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In honor of May being Mental Health Awareness Month, we will be highlighting ways to help keep you on the path to good mental health, all this month during our #LiveWellWednesday posts. Be sure to check back each Wednesday in May for more information from Tom Marsh, Compass Community Health Care Center Behavioral Health Counselor .
Everybody goes through periods of time where they feel moody or depressed and it is easy to feel frustrated and overwhelmed with the demands of life. Think about how people talk about having to go to work on Monday mornings then how people look forward to TGIF. Many people use the term bi-polar to describe someone who is irritable, moody or just hard for them to get along with. This does not mean they are truly mentally ill. Just because a person is irritable or has mood swings does not make them necessarily bi-polar.
Bi-polar disorder is a serious disturbance of mood and conduct characterized by alternating periods of elevated, irritable or expansive mood that must be present most of the day every day and last for at least one week followed by periods of low mood or depression that must last at least two weeks. Both of these changes must be significant changes from the individual’s previous functioning level. Sometimes you hear people use the expression manic depression to describe what the experts now call bi-polar.
The main features of bi-polar center in the elevated or manic phase of disturbance where the individual experiences elevated self esteem or grandiosity, decreased need for sleep, being more talkative than usual, racing thoughts, easily distracted, increase in goal directed activity (having many perhaps unrealistic projects going on at the same time), excessive involvement in risky behavior like spending sprees or inappropriate relationships. In severe cases patients will experience psychotic symptoms (hallucinations and delusions). Of course this needs to happen without the use of any substance of abuse especially stimulant drugs like methamphetamine.
In my clinical experience most people who are in a manic phase tend to feel good about themselves and relish the excessive amounts of energy they have, they cannot be persuaded there is anything wrong with them at the time. In fact, if they are completing many tasks and succeeding in completing their goals they not only do not want any intervention they may be reinforced by others like bosses at work who appreciate their long hours or their families who like the house being cleaned from top to bottom including vacuuming the ceilings! Carrie Fisher who recently passed away revealed she suffered from bi-polar as have other celebrities. It has recently come to light that Winston Churchill who wrote about struggling with his bouts of depression he called his “black dog” was also highly productive during his manic phases.
It is only after they experience some type of consequences or when they become severely depressed do bi-polar individuals land in services. It seems that manic phases develop in people who have a family history of depression or a psychotic disorder after prolonged periods of anxiety and stress. Again, for many people the manic phase is productive so people with bi-polar disorder just accept that “this is the way I am” or “those are the times when I get things done.” Many people with bi-polar use substances to cope or to deal with feelings of guilt after excessive behaviors or interpersonal relationship conflict. Because they often struggle to get along with people at work due to bi-polar related relationship issues many people with this disorder will create job situations where they work for themselves or work excessively during their manic phases. While this is an adaptive coping strategy it also insulates these people from stressors that might bring their issues to light.
Bi-polar disorder can be difficult to identify because people present to services in a depressed state and will receive treatment for depression that does not include treatment for mania. The other challenge, as mentioned above, is that even when a person is correctly diagnosed with bi-polar they will often cease taking medications or attending counseling sessions because of the success they experience when they are manic. People with bi-polar benefit from a full assessment, if available they need to be referred to a psychiatrist who can best decide on medications to treat the disorder. In addition they will benefit from follow up support including counseling to insure continued compliance with treatment recommendations.
For additional information on this topic or to schedule an appointment with one of our providers, please contact our office at 740-355-7102.