How to manage the highs and lows that Is bipolar disorder

It is a diagnosis that many patients keep as a secret, fearing personal or career fallout because of the stigma attached to mental illness. Others may actually have no idea why one day they feel a “high” one day characterized by a burst of energy, increased talkativeness, a decreased need for sleep, and racing thoughts followed by an extreme “low” or depression that can barely render them functional or able to get out of bed.

According to the National Institute of Mental Health (NIMH) an estimated 2.8 percent of adults in United States experience these symptoms, otherwise known as bipolar disorder. It can be an elusive disorder for doctors to identify because they symptoms can vary widely and it is often exacerbated by other factors such as drug use. Most cases of bipolar disorder are not diagnosed until later in life.

Bipolar disorder was recently catapulted into national news when singer Mariah Carey revealed she has suffered from bipolar disorder since 2001. Carey, like many others who have this primary mood disorder, lived in denial, isolation, or fear that the stigma of having a mental disorder carries.

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Dr. Edmi Y. Cortes Torres is a psychiatrist within the University of Miami Health System’s Department of Psychiatry and an assistant professor of clinical psychiatry with the University of Miami Miller School of Medicine.

Bipolar disorder is characterized by its “ups and downs” phases that are usually present for at least a week or two but can sometimes last longer.

Mania and hypomania are characterized by expansive, elated or irritable moods accompanied by an increase in goal-directed activities. An episode of mania often leads to severe disruption in functioning and high-risk behaviors such as spending, gambling, or reckless sex that may put their safety, as well as the safety of others, at risk.

Depression is characterized by a sad, despondent mood that may include among others, a decrease in energy levels, feelings of helplessness and/or hopelessness, thoughts of suicide, and suicidal behavior. When experiencing this low, patients may have trouble sleeping or sleep too much as well as feeling as if they cannot really enjoy anything. Overall, patients with severe mood symptoms either way may also experience a lack of touch with reality that may include hallucinations and delusions. According to the NIMH, patients are more likely to seek medical attention during depressive phases than manic ones.

There are two forms of bipolar disorder that differ in duration of symptoms and severity:

  • Bipolar I is the more severe variety where manic phases can last a week and depressive phases for up to two weeks. Sometimes, a patient can exhibit both manic and depressive symptoms at the same time.
  • Bipolar II, the kind that Carey has, is less acute with manic phases that are not as severe. However, the depressive phases can be as bad as with Bipolar I.

Patients with bipolar disorder can achieve a higher level of functioning with the help of a mental health professional who can minimize impairments. Mental health treatment for bipolar disorder can consist of a combination of medications — namely mood stabilizers —and psychotherapy. Finding a trusted psychiatrist that can prescribe and recommend the right medication regimen is essential.

Psychotherapy, although not a substitute for medications, is also an important part of treatment as it provides patients with needed support during mood exacerbations and remission periods.

If you think you or a loved one may be experiencing symptoms of bipolar disorder, it is important that you reach out to a mental health specialist. Early intervention and treatment is important to achieve a good outcome that can improve long-term prognosis and quality of life.

Dr. Edmi Y. Cortes Torres is a psychiatrist within the University of Miami Health System’s Department of Psychiatry and an assistant professor of clinical psychiatry with the University of Miami Miller School of Medicine. For more information, visit umiamihospital.com/specialties/psychiatry or call 305-355-9028.

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