Written by: Jacynthe Liew (21-O3), Jachin Khoo (21-U5), Jervis Chng (21-U5), Jolina Nair (21-E5)
Designed by: Jervis Chng (21-U5)
Introduction: What is bipolar disorder?
Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out daily tasks.
Bipolar disorder consists of three types. All three types have common changes in mood, energy and activity levels. Manic episodes are periods of extreme highs while depressive episodes are periods of extreme lows. There are also less severe manic episodes known as hypomanic episodes.
- Bipolar I Disorder— defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Depressive episodes occur as well, typically lasting at least 2 weeks. Episodes where both depressive symptoms and manic symptoms occur simultaneously are also possible.
- Bipolar II Disorder— defined by a pattern of depressive episodes and hypomanic episodes without full-blown manic episodes that are typical of Bipolar I Disorder.
- Cyclothymic Disorder (also called Cyclothymia)— defined by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least 2 years. However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
Bipolar disorder is usually diagnosed during late adolescence (teen years) or early adulthood. Occasionally, bipolar symptoms can appear in children. Bipolar disorder can also first appear during a woman’s pregnancy or following childbirth. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. It can never be completely cured.
What are the symptoms?
People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and uncharacteristic behaviour—which have harmful or undesirable effects.
During manic episodes, people may be abnormally upbeat, jumpy or wired, have an increased activity, energy or agitation and an exaggerated sense of well-being and self-confidence. They also experience a decreased need for sleep, unusual talkativeness, racing thoughts, distractibility and poor decision-making.
On the contrary, during depressive episodes, people may feel sad, empty or hopeless. They experience a loss of interest in nearly all activities and significant weight loss, weight gain, or decrease or increase in appetite. They can also suffer from either insomnia or sleeping too much and either restlessness or slowed behavior. They may also experience feelings of worthlessness or excessive or inappropriate guilt and an inability to concentrate, or indecisiveness. In more severe cases suicidal thoughts are also common.
Both manic and depressive symptoms can occur in the same episode. This kind of episode is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while simultaneously feeling extremely energized.
Ways to support those with bipolar disorder
A good way to start is to educate yourself on bipolar disorder. Learning about the disorder will allow you to be better equipped to help your loved one and keep things in perspective.
Next, encourage your loved one to get help. The sooner bipolar disorder is diagnosed and treated, the better the prognosis, so urge your loved one to seek professional help right away.
Thirdly, be understanding. Let your friend or family member know that you’re there if they need a listening ear, encouragement, or assistance with treatment. People with bipolar disorder are often reluctant to seek help because they don’t want to feel like a burden to others, so remind the person that you care and that you’ll do whatever you can to help.
Finally, show patience. Getting better takes time, even when a person is committed to treatment. Don’t expect a quick recovery or a permanent cure. Be patient with the pace of recovery and prepare for setbacks and challenges. Remember that managing bipolar disorder is a lifelong process.
What not to say
- “You’re Just Overreacting Again”
Overreacting is a symptom of bipolar disorder. Hearing harsh words would be painful to anyone, but for people who suffer from bipolar disorder, they may respond with extreme anger or dark depression. Even a sad movie can make a person with bipolar disorder overreact. You have to understand that it is difficult for them to control their emotions and the way they react.
- “Anything That Doesn’t Kill You Makes You Stronger”
Yes, it’s true that some people go through difficult experiences, learn from them, and come out of it stronger. But this phrase is wrong, bipolar disorder can kill. At least 25% to 60% of people with bipolar disorder attempt suicide and between 4% and 16% die from suicide. If you have a friend or family member with bipolar disorder, be alert for when they might go into a crisis and do not leave them alone.
- “Everybody Has Mood Swings Sometimes”
That’s true. Even those who do not have a diagnosable disorder experience changes in mood. However, only people with bipolar disorder, and related mental illnesses have repeated and severe mood swings between mania or hypomania and depression.
- “Everyone’s a Little Bipolar Sometimes”
This similar phrase is insensitive for the same reasons. Having mood swings is not the same as having a diagnosable disorder.
- “But You Seem So Normal”
Maybe the person with bipolar disorder is between cycles, or maybe they are good at hiding what they’re feeling. They may be in a hypomanic episode and only the good things about it are visible at the moment. Consider how this would sound if you had a serious illness such as cancer and someone said, “You can’t be sick, you look so normal!”
Bipolar disorder is a serious mental illness that should not be joked about. It can be overwhelming for one to have to handle on their own. Take time to support your loved ones and encourage them to seek help to better cope with their symptoms. Even a listening ear can make a world of a difference.
National Institute of Mental Health. (2020, January). Bipolar Disorder. Retrieved June 18, 2021, from https://www.nimh.nih.gov/health/topics/bipolar-disorder/#:~:text=Bipolar%20disorder%20
Mayo Clinic. (n.d.). Bipolar Disorder. Retrieved June 18, 2021, from https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
Segal, J., & Smith, M. (2020, September). Helping Someone with Bipolar Disorder. Retrieved June 18, 2021, from https://www.helpguide.org/articles/bipolar-disorder/helping-someone-with-bipolar-disorder.htm#
Purse, M. (2021, February 26). 9 Things Not to Say to Someone Who Has Bipolar Disorder. Retrieved June 18, 2021, from https://www.verywellmind.com/what-not-to-say-to-somebody-with-bipolar-disorder-380598