This content is associated with The Open University’s Health and Wellbeing qualifications.
Not everyone with bipolar believe they have an illness, instead accepting their experiences as an integral aspect of themselves, however troublesome this might be.
What is it like to live with bipolar?
Bipolar as a disorder
Bipolar disorder is classified as a severe mental illness. It is characterised by extreme mood swings with both episodes of severe depression and episodes of mania. People with bipolar can go into a ‘mixed state’ too, where symptoms of depression and mania occur at the same time, or they can experience ‘rapid cycling’ with frequent changes to their moods.
…or just me?
Some people who have been previously diagnosed with ‘bipolar disorder’ prefer to say they are bipolar. They view it as something which is part of them and part of their identity rather than a label or diagnosis given to one aspect of them. Others see this as being defined by an illness; something akin to saying ‘I am cancer’ rather than ‘I have cancer’. Other people prefer to say they are ‘living with bipolar moods’ or have a ‘bipolar brain’. This may look like semantics, but for people who are diagnosed it can represent much more. How they talk about it links to control, identity and stigma. It is so important to respect the choices people make about defining their relationship to their experience of having bipolar.
How might bipolar affect someone?
At worst, a person with bipolar can experience episodes of mania or depression so severe that they require involuntary hospitalisation and medication. According to Bipolar UK, having bipolar increases an individual’s lifetime risk of suicide by up to 20 times.
Initial feelings of energy and wellbeing, confidence and euphoria develop into a reduced need for sleep, reduced inhibitions, overactivity, restlessness and agitation. This can lead to risk taking or extreme physical health problems due to lack of sleep, lack of food and dehydration. Severe manic episodes may also involve psychosis. This is when the person may hear, see, feel, smell, touch or taste things which are not really there, or may hold strong beliefs which are not normally held by them, or are not based on what’s happening in the world around them - most commonly these are paranoid or grandiose thoughts (known as delusions).
Episodes of mania are usually followed by a period of
depression when the mood drops to a very low level. At worst, the person may be
so slowed down by the depression that they become completely mute, withdrawn
and do not respond to stimulus or to the world around them. This is known as
catatonia.
The experience of bipolar is uniquely personal. No two people have the same
experience, responses to treatments or recovery patterns.
Who gets bipolar?
How and why people get or become bipolar is not well understood. It has long been thought that genetic factors contribute to the development of bipolar, but it is not clear how gene-environment interactions do this. Childhood adversity, such as trauma and abuse, and significant stressful life events may act as a trigger. More recent advances indicate that inflammation and stress pathways in the body may be factors in how bipolar begins.
What helps?
Treatments tend to be medicines that may help with depressive or manic phases. Support can also come from talking therapies. The unpredictability of bipolar can make it difficult to anticipate if someone might be struggling. It may be helpful for friends and loved ones to assist in planning. This could be from noticing symptoms changing to more direct support such as being with the person, encouraging them with doing things they typically enjoy, and listening to them.
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