(The little known truth about Bipolar Disorder!)
By Shari Schreiber,
you've already tried antidepressants but felt they "didn't
work" or they only worked short term, you may have
fallen slightly below the radar of your physician or referring
psychotherapist, in terms of an accurate diagnosis. In many
instances, Bipolar Disorder (formerly referred to as manic-depression)
is under-diagnosed or misdiagnosed, and if this happened with
you, your treatment was seriously compromised, and antidepressant
therapy probably left you feeling disappointed and discouraged.
a bipolar condition, you're usually not aware that you have a
problem or something’s wrong, because you have no frame
of reference for feeling differently! Your moods have never really
been consistent or stable for extended periods, so what you've
experienced thus far, is your definition
of “normal,” even if every few months (more or less) you can barely
make it out of bed for several days or longer. Between these intervals,
you may feel fine and be able to socialize and function well in
your chosen field of work, but when a depressive cycle hits, it
pulls the rug out from under you--and all you really
want to do, is to hide under your covers 'till it passes!
Disorder may be only a part of an individual's diagnostic
picture, and other critical diagnoses are very frequently overlooked.
This disorder may be genetically inherited, and is often attended
by other neurological issues like ADD/ADHD--but patients could
also have features of Borderline
and a dual-diagnosis should at least
be ruled out. This wellness site houses a great number of articles
on BPD. Be sure to explore them!
personalities engage in acting-out behaviors, such
as extreme jealousy, drug/alcohol abuse, desperate
attempts to gain attention, lying, self-harm (cutting or burning
skin), intense/irrational abandonment concerns, lack of empathy,
stalking, rebound relationships, perceptions that rapidly shift
from loving/glorifying/idealizing you--to diminishing/criticizing/rejecting
you (and back again), hypersexuality, 'crazy-making' interactions,
histrionics, low self-esteem, poor impulse control, infidelity,
selective memory or recall, emotional cut-off, cognitive
distortions, suicidal ideation, eating disorders, anxiety
or OCD (Obsessive-Compulsive Disorder) traits, emotional blackmail,
extra-marital affairs, etc.
these two disorders can easily coexist within the same person,
they're distinctly separate issues! It would be like comparing
apples to oranges, to ignore the differences between a mood
disorder and a personality disorder, which is precisely
how folks remain confused and untreated. It's extremely
important to make this distinction so that you can determine what
you're up against, and find appropriate, useful help.
studies are suggesting there's a link between ADHD
(seldom seen or diagonosed in females) and Borderline Personality
Disorder. Attention deficit issues are attended by mood
cycles, which can certainly heighten acting-out behaviors. This
may help us more readily discern what type of pharmaceutical interventions
can lead to favorable outcomes. While this does not imply that
BPD problems are exclusively neuro-chemical rather than emotional,
we might begin to treat and manage the symptoms of this
disorder differently and more effectively.
are three main types of Bipolar Disorder: Bipolar
I is characterized primarily by manic episodes, Bipolar
II has mostly depressive periods with hypomanic
(or brief) episodes, and Bipolar III (or Cyclothymia)
is a rapid-cycling mood disorder that can produce numerous high
and low mood swings during the course of a day. The diagnostic
criteria for these types of BD are very specific, according to
the DSM-IV (the Diagnostic and Statistical Manual of Mental Disorders,
fourth edition), but what happens if your symptoms fall slightly
outside these sets of criteria--are
you ever diagnosed and treated, or do you slip through the cracks?
unfortunate truth is, thousands of people suffer with Bipolar Disorder,
but their cycles are non-specific or atypical,
in relation to how it's generally identified or thought of clinically!
They may struggle through numerous drug trials to alleviate
depression, and some could be temporarily more effective than
others, but short term relief can
frequently be attributed to inaccurate or inadequate diagnosis of
a Bipolar II type mood disorder. If your
physician overlooks a bipolar issue and
medicates you only for depression, it's very likely you'll be dissatisfied
with treatment, and feel "what's the point?"
in reference to pharmaceutical intervention. Just be aware
that the right drug therapy can prevent fatal consequences
(suicides) commonly associated with depressive spirals, and help
you surmount this daunting condition.
features of Bipolar II might mean that severe depressive episodes
occur on an extremely rare basis. There could be months, or even
years in-between a down spiral that may have to be relieved
with electro-convulsive therapy (ECT) or 'shock treatments,' used
to restore neurological balance. If you know someone who suffers
from these horrible occurrences, they might need you to function
as their advocate, by helping them find highly qualified care to
avoid this invasive procedure.
effective relief from bipolar depression, a mood stabilizer
is often needed in addition to your
antidepressant therapy, and vice-versa. Some doctors believe that
a mood stabilizer alone will be effective for treating
Bipolar II symptoms--but in my experience, this is seldom true.
Finding the right
that works with your body is imperative, as everybody's
system is somewhat different. If your antidepressant triggers a
manic response, this might indicate a bipolar issue. Manic
or hypomanic episodes can present as extreme irritability or rageful
outbursts, as opposed to elation, extravagant shopping sprees, or
compulsions to paint a room of your house in the middle of the night.
stabilizers are different drugs than antidepressants, as they are
anti-convulsive medications that control extreme mood shifts
your physician has found a solid drug protocol to effectively treat
your unique chemistry, symptoms should feel reduced/controlled within
48 hours. You'll likely experience significant relief from this
neurological balancing, and have some hope for a brighter future.
