Many people experience periods in their lives when they just feel down and out. These moods tend to depart pretty quickly and without much (if any) recurrence. This is not the case for those who live with bipolar depression (also known as BD and, formerly, manic depression).
For those with BD, daily life is often disrupted by major shifts in mood. While BD is difficult to cope with at times, there is hope. There are many different therapies and medications available that help to treat symptoms and make life livable for those with BD.
What Is Bipolar Depression?
Bipolar disorder is a chronic mental illness that is characterized by extreme shifts between manic and depressive moods. In between these polarized moods, a person with BD will experience a leveled-off period in which they experience a normal mood. In other words, BD is a lot less disruptive during these normal periods.
When someone goes into a manic mood, they will seem euphoric and more restless than when they’re in a normal mood. On the other hand, when the person enters a depressive mood, they might lose sleep, feel worthless, and even experience suicidal ideation. However, the duration of these moods can vary. It may last anywhere from a few weeks to a few months. In serious but rare cases, these moods can last for over a year.
Symptoms of Bipolar Depression
The most important thing we should all know about BD is that it looks a little bit different for everyone. BD has multiple comorbidities and shares similar symptoms with other illnesses. BD is typically separated into the five categories:
- Bipolar I;
- Bipolar II (a variation in which hypomania symptoms are milder than they are in those with Bipolar I);
- Cyclothymic disorder (brief and alternating bouts of depression and hypomania);
- Mixed Features (the simultaneous occurrence of mania, hypomania, and/or depression symptoms; major symptoms include insomnia and suicidal ideation);
- Rapid-cycling (the occurrence of four or more episodes within a 12-month timeframe).
Symptoms of mania can include:
- Long periods of elation;
- Being overconfident;
- Not feeling tired;
- Extreme feelings of being impulsive and/or restlessness;
- Racing thoughts and/or speech;
- Being easily distracted;
- Engaging in risky behavior.
On the other hand, when someone enters into a depressive mood, common symptoms are:
- Social withdrawal;
- Extended periods of sadness or hopelessness;
- Loss of or a major increase in appetite;
- Loss of interest in favorite activities;
- Feeling fatigued;
- Struggles with concentration, memory, and making decisions;
- Having suicidal thoughts or a preoccupation with death.
If one believes that someone might harm themselves or someone else, they should not hesitate in seeking help. Calling a local emergency number or 9-1-1 and remaining with the person in need until help gets there can help save lives.
Causes of Bipolar Depression
While researchers have yet to pinpoint a particular cause of BD, there are some risk factors:
- The structure and functioning of the brain;
- Family history.
In 2007, British scientists studied scans that show accelerated brain shrinkage in those with BD. Those with BD might have interruptions or impairments in the way that the regions of the limbic system (the hippocampus, amygdala, and cingulate gyrus) communicate since these areas are are part of the regulation of emotions, learning, memory, fear, and motivation.
As far as genes go, scientists are finding that mutations in certain genes, especially in the MTHFR gene, might be the culprit behind many physical and mental illnesses, including BD. Also, BD seems to run in families, although it does not seem to pass to all offspring of someone with BD.
Other Issues Related to Bipolar Depression
One of the less-talked-about issues with BD is the co-occurrence of psychosis. Bipolar psychosis can manifest during periods of depression or mania but seem to occur most commonly during manic episodes.
At the onset, an individual dealing with bipolar psychosis will likely experience:
- Struggle at work or in school;
- Socially withdraw;
- Not express much emotion;
- Not communicate or think clearly;
- Be suspicious of others.
As time goes on, this can lead to a loss of awareness of reality, delusions, hallucinations, and incoherent speech and/or thought patterns.
Bipolar Depression Treatment Options
There is hope for those living with BD. Children and adults can be diagnosed and receive treatment. Treatment options typically include medications, therapy, and, in severe cases, hospitalization. There are a wide array of different medications that can be used, including mood stabilizers (such as lithium), antipsychotics (like Latuda), antidepressants, an antidepressant/antipsychotic combination, or anti-anxiety medications.
- Psychotherapy is commonly used in conjunction with medications and/or hospital stays. Cognitive Behavioral Therapy (CBT) and Interpersonalization and Social Rhythm Therapy (ISRT) are two of the most effective forms of psychotherapy for treating those with BD. CBT emphasizes recognizing and changing negative thought patterns to more realistic and healthy ones. This makes it helpful at identifying BD triggers. ISRT helps people understand their body’s natural and social rhythms. Also, this allows clients with BD to develop skills that de-escalate and even prevent future episodes.
- Additionally, those with BD incorporate calming activities into their daily routines. These activities can range from quiet walks in nature to yoga. Many therapists also encourage practicing mindfulness and visualization techniques.
Bipolar Depression in Popular Media
Over the years, celebrities have been more vocal about their struggles with bipolar depression.
- Singer Demi Lovato received inpatient care in 2010 to 2011 for bipolar disorder and bulimia.
- Author Sherman Alexie, rapper Chris Brown, and comedian David Walliams have all been diagnosed with forms of BD. Moreover, Walliams has called his 2006 swim of the English channel a redemption in his battle with BD.
Regardless of which type of bipolar depression any of us is diagnosed with, there are treatment options available. While BD can certainly bring about a sense of hopelessness, there is a reason to hope.
Many individuals with BD have found peace of mind in the inpatient and outpatient treatments they have received for their symptoms.
The images are from depositphotos.com.