to be prioritized, even incentivized,” he says, in order to break the cycle of what he calls the “catastrophic sleep-loss epidemic.”  

While Walker points to startling physical and mental effects that sleep loss has on our bodies over time, preventative care is not the only reason to get your eight hours of shut-eye per night. Those with pre-existing mental health disorders are also greatly affected by lack of sleep. Bipolar, for instance, had previously been connected with sleep disturbances such as insomnia, but these sleep disturbances were most often thought of as an effect of the manic episodes and not necessarily the trigger. It turns out that lack of sleep can actually precede the patient’s decline into mania. The previously-mentioned study, just recently published by Cardiff University researchers led by Ph.D. student Katie Lewis, shows a clear connection between sleep loss and manic episodes in bipolar disorder. According to her findings, “20% of people with bipolar disorder reported that sleep loss had triggered episodes of high mood, whereas 12% reported that sleep loss had triggered episodes of low mood.” Though she did find that women and those with bipolar I were more likely to experience this sleeplessness-mania correlation, Katie and her researchers still discovered the same general patterns across her study population even when accounting for age differences, intensity of illness, and other similar variables.

This is a significant finding because a link like this between sleep and manic episodes can prompt new research studies and possible avenues for new treatment options. While this link between bipolar and sleep is relatively unexplored as of yet, research has already been done on the effects of sleeplessness as it relates to depression. Extended periods of wakefulness has actually been shown to be effective in kickstarting treatment for depression, believed by researchers to be due to the fact that lack of sleep prompts your body into a deeper sleep cycle the next time it has a chance to rest. The fact that a deeper sleep cycle can help with mood regulation is an unsurprising result when compared to the Cardiff University study on bipolar. However, much more research still needs to be done on the topic in order to understand its correlation to mental health even more clearly. Perhaps in the future, as Matthew Walker states, the importance of sleep will fully be recognized, and people will begin to think of sleep as a prescription for mental health, and not an unnecessary burden cutting into their social time and leisure activities.


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Lewis, K. S. et al. Sleep loss as a trigger of mood episodes in bipolar disorder: individual differences based on diagnostic subtype and gender, The British Journal of Psychiatry (2017). DOI: 10.1192/bjp.bp.117.202259

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Anxiety and Anxiety Disorders Bipolar Disorder

Bipolar Vs. Anxiety: The Unlikely Relatives

Imagine being on a euphoric mental high so powerful, it makes you dangerous to yourself and others. It makes quickly spending your life savings and engaging in risky sexual behaviors seem like a natural course of action for the intense euphoria you’re experiencing.  After this “high,” your mental state quickly takes a downturn. You crash, you hit the proverbial wall. It becomes hard to function, even though everything was so effortless just days before.  As one patient, comparing her mental state during highs and lows to a sprinting race, puts it,Life, everyone and everything in life, me included, are exquisitely and fabulously beautiful. But then the sprint and marathon race inside my brain finishes. My brain becomes completely exhausted — depleted of everything it had.” By definition, you are experiencing the manic and depressive episodes shared by all sufferers of this disorder, commonly known as bipolar.  

Now, imagine you are fearfully anticipating an upcoming event. Your anticipation is so pervasive it makes it hard to think about anything else or to focus on things that need to be accomplished for school or for work. In fact, it’s even affecting you physically, in the form of muscle tension and lightheadedness. “It feels like a constant heaviness in your mind; like something isn’t quite right, although oftentimes you don’t know exactly what that something is.” You would be experiencing generalized anxiety.  

Now put the two together, the manic highs and depressive lows, the heavy thoughts and the fearful anticipation. This combination of bipolar and anxiety disorders, something psychologists refer to as comorbidity, is in fact what many bipolar patients experience regularly.  According to a study performed on bipolar patients who were part of the National Epidemiologic Survey on Alcohol and Related Conditions, an estimated 60% of people diagnosed with bipolar have also suffered from an accompanying anxiety disorder. This is in contrast to the 2.9% of the population of American adults that suffer from anxiety disorders who may or may not have an accompanying mental illness. Although anxiety may be hard to distinguish from the highly aroused mental state that comes with bipolar manic highs, Dr. Naiomi M. Simon, Associate Director of the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital and Assistant Professor in psychiatry at Harvard Medical School, says that several key factors can help in making a diagnosis. The presence of anxious mood, general worry, panic attacks, or related anxiety symptoms, extended periods of sleeplessness when not in a manic state, and even the time frame during which anxiety symptoms develop, all aid in making a proper diagnosis for an accompanying anxiety disorder.

The fact that these two diseases are so closely tied together is problematic for several reasons. First, some studies show that individuals diagnosed with both disorders were twice as likely to be hospitalized during a depressive episode than those strictly diagnosed with bipolar. The study also correlated stronger bipolar symptoms, such as more manic and depressive episodes and a higher likelihood of suicidal behavior, with a co-occurrence of an anxiety-related diagnosis. Second, just as bipolar is tied to a higher likelihood of experiencing anxiety, the reverse is true as well; those experiencing symptoms solely related to an anxiety diagnosis are nine times more likely to develop bipolar disorder at some point in their lifetime.  Third, treatment for comorbid anxiety and bipolar may be more difficult, as some of the medications prescribed for anxiety may trigger manic episodes even when the patient is taking medicine to control the effects of their bipolar. In addition, antidepressants are sometimes addictive, which may be especially problematic for those more prone to substance abuse as a result of their bipolar.

Despite the potential complications in treatment, there is still hope for decreased symptoms for those struggling with both bipolar and anxiety. According to the Anxiety and Depression Association of America, therapy, in addition to taking prescribed medication, may play a crucial role in mitigating patients’ anxiety symptoms. Research is still being done to investigate the effectiveness of these techniques as they relate to anxiety and bipolar comorbidity.

Though bipolar and anxiety treatment together is still proving to be a challenge for healthcare providers, the combination of both disorders is certainly not uncommon or unique by any means. The comorbidity of these two disorders affects over half of the those diagnosed with bipolar, an important and startling statistic. According to this statistic, patients of both illnesses would actually be in the majority.  Dealing with this sort of mental illness is a complex battle, but with continued research and developments in this field of psychology, perhaps bipolar may one day feel a little less like an exhaustive marathon race and anxiety may feel a little less all-consuming. In the meantime, perhaps increased awareness for the complications of both these disorders can give those of us who do not have to suffer under the grip of manic and depressive episodes and generalized anxiety a better understanding of what sufferers of these disorders experience regularly, perhaps every day.


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