Do not settle for minimal outcomes. Keep trying to refine
your drugs and dosages to where you're feeling mostly at ease, and
able to function well in your personal and professional spheres.
episodes can feel wonderful. If you're afraid you'll have to give
these up if you take medication, this is an erroneous belief associated
with up or down (good or bad) feelings, which
typically accompany a bipolar issue. Rest assured, you'll still
be able to access good, positive, empowered feelings on medication,
but they won't be as likely to play out in self-destructive ways
(compulsive behaviors or substance abuse), especially if you're
in solid talk therapy to help you resolve any underlying emotional
Disorder is a medical condition that must
be ruled out by a therapist and/or prescribing physician, to avoid
treating you for other issues (like personality disorders) that
may not be the cause of your difficulties.
If you live with this disorder, you can easily have a dual or mixed
diagnosis, which includes Attention Deficit Disorder (ADD/ADHD)
and/or Dysthymia (chronic, mild to moderate depression), so a full
evaluation of your symptoms and emotional history is critical
in determining your treatment needs! ADD is also a cyclical
disorder that can cause mood fluctuations, and prompt you to wonder
if you're "a little bipolar."
While ADD symptomology
is less severe than with a bipolar condition, this neurological
issue can definitely interfere with mood stability, and the effectiveness
of your antidepressant therapy.
should be advised that alcohol is a depressant;
drinking counteracts the positive effects of medications you're
taking to combat your discomfort, and undermines even the most solid
therapeutic intervention. This aside, if your current drug therapy
feels insufficient for managing your symptoms, talk to
your therapist and/or physician about switching to a different prescription,
or increasing the one you're on. If it seems like your doctor is
unresponsive to your concerns or needs, find another one!
Bipolar Disorder is genetically inherited or brought on by severe
head trauma, but more recent studies indicate that environmental
influences can also predict outcome. A baby's brain continues
to develop in critical ways in the first eighteen months or more
of life: Inadequate amounts of nurturant care/attention
during early stages of life, can inhibit normal
neurological development specific to parts of the
brain that control mood regulation, and put a child at risk for
acquiring a bipolar condition or Borderline Personality Disorder
finally seek help when depression overtakes them to the
point they’re contemplating suicide. Those with BPD traits may hear
voices telling them to kill themselves ("why not~it's
a way out of the pain") and suicides are fairly
common during depressive episodes. Acute depression is seldom observed
in someone with a Bipolar Disorder, because he/she withdraws and
virtually disappears from social functioning during a spiral or
down cycle. Typically, friends and relatives are
shocked by a loved one's suicidal demise, having had no prior awareness
of this disturbance. Sometimes there’s a precipitating event that
triggers a depressive episode, but often there’s not--which
makes this a frustratingly unpredictable issue!
UNTREATED BIPOLAR PATIENT
suffer from undiagnosed/untreated mood disorders. The risk of public
shame they'd experience if their condition were disclosed,
usually keeps them from seeking the help they desperately
need. Bipolar Disorders are often the cause of celebrity suicides
or attempts. We're always surprised and confused when we hear that
someone we've perceived to be very jovial, has tried to do away
with him/herself, or died of a drug overdose! Sadly, most "rehabilitation"
facilities target addiction with behavioral or
emotional interventions, but neglect to address neurochemical imbalances
which could have spawned the
addiction in the first place! When rehab clinics neglect to
properly assess and balance/normalize a client's brain chemistry,
relapses are inevitable--and so is lucrative repeat business.
Every relapse magnifies a celebrity client's shame;
on one hand, they've failed at something that "should
have worked" for them, and on the other, each regressive episode
turns into a media event! Hence, the very thing this individual
had hoped to avoid, becomes a deeply humiliating reality.
perspectives on Bipolar Disorder have altered dramatically over
the past decade or so. Graduate schooling suggests that an individual
must fit one of three specific sets of diagnostic criteria to have
a bipolar diagnosis. Atypical variations
are often missed during a clinical consult or psychiatric
evaluation ("psych-eval") with a psychopharmacologist
or physician, because of doctor or therapists' limited clinical
experience--or a client/patient's reluctance to fully disclose their
symptoms, due to feelings of shame.
you resistant to any medical intervention?
Well, you're not alone! Your entire life may have been spent defending
against the notion of having any kind of deficit or need.
When you've been programmed from an early age to repress
your needs, feelings of shame are triggered when they finally begin
to surface. Shame is the primary sensation of core
trauma (or narcissistic injury), which
first occurs in infancy, and is reinforced during childhood.
You couldn't have averted this trauma, any more than you could have
avoided inheriting genetic factors, and this depression is not
others can't relate to your struggle: Only if you've
lived with depression all your life, can you know what the torment
from constant psychic pain feels like! We humans
are pretty resourceful when it comes to figuring out how to help
ourselves feel better; whatever it takes, we'll
find ways to escape our depression and feelings of emptiness or
self-loathing, even if it means putting our personal or
professional world in jeopardy.
experience of needing therapeutic or medical help seems
to activate an old stigma that stops us from seeking assistance.
