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.
Learn More
Five Surprising Ways to Bust a Bad Mood
Everyone has experienced irritability and bad mood or a mood swing at some time in their life. Sometimes that can result in a few hours or a day of feeling on edge, like nothing is going your way. Maybe you are more short with friends and family, things that wouldn’t normally had gotten on your nerves really feel like they are pushing you over your limits, welcome to a bad mood! Below are some ways to beat irritability and a mood swing. If your bad mood or mood swings have lasted for weeks, or months, you may be experiencing a mental health related disorder, you should speak with a mental health counselor or therapist to diagnose and treat this.
Smile! When we activate the zygomatic muscles which course around our cheek bones and eyes, with the process of biofeedback, it sends messages to our brain to signal happiness. This effect has been researched, in studies, when participants held objects in their mouth, forcing the activation of the zygomatic muscles, they rated comic images as much funnier than those who were not holding objects in their mouths. Sometimes, ‘fake it till you make it’ works!
Make sure to smile!
Go for a walk in nature. While any exercise has a positive impact on mood, memory, energy and feelings of wellbeing, those positive effects are doubled when cardio vascular work outs happen in green space. Additionally, the stress marker cortisol is significantly reduced in post measures of participants who took walks in nature. This is compared to those who took the same kind of walk in a city space. Nature really does enhance our mood.
Watch out for cognitive distortions. Pay attention to the way you frame a bad mood, the way we talk to ourselves, or our internal script, really matters. If we run into an annoying situation, we should refrain from allowing that to define the whole day or week. For example, if your alarm doesn’t go off causing you to be late for work, instead of saying, “This is going to be a bad day.” We can say, “Well, this situation happened and I am devoted to making the rest of the day better!”
Dose up on omega 3’s and take that fish oil. Norway, is the country where citizens report being most happy in the world, there are a lot of hypothesis being tested around what makes them so blissed out. The answer might be their access to a diet rich in oily fish. We have long known that oily fish and omega 3’s enhance brain function by reinforcing the myelin sheath of our neurotransmitters, this may hold the key to our happiness.
Reach out to a friend
Phone a friend! Having a best friend, a vent buddy, or other person who will listen to your troubles has protective effects on our health. It is no surprise that those who state that they feel most socially isolated have poorer health outcomes. There is an effect called ‘tend and befriend.’ Women seem to benefit most from tend and befriend, we see this in the way that women often reach out to social supports to talk out their concerns. Women get the benefit of reducing cortisol stress markers and limiting their cardiovascular stress when they talk with friends, even better if they feel that their friend responds with attention, care, and compassion!
Call us at 412-322-2129 for an appointment in any of our Counseling Centers.
Please note, if you are experiencing depression, bipolar disorder, or another mood disorder, this advice will help best while paired with mental health counseling and psychological care from your therapy team, the above advice will not treat or cure a mental health disorder and may not apply depending on the particulars of your psychological needs.
Learn More