I decided, that to maintain some semblance of order between these posts that I'll stick with 3. It's an unusual change from my otherwise utterly chaotic schedule that makes sense only to me, but change is always welcome, by me. I think that, if I'm being honest with myself, this is also an attempt to distance myself from the emotional outburst of 2 days ago, by applying cold-hard logic to it. It's probably my tertiary function, Ti, coming into play, seeking internal consistency of logic where my Ni (dominant) has failed to create the harmony required of Fe (auxiliary).
Bipolarity Disorder
A) What is it?
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide.
Despite the common belief that bipolarity is a personality disorder, it is actually not. It is classified as a mental disorder that can cause the manifestation of personality orders usually of the Cluster B kind (antisocial, borderline, histrionic, narcissistic) or AvPD (Avoidant Personality Disorder).
As suggested by the name, sufferers of Bipolar disorder experience uncontrolled and extreme swings in mood. To people on the outside, Bipolarity may be very difficult to distinguish from the usual moodswings that everyone experiences. This is especially true of Bipolarity II, in which the elevation of mood is less severe, while depression is relatively more severe.
B) Common Symptoms
Bipolar disorder is characterised by periods of mania or manic episodes and depressive episodes.
Mania
1. Mood Changes
- A long period of feeling "high" or an overly happy or outgoing mood
- Extreme irritability
2. Behavioural Changes
- Talking very fast, jumping from one idea to another, having racing thoughts
- Being easily distracted
- Increasing activities, such as taking on new projects
- Being overly restless
- Sleeping little or not being tired
- Having an unrealistic belief in one's abilities
- Behaving impulsively and engaging in pleasurable, high-risk behaviours
Depression
1. Mood Changes
- An overly long period of feeling sad or hopeless
- Loss of interest in activities once enjoyed
2. Behavioural Changes
- Feeling tired or "slowed down"
- Having problems concentrating, remembering and making decisions
- Being restless or irritable
- Changing eating, sleeping or other habits
- Thinking of death or suicide, or attempting suicide
It's easy to see how people with bipolarity can easy be seen as just pure cranky or queer. Often, it is only the person himself/herself who can identify the disorder from how uncontrollable and random the episodes seem. In my case, for example, my manic and depressive episodes are rarely marked by any occurrences and just happen without warning. It's not as if something great or terrible happened, I can just be going along with my day as usual and an episode happens.
C) Four Basic Types of Bipolar Disorder
1. Bipolar I Disorder - defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually depressive episodes occur as well, typically lasting at least 2 weeks.
2. Bipolarity II Disorder - defined by a pattern of depressive episodes and hypomanic (less severe form of mania - feel good, highly productive, function well) episodes, but no full-blown manic or mixed episodes.
3. Bipolar Disorder Not Otherwise Specified (BP-NOS) - diagnosed when symptoms of the illness exist but do not meet diagnostic criteria for either bipolar I or II. However, the symptoms are clearly out of the person's normal range of behaviour.
4. Cyclothymic Disorder - a mild form of bipolar disorder. People with cyclothymia have episodes or hypomania as well as mild depression for at least 2 years. However, the symptoms do not meet the diagnostic requirements for any other type of bipolar disorder.
I can say, as a Bipolarity II person, that the differences, though quite small in the descriptions, is actually quite significant. For example, Bipolarity I and II sufferers experience very different moods in that Bipolarity I sufferers generally experience more of the mania than Bipolarity II sufferers.
I'm not exaggerating when I claim to experience Major Depression because I have been tested for that before. However, because that one trip to the psychiatrist was a secret, not known by anyone else and funded by my own saved up pocket money, I can only be diagnosed with it and not treated for it.
D) Causes of Bipolarity
1. Genetics
Bipolar disorder tends to run in families. Some research has suggested that people with certain genes are more likely to develop bipolar disorder than others. Children with a parent or sibling who has bipolar disorder are much more likely to develop the illness, compared with children who do not have a family history of bipolar disorder. However, most children with a family history or bipolar disorder will not develop the illness. In my case, my dad has quite a mild form of personality disorder, but there is no form of bipolarity on either side of the family besides that.
