Treatment Corner: Bipolar Disorder

We think of someone as being “bipolar” in quite casually these days; usually we’re describing someone who is moody. Be careful with that label: true bipolar symptoms are like no moodiness you’ve ever seen. Bipolar Disorder is actually two separate disorders:

Bipolar I (classic): one or more manic or mixed episodes of mood; sometimes includes depressive episodes.
Bipolar 2 (rapid cycling): at least one hypo-manic episode and one major depressive episode. Depressive episodes are usually more frequent and intense.

Bipolar I, which is classic bipolar and a more serious diagnosis is more characterized by its manic episodes and does not even always include depressive episodes. A true manic episode has three of the following:

  1. Inflated self-esteem or grandiosity
  2. Decreased need for sleep (feels rested after only 3 hours of sleep)
  3. More talkative than usual or pressure to keep talking
  4. Flight of ideas or experience that thoughts are racing
  5. Distractibility (attention too easily drawn to unimportant or irrelevant external stimuli)
  6. Increase in goal-directed activity (at work, at school, or sexually)
  7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

While rapid-cycling bipolar (Bipolar 2)’s hypo-manic episodes can look simply like a high-functioning person, the depression in this disorder is what usually brings a client in for treatment.

How It’s Treated: Classic bipolar in treatment has some experimentation at first followed by hopefully a steep rise in improvement. Bipolar disorder is one of those diagnoses that therapists very grateful for the medication options available. Clients almost always require medication. There’s usually a mood stabilizer, as well as two other medications to help frame the high and low. When properly medicated, a person with Bipolar disorder feels relief and usually sees their medication as an important part of treatment.

Therapy is essential to help control behavior that results from bipolar disorder. A trusted therapist is crucial to maintaining a stable level of functioning. A client must also have his medication monitored regularly.