Bipolar Disorder

What is Bipolar?

Bipolar disorder, also called manic-depressive disorder, is a psychological illness that severely reduces a person's energy, mood and concentration, especially in daily activities. Basically, bipolar disorder is when patients feel very well one moment and then become withdrawn after a while. For this reason, the most characteristic feature of bipolar patients is that their moods are extreme. For this reason, when bipolar disorder is at its peak, patients experience a burst of energy and feel very happy. However, when patients develop depressive moods, they tend to become suicidal with depressive moods.

If there is no severe bipolar disorder, patients may experience these episodes only a few times in their lifetime. Although many patients can recognize these changes in themselves, this is not the case in advanced patients. Bipolar disorder, which develops due to many different causes, is usually the most common disorder in patients who consult a doctor for depression.

Symptoms of Bipolar Disorder

Bipolar disorder is a disease with extreme extremes. For this reason, bipolar patients tend not to realize what they are experiencing, especially during the mania phase. It is only after the manic phase has passed that they begin to question their actions. Since bipolar patients are not aware of their condition, they usually go to a specialist with the encouragement of their relatives.

Patients with an advanced bipolar diagnosis have these episodes much more severely. As a result, their work, family and social lives are severely affected. In addition, patients with bipolar disorder may experience hallucinations and believe in delusions, especially during periods of mania and depression. Symptoms of bipolar disorder vary depending on whether patients are in mania or depression.

Symptoms of manic episodes

The manic period of people with bipolar disorder is usually a period of high energy. For this reason, the symptoms seen in the manic period include the following:

• Feeling too happy, too angry or too irritable
• Being more active than usual
• Feeling tense
• Reduced need for sleep
• Speaking quickly about different topics
• Increased appetite for pleasures such as food or sexual intercourse
• Feeling unusually strong or capable

Symptoms of depressive episodes

Symptoms seen in the depressive episodes of people with bipolar disorder include the following:

• Feeling very sad
• Being anxious
• Feeling slowed down
• Being restless
• Concentration problems
• Indecision
• Tendency to sleep more
• Speaking too slowly
• Finding nothing to say
• Forgetfulness
• Lack of interest in all activities
• Inability to perform daily activities
• Feeling hopeless and worthless
• Thinking about suicide

Manichean Period

• Experiencing extreme emotions such as restlessness,
• Spending money all the time,
• Impatience
• Alcohol and drug use,
• Creativity,
• Don't talk fast,
• Hallucinations
• Difficulty focusing,
• Overconfidence,
• Increased sex drive,
• Don't sleep less,
• Hyperactivity
• A sense of being at the center of things,
• Excessive joy,

Depressive Period

• Inability to perform daily tasks,
• Suicidal thoughts,
• Decreased sexual desire,
• constantly arguing with people around you,
• difficulty sleeping,
• Seeing delusions,
• Loss of appetite
• Constantly having doubts,
• A state of hopelessness,
• Don't feel guilty,
• Difficulty concentrating on things,
• Discontentment,
• Fatigue
• Desire to sleep for a long time

Mixed Period

In patients in this period, symptoms of both mania and depression are observed together. During this process, patients can be very happy one moment and depressed the next.

Who Has Bipolar Disorder?

The incidence of bipolar disorder is equal in men and women. However, women experience longer periods of depression, while men experience longer periods of mania.

Patients' personalities also play a role in the development of bipolar disorder. Especially extroverted, fun and colorful personalities and people with melancholic and sunny melancholic personality structures are more likely to have bipolar disorder. Those who are described as sunny melancholic are people who are enthusiastic one moment and then introverted the next.

In addition, the likelihood of bipolar disorder in people with a family history of psychological disorders and in cases where one of the parents suffers from bipolar disorder increases.

What Causes Bipolar Disorder?

The exact cause of bipolar disorder has not been established. However, some factors increase the risk of bipolar disorder. Among these factors, there are three particularly influential topics.

Genetics

Especially the presence of bipolar disorder in first-degree relatives is among the reasons that increase the risk of patients. For this reason, if a mother, father or sibling has bipolar disorder, it is recommended that other members of the family also go to a doctor. However, a specific gene is not the only cause of bipolar disorder. Many inherited genes and triggering environmental factors influence bipolar.

Chemical Imbalances in the Brain

Chemicals that control brain function are called neurotransmitters. Imbalances in one or more neurotransmitters can cause bipolar disorder. As a result of these imbalances, patients may experience symptoms of bipolar disorder.

Triggering Factors

Stressful or traumatic events are among the causes of bipolar disorder. Separation or death of a loved one, sexual or physical abuse or brain trauma are among the triggering factors of bipolar illness.

How is Bipolar Disorder Diagnosed? (Diagnosis)

In the diagnosis of bipolar disorder, family history is as important as the history of the patients. Bipolar disorder, which can usually be diagnosed with clinical follow-up, can be difficult to diagnose if it is in the depressive phase.

In order for a patient to be fully diagnosed as bipolar, they must be fully observed by specialists during both depressive and manic episodes. In addition, if patients are addicted to drugs or alcohol, the diagnosis can be difficult.

Another factor that makes the diagnosis of bipolar disorder difficult is the similarity of symptoms with other disorders in the disease group. For this reason, it is necessary to observe both episodes.