Genes are not the only risk factor for bipolar disorder. Studies of identical twins have shown that the twin fo a person with bipolar illness does not always develop the disorder, despite the fact that identical twins share all of the same genes. Research suggests that factors besides genes are also at work. It is likely that many different genes and environmental factors are involved. However, scientists do not yet fully understand how these factors interact to cause bipolar disorder.
2. Brain Structure and Function
Some imaging studies show how the brains of people with bipolar disorder may differ from the brains of healthy people or people with other mental disorders. For example, one study using MRI found that the pattern of brain development in children with bipolar disorder was similar to that in children with "multi-dimensional impairment", a disorder that causes symptoms that overlap somewhat with bipolar disorder and schizophrenia. This suggests that the common pattern of brain development may be linked to general risk for unstable moods.
Another MRI study found that the brain's prefrontal cortex in adults with bipolar disorder tends to be smaller and function less well compared to adults who don't have bipolar disorder. The prefrontal cortex is a brain structure involved in "executive" functions such as solving problems and making decisions. This structure and its connection to other parts of the brain mature during adolescence, suggesting that abnormal development of this brain circuit may account for why the disorder tends to emerge during a person's teen years. Pinpointing brain changes in youth may help detect illness early or offer targets for early intervention.
3. Environmental
Evidence suggests that environmental factors play a significant role in the development and course of bipolar disorder, and that individual psychosocial variables may interact with genetic dispositions. This can explain why identical twins may not both develop the disorder as environmental factors are key in triggering its development. There is fairly consistent evidence from prospective studies that recent life events and interpersonal relationships contribute to the likelihood of onsets and recurrences of bipolar mood episodes, as they do for onsets and recurrences of unipolar depression.
There have been repeated funding that 30-50% of adults diagnosed with bipolar disorder report traumatic/abusive experiences in childhood, which is associated on average with earlier onset, a higher rate of suicide attempts and more co-occuring disorders. The total number of reported stressful events in childhood is higher in those with an adult diagnosis of bipolar spectrum disorder compared to those without, particularly events stemming from a harsh environment rather than from the child's own behaviour.
My Take on the Issue
While Bipolarity is nothing to laugh at, since it can be worse than depression in some cases, as the rapid moodswings can easily wear down a person, I don't think it's a cause for concern. As far as I am concerned, I have been rather bipolar since I was young, with the trend becoming more obvious and more severe as I get into my teen years. What started as random episodes of happiness and sulkiness in childhood developed into recklessness and suicidal thoughts from as young as I was 13. For as far as I am concerned, for as long as I had been in this state of emotional maturity, I always had to deal with untreated bipolarity.
I can't remember the first person who said I'm a person with so many faces that it's hard to tell what mood I'll be in the next second, and I certainly won't meet the last any time soon. Well, if it makes you feel any better, I can't predict the next swing coming either. It's rather like my migraine attacks - you can't tell it's coming until it's already here and I'm already going blind in one eye.
I think the biggest confusion is the trigger point. Yes, there is a trigger for Bipolarity, but once the disorder is triggered, there exists no identifiable triggers for the episodes that define the disorder. In other word, it is easy to tell what in your life has caused the recurrence, but it is never possible to tell why you are feeling a certain mood at a certain time. In fact, I could be laughing at a joke one minute and the next, I'm feeling like I want to kill myself for no apparent reason other than I got reminded, by myself, that I'm useless.
The best way to deal with it, for me at least, is to avoid triggering the disorder. It had died down for a while, at least in the first few months last year, but I stupidly went ahead and dove into a situation that triggered it again. I should know by now that while I'm super into risk-taking, I just don't have the mental capability to deal with the consequences, even if I thought I was prepared to. I can certainly put on a façade and pretend I'm not bothered while I'm basically tearing tissue of my being apart on the inside, but it does not lower the risk of triggering a recurrence.
I'm pretty sure the AvPD that was caused by 2 years ago has already been cured, but as far as Bipolarity is concerned, I'm pretty sure it's here to stay.
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