A Therapist’s Thoughts on Bipolar Disorder Inside and Outside the Therapy Room
As a therapist I have had many clients who were diagnosed with or in the process of being identified as having Bipolar I Disorder. Similarly, I recognize experiences with acquaintances whose personalities seemed to dramatically change over time. Before learning more about bipolar disorder, I wondered what had caused these changes, was it me, them, or had our relationships simply changed.
Bipolar I Disorder was once called manic depression because a person with this diagnosis often swings from extreme highs and lows as part of mania and depression phases. Typically, mania involves extreme increases in energy levels and reduced sleep needs, risky and impulsive behaviors, poor decision making, restlessness, and irritability among other symptoms. During a manic episode, a person may feel invincible, on top of the world, and as though nothing can stand in the way of success.
And after, depression occurs as part of a cycle—what goes up, must come down. As good as the mania feels, the depression feels equally bad, including extreme symptoms of sadness, emptiness, and hopelessness/helplessness. Both mania and depression symptoms may occur for several days as part of a repeated cycle. A person can become psychotic during each phase, seeing, hearing, or smelling things that are not there. Likewise, a person may experience suicidal ideation during each phase of bipolar disorder, wanting to end their cycle of pain, poor decision making, and confusion about what happened.
Without treatment a person with Bipolar I Disorder can cycle more regularly between mania and depression, also experiencing more extreme symptoms of each. Examples could be a person quitting their job, filing for divorce, or trying to end their life. Bipolar I Disorder can be difficult to diagnose. This is because mood swings may look different for different people. Additionally, symptoms of mania, including jumpiness, anxiety, and restlessness, may be confused with a generalized anxiety disorder. Distractibility can be confused with ADHD. Depression can look like a simple depressive disorder.
Diagnosis and treatment for a bipolar disorder may not occur until a trained mental health professional observes the significant and long-lasting symptoms of mania and depression as part of a recurrent cycle. Likewise, obtaining a history of similar symptoms among family members can be critical for making a bipolar diagnosis. Additionally, knowing a history of recent trauma as potentially triggering the beginning of the mania/depression cycle might be helpful.
The good news is that there is help to better regulate mood swings and return to a more stable lifestyle. As with any other medical condition, taking medications has proven beneficial for feeling more in control of mania/depression symptoms. Mental health therapy, including individual therapy, couples/marital therapy, and family therapy, has been proven helpful for understanding the impact of having bipolar symptoms, including how we perceive ourselves and are perceived by others.
Supportive therapy can help people with a bipolar diagnosis learn how to create balances between working excessively, staying up late, doing drugs, drinking too much alcohol, and building financial safeguards for preventing overspending. Establishing a supportive circle of friends, professionals, and community resources is usually part of feeling better about self and the world. Keeping mood diaries through various apps can help people monitor potential mood swings.
I look at the world today as being more humane and supportive of people with a mental illness like Bipolar I or II. However, it remains essential that a person with manic/depression symptoms recognize the advancements in treatment of this disorder and reach out for help.
The Counseling and Wellness Center of Pittsburgh is here to help if you are experiencing symptoms of bipolar disorder. Please contact us at 412-322-2129 if you need support.
Written by: Stephanie Davis, MEd, LPC at the Counseling and Wellness Center of Pittsburgh.
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Suicide Prevention
With the suicide of two Hollywood Stars this week, both Kate Spade fashion designer, and beloved Anthony Bourdain, American chef and champion of human rights, we at the Counseling and Wellness Center of Pittsburgh wish to express our condolences to the families, friends, and all of those effected by these tragic losses. According to the National Institute of Health, suicide rates are rising, 40,000 people will die by suicide each year. As a nation, and as people who want to help, we should think about the signs, symptoms, and behaviors of the people around us so that we can do our best in having awareness to prevent suicide. Suicide is a topic which holds personal importance to me, many years ago, when I was an undergraduate student studying psychology, my boyfriend attempted suicide in my bed by placing a bullet into his brain, after months in a coma, he was lucky enough to survive. Yet the act was one which was shocking for all of his friends, his family, and something that impacted me to this day. As a woman who has devoted herself to studying and working in the mental health field, at the time, I did not see the signs that my boyfriend was suicidal.
Suicide is a taboo topic and product of dismal and ill mental health; major depression, bipolar disorder, borderline personality disorder, psychosis, and schizophrenia, are a few of the disorders which are typically associated with an increased risk for suicide. For those who are closest to someone suffering from mental health disorders, the symptoms are very difficult to see for what they are. The thoughts, behaviors, and feelings of a depressed person are a set of treatable symptoms which are a produced by mental illness. Our science and psychology hold diagnostic labels but for the human beings who act out suicide, these symptoms are a daily life experience, they are much more than a label. Mental illness is an often invisible disease causing people to suffer immensely, those who are in the depths of depression or other mental illness, often have not sought treatment with a therapist or mental health professional. A person may walk through life for many years, hollow and bleak, no longer able to experience the hope or purpose to continue living. They may become so overwhelmed that they can no longer imagine the purpose of surviving more days while struggling with their feelings of despair, sadness, conflict, and internal pain. Often the person who commits suicide is one whose self-esteem and thoughts have entered a place of such distortion that they imagine the people who survive them will be better off without them in their lives. Again, this kind of thinking is a product of the illness. Please spend a few moments looking over the suicide warning signs according to the American Foundation for Suicide Prevention.
Behaviors
- Isolating themselves.
- Not returning phone calls.
- Not showing up for family or friends invitations.
- Being withdrawn.
- Giving away possessions.
- Sleeping too much.
- Sleeping too little.
- Using substances to excess.
Talk
- Talking about suicide. *Especially sharing that they have a plan and a way to carry it out.
- Saying that friends and family would be better off without them.
- Feeling like a burden.
- Feeling hopeless.
- Feeling that there is no reason to live.
- Talking about deep feelings of depression or anxiety.
Mood
- Depressed
- Anxious
- Angry
- Confused
- Tearful
- Sudden increase in mood or energy
Environmental Risk Factors
- Relationship problems.
- Financial problems.
- Having access to lethal means such as pills or guns.
- Prolonged stress.
If this sounds like someone you know, or if you have been feeling these things recently, please seek help. Call your local crisis center, here is a number for a national suicide hotline 1-800-273-TALK. Remember that the emotions are temporary and life’s situations which overwhelm us are solvable. Mental health help is around the corner. If your loved one has expressed these things to you, or is exhibiting some of the warning signs, stay with them, ask questions and let them talk about their worries and problems, your presence will help, listen with patience and compassion and be with them while calling the suicide prevention hotline or getting them to a local hospital.
In love and life,
Stephanie Wijkstrom, MS, LPC, NCC
Counseling and Wellness Center of Pittsburgh
830 Western Avenue
Pittsburgh Pa, 15233
2539 Monroeville BLVD
Monroeville Pa, 15146.
Serving Western Pennsylvania with Individual, Marriage, Family, Counseling and Wellness Services.
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