Learning To Understand Bipolar Disorders

In the alternating bath of emotions – life on a roller coaster.

Heavily cheering, saddened to death. The winged word borrowed from Johann Wolfgang von Goethe’s tragedy “Egmont” describes the psychological disorder known to us as bipolar affective disorder (BAS) more accurately than any other. Affected people live in extremes. Today they have unstoppable energy, a thirst for action, thousands of ideas and an infectious good mood. But soon thereafter the case, the conspicuous fizzling out of energy and drive. Fear and deep sadness take over the helm in the emotional chaos. How can this emotional roller coaster be explained? What is it about this mental illness?

What does the clinical picture of the bipolar disorder include?

Bipolar disorders are counted as so-called affect disorders, i.e. mood disorders. Affected persons sometimes suffer from extraordinarily opposite characteristics of mood, activity and drive. Manic (high) phases alternate with depressive (low) phases without this being controlled intentionally. Between these episodes, people with bipolar disorder usually return to an inconspicuous normal state.

If the high phases are slightly pronounced, they are referred to as hypomaniac, and if they are pronounced, as manic. Severe mania can be accompanied by symptoms of psychosis, such as delusions of grandeur or persecution. Typical signs of mania are increased activity, restlessness, the urge to speak, leaps of ideas and thoughts (not being able to focus on a topic), reduced need for sleep, poor concentration, loss of social inhibitions, excessive self-esteem, reckless or foolhardy behaviour, increased libido.

A mania lasts for several days and can initially contribute to an increase in performance, but from a holistic point of view it represents a serious impairment of lifestyle.

The depressive phase following mania forms the opposite episode of the state of mind. Paralyzing, deep sadness lies like a black curtain on the feelings of those affected. Typical signs of depression are: Lack of drive, loss of interest, lack of motivation, deep depression, self-doubt, feelings of guilt, sleep problems, loss of appetite. The increased risk of suicide associated with the depressive phase should not be underestimated, which is why BAS is also classified as a severe mental illness.

Forms of bipolar disorder

The onset of a bipolar disorder is usually in young adulthood (15-25 years of age), which is a disease group with great epidemiological and health policy significance. It is assumed that 1-3 out of 100 people suffer from a bipolar disorder. Family interdependencies are also discernible. Relatives of an affected person (e.g. children) have a tenfold increased risk of also becoming ill.

As a rule, a distinction is made between bipolar I and bipolar II disorders. People with a bipolar I disorder have pronounced mania and depression phases. In bipolar II disorder, depressive phases alternate with less pronounced manic episodes, the hypomanias.

Cyclothymia is the name given to strong mood swings that last at least two years, but which do not reach the intensity of manic-depressive phases. Basically, this is an attenuated bipolar disorder. Rapid cycling occurs when more than four episodes of disease occur each year.

A combination of several factors is considered to be the cause. This includes biological causes such as genetic changes or modifications in the messenger system of the brain and hormone balance, as well as environmental factors such as permanent stress, experiences of loss or traumatic experiences.

Treatment options for bipolar otherness

The treatment of a bipolar disorder is always individual and usually consists of two components: a drug therapy and a psychotherapeutic approach. Drug treatment serves to normalise mood, drive and sleep rhythms and to prevent further phases of illness.

Accordingly, a distinction is made between acute and maintenance therapy as well as phase prophylaxis. Psychotherapy of bipolar disorders influences the various disease factors, i.e. it aims to identify stress factors in good time and to deal with emotional problems. Her focus is on the stabilisation of social life rhythms, activation in depressive phases and stimulus regulation in manic phases.

Complementary treatment therapies

Recent studies have also demonstrated the effectiveness of so-called light therapies in the treatment of bipolar disorders. It is increasingly used for seasonally dependent depressions (e.g. winter depression), but has also shown success in the treatment of bipolar disorder:

Northwestern University in Chicago in its trial with 46 subjects came to the conclusion that a light shower at noon leads to a surprisingly high remission rate. Controlled sleep deprivation (wakefulness therapy) and electroconvulsive therapy (electroconvulsive therapy) can also help to alleviate symptoms.

The influence of healthy nutrition and sport should not be underestimated. Regular exercise and a healthy lifestyle not only strengthen the body and the immune system, they also sustainably improve well-being and thus counteract manic and depressive phases.