Bipolar Disorder

Bipolar Disorder, Treating the Whole Person

Allan Schwartz, LCSW, Ph.D.

an unquiet mindThe impact of Bipolar Disorder can be so severe that it impacts people along four main dimensions of life: Body, Mind, Emotions and Social Life. Consequently, it impairs the a person's ability to work and maintain intimate relationships. People with this disorder experience a high rate of divorce. There is also a very high correlation between having the disorder and using alcohol and other drugs of abuse. At its worst, someone with Bipolar Disorder experiences hallucinations, delusions and suicidal ideation with the intent to end their lives.

It is for these reasons that treatment of the whole person is the key to regulating the disorder and preventing relapse. In other words, treating symptoms with meditation is an important first step in the recover process. Then, psychotherapy in conjunction with medication becomes all important. Psycho education is also necessary to help the patient recognize triggers to relapse. Armed with medication, information and psychotherapy, patients learn how to avoid a relapse. Avoiding relapse includes remaining compliant with medications while staying away from drugs and alcohol. Stress, overwork and too little sleep are among the types of factors that trigger Bipolar symptoms.

Symptoms of Bipolar Disorder:

Manic Symptoms:

1. Irritability
2. Sleeping less without tiring.
3. Experiencing a rush of energy.
4. Uncontrolled spending.
5. Feeling more self-confident than usual.
6. Socializing/partying out of character.
7. Talking fast and more than usual.
8. Disjointed racing thoughts and ideas.
9. Difficulty concentrating.
10. Increased desire for sex.
11. Uncharacteristic reckless behavior.

Much of this happens because the individual is in a delusional state.

Depression Symptoms:

1. prolonged sadness and crying.
2. Significant change in appetite with eating more or less.
3. Sleeping more than usual.
4. Loss of pleasure in usual interests.
5. Social withdrawal and isolation.
6. Feelings of worthlessness.
7. Suicidal thoughts.
8. Irritability, anger, anxiety.
9. Negativity and indifference.
10. Loss of energy and increased tiredness.

Here, too, delusions and hallucinations are possible.

There can be variability of symptoms with some people rapid cycling between manic and depressive symptoms while others remain stuck at the depressive pole, and every other variation in between rapid cycling and unipolar depression.

The depression pole of this disorder occurs 4 times more often than the mania. It is possible to have one episode of mania and, later, episodes of depression alone.

It is estimated that some four percent of the population has Bipolar disorder. There are those who point out that diagnosis is so difficult and frequently incorrect that the percentages can range up to ten percent of the population.

Diagnosis is very difficult with Bipolar disorder because it overlaps other conditions. For example, dysthymia or mild depression is often diagnosed instead of Bipolar disorder. Also, Bipolar often resembles Attention Deficit Hyperactivity Disorder (ADHD). It is estimated that it can take ten years before some people are correctly diagnosed and treated for this illness.

In returning to the main theme of this article, it is quite important that the whole person be treated. There was a time when mental health experts believed that Bipolar patients could not benefit from psychotherapy. It is now known that this is not true.  In actuality, psychotherapy is important, along with medication,  to treat and control the awful symptoms that afflict people with Bipolar.  There is a real human being, under the symptoms, who struggles with all the usual daily stresses of life. Among these are marriage, children, employment, finances and all the other pressures of life.

Either psychodynamic or cognitive behavioral psychotherapy are very helpful for patients. The advantages of CBT are that it helps the patient learn to counter the types of thoughts that can lead to relapse. Many of these have to do with low self esteem, the wish to resume substance abuse and thoughts of hopelessness.

In my experience it has been very interesting that some of the brightest and most creative people are afflicted with this disorder. However, counter to the romantic idea that being in a manic or depressive phase is what gives rise to creativity, it is only when a person's mood is stabilized that they have access to their full creativity and intellectual abilities.

I recommend the autobiographical by Kay Redfield Jamison, An Unquiet Mind, for a graphic and accurate description of what it is like to cope with this mental disorder.

Your comments and questions are encouraged.

Allan N. Schwartz, PhD.




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