We may think; “if I need drugs or psychological support, something
really must be wrong with me!” Ironically, we might have
self-medicated most our life, with alcohol/illicit
or compulsive behaviors such as over-work, shopping, gambling, sex,
excessive exercise or religious/cult affiliations, to alleviate
or numb our pain--but when considering drugs that are made
to balance brain chemistry and provide relief,
this seems the hardest pill of all to swallow!
TREATMENT - GOING THE MEDICAL ROUTE
stabilizers most commonly prescribed for bipolar issues are;
Neurontin, Topamax, Lamictal, Depakote and Lithium. Some
of these drugs are more effective when smaller doses are taken 2
- 3 times throughout the course of a day, rather than only once
within a 24-hour period. While Topamax is generally
indicated for Bipolar I (manic) issues, in some cases it's been
very effective for treating Bipolar II (depressive) symptoms with
little or no side effects. Lamictal could
be better tolerated at lower doses, but can cause lethargy or fatigue
as dosage escalates (with some of these drugs, less is more).
Depakote and Lithium require routine
blood tests during initial/early months of treatment, to monitor
potential adverse effects they may have on your liver.
the inception of this piece, the mood stabilizer, Abilify
has been made available to the public, and you've probably seen
television commercials on it. I've known a few folks who've done
very well with this drug, whether it's been added to their existing
antidepressant regimen, or taken alone.
stabilizers can cause hand tremors and difficulty with fine/detailed
tactile functioning (fastening a necklace, for instance), especially
at higher doses. Your doctor may send you home with pharmaceutical
sample packs that tend to increase dosage exponentially, forcing
you to double your pre-existing intake. This can prompt
repercussions, as your body tries to adjust to this significant
change. A more gradual increase (cutting tablets whenever
possible) may help you circumvent this difficulty, but always check
with your physician before you explore any options relating to your
medication dosage. This information is intended to help normalize
the experiences you might have with a mood stabilizer,
and alert you to potential issues that can be easily managed. I
realize some of this could sound pretty scary--but overall, these
drugs are very helpful/safe, and they can greatly enhance
the quality of your life.
HERE'S SOME EXCITING NEWS . . . !
been researching potential benefits of cranial adjustments, in relation
to Bipolar and Attention Deficit Disorders. Preliminary information
strongly suggests that this modality of treatment can positively
impact neurological issues, particularly if onset of symptoms
is associated with head trauma. I had an accident in September,
2007 that left me with a concussion--and this type of help assisted
my recovery. Relatively few chiropractors specialize in this
work, but if you think you'd benefit from seeing a practitioner
who does, you can find cranio-sacral
practitioners in your geographic area, by going to The
Upledger Institute's website; www.Upledger.com.
the realm of natural treatment, Omega
3 (fish or flax) EPA/DHA oils can sometimes enhance mood and lessen
bipolar symptomology. Some of us have difficulty with these 'repeating'
(particularly the fish oil capsules) and understandably, neglect
to take them consistently for this reason.
Any deep sea or cold water (check the label)
fish oil is especially well tolerated, and unlikely to repeat or
leave an aftertaste. The brand, Nature's Bounty makes a
'deodorized' version of this product. Other types can be taken just
prior to eating, to eliminate most of this unpleasantness.
Both types can usually be found at most retail health food establishments--or
local drug chains, like CVS pharmacy. If you cannot find this type
of product, ask your local vendor to order it for you! Two to three
capsules with each meal may alleviate depression and improve cognitive
function. Omega 3 oils won't interfere with your drug therapy, but
they might eventually decrease your reliance on it. Refrigerate
these products once you get them home.
natural approaches, I don't want to neglect to mention bio-feedback
and homeopathy. You might be inclined to explore whether these
options can be effective for you, before trying pharmaceutical intervention.
As is the case with any treatment modality, results may
vary widely. Some feel that homeopathy and bio-feedback are more
effective for children than adults, but (so far) I haven't seen
outcomes that seemed conclusive enough to justify the significant
time commitment or costs associated with either approach.
HGH (human growth hormone) may relieve bipolar
symptomology in certain individuals, but this is an expensive way
to go, and we're not yet certain if extended use is physically safe.
shouldn't have to be so tough and it can be infused with
more joy, but healing
takes place on many different levels. I've assisted people who've
experienced fewer physical ailments or pain, lost weight, let go
of crippling addictions, and expressed "feeling happy for
the first time," because we've identified various obstacles
and/or brain chemical imbalances, and provided the help they've
needed. What will happen if you don't attend to your mood
swings? You'll continue to suffer with these terrible, disruptive
cycles--and that's the problem! If you've experienced an
ongoing pattern of emotional highs and lows, this can be due to
a Bipolar Disorder. Recovery is never "just
a chemical issue," but addressing this piece certainly
helps you begin to see some light at the end of a
very long tunnel. This is your Life that's
on the line~why postpone living it any
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Schreiber, M.A. All Rights Reserved.