In addition, patients with an overactive thyroid may also experience similar symptoms. For this reason, specialists may refer to blood tests for thyroid hormones. In addition, imaging methods such as MRI can be used to observe brain activity.

How is Bipolar Disorder Treated?

The treatment process of bipolar disorder and the success of the treatment are closely linked to the patients' relationships with their physicians and how much support their relatives provide in this process.

Psychotherapy

Psychotherapeutic methods are particularly important when it comes to bipolar disorder. These treatments can be group, family or individual. Psychotherapy treatment methods include psychoeducation, social rhythm therapy, interpersonal therapy, cognitive behavior therapy and family therapy.

Drug Treatments

The medications used for sudden attacks aim to prevent patients from harming themselves and their environment. Antipsychotic drugs are an important part of treatment to regulate patients' mood. Lithium is the gold standard of bipolar treatment, especially for the manic episodes of patients with ongoing mania.

The classes of drugs used include anticonvulsant drugs that prevent seizures. In addition, atypical antipsychotic medications may be initiated if deemed necessary by physicians.

Hospital Treatments

Some patients need to be treated in clinical settings if they pose a danger to themselves or others, or if they lack the capacity to care for themselves. It is the most preferred treatment option especially for patients with psychotic symptoms.

How long does treatment for bipolar disorder last?

Treatment of bipolar disorder is not aimed at curing the illness completely. Instead, it is carried out to alleviate the symptoms seen in patients. With this treatment, patients can regulate their mood more easily.

With regular follow-up of the treatments, 15% of patients will be free of attacks for life. In 45% of patients, they experience attacks at various times in their lives, but lead a normal life between attacks. For this reason, the treatment of bipolar disorder is a lifelong process. However, during manic or depressive episodes, people are treated with external therapies and these therapies last for a long time.

Bipolar Disorder Attacks

Bipolar disorder episodes refer to sudden and severe changes in mood. Attacks are infrequent and short-lived in the early stages of the disease, but in the absence of treatment they become more frequent and last longer.

Marriage and Sexual Life in Bipolar Disorder

In marriage, which is generally a difficult experience, the relationship becomes more complex when one of the spouses is diagnosed with bipolar disorder. Despite this, people diagnosed with bipolar also have happy marriages.

Contact

The fact that one of the partners is in a manic or depressive episode prevents communication from being fluent. However, if spouses are understanding of each other, communication can improve. A certain level of emotional disclosure by couples is vital for stronger communication.

Studies conducted with bipolar patients and their spouses have revealed that when one spouse is ill, the other spouse feels sad and helpless. They also found it difficult to assess the effects of bipolar illness on their marriages. As a result, if one of the spouses has bipolar disorder, communication within the marriage is affected.

Sexual life

Bipolar spouses' interest in sexuality varies depending on the period they are in and the medications they are taking. While some medications cause a person's interest in sexuality to decrease, being in mania causes them to be overly interested in sexuality.

In addition, studies on bipolar disorder show that patients are prone to hypersexuality during mania. For this reason, partners in this period are more prone to dangerous sexual intercourse or infidelity.

Parenting

For people with bipolar disorder, being a parent can be rewarding, but it can also worsen the condition. Because for bipolar patients, family responsibilities and children's illnesses are a source of stress. This leads to mood swings. This causes difficulties for the other spouse. On the other hand, depending on the age of the child, it is also difficult to explain the bipolar disorder experienced by one of the parents and for the child to understand this situation.

How can it help?

When one spouse in a marriage has bipolar disorder, it can be challenging for both partners to show compassion for each other. Because the spouse with bipolar disorder may feel guilty about their behavior in the previous period. On the other hand, the other partner may feel angry or resentful about what happened. This may cause some problems in the continuation of the relationship. However, this process can be easily overcome if couples learn to support each other. There are many ways to help a spouse with bipolar disorder. These include the following:

• To have sufficient knowledge about bipolar disorder
• Accepting that the spouse has a character outside of their illness
• The partners should share their experiences of the situation and identify issues that need attention.
• Asking questions and actively listening to the bipolar spouse is one of the most important steps to communicate.
• A plan needs to be put in place to help the partner and the home when bipolar episodes occur.
• A plan needs to be in place in case symptoms worsen.
• The bipolar spouse needs to be supported to be consistent in their treatment.
• Healthy daily routines need to be supported.

In addition, the spouse who does not have bipolar disorder also has some points to consider for himself/herself. These points can be briefly summarized as follows:

• They should always be kind and compassionate to themselves.
• They should not neglect their self-care.
• Coping skills need to be developed.
• Help should not be avoided if needed.
• Boundaries need to be defined and adhered to
• It is always necessary to be clear about what will happen if boundaries are neglected.

When should divorce be discussed?

In some cases, marriages can also fail for people with bipolar disorder. In this case, divorce is an option for spouses. Divorce should be considered especially in the occurrence of the following points:

• In bipolar disorder, especially during manic episodes, people's excessive behavior can lead to abuse of the other partner. Among these excesses, financial problems and deception are particularly prominent. Causing the family to suffer financially or being unfaithful is one of the main reasons for divorce.
• The relationship becomes permanently unhealthy
• Your own needs become unmet
• Not feeling safe

It is also quite normal for a person with bipolar disorder to decide to leave. The situations that may be valid for this decision to be taken are as follows:

• The relationship feels physically, mentally and psychologically insecure
• Lack of support from spouses
• Constantly being judged by their spouses