(*Originally written for my Introduction to Psychology course)
Bipolar Disorder Overview
Bipolar disorder, or sometimes called manic depression, is a chronic mental illness consisting of sudden changes in an individual’s mood, activity, and sense of reality, due to a chemical imbalance in the brain. The condition juxtaposes between varying degrees of mania, and bouts of depression. The duration of manic or depressive episodes can last anywhere from days to months, although stints of mania tend to subside quicker than episodes of depression. The illness tends to first become visible during the age of adolescence or early adulthood, and lasts for the individual’s lifetime (Duckworth, Bipolar Disorder). Although an ultimate cause of the disorder is unknown, the initial trigger is thought to be brought on by a coupling of internal and external factors; a biological predisposition due to a hereditary gene, and a series of emotionally taxing events in the person’s life (Endicott & Quitkin, 1992).
Depending on the individual, manic episodes can either entail a feeling of euphoria, putting the person in an optimistic, pleasant state of mind, or in a more aggressive, irritable headspace. Typically, the excess energy that mania provides causes increased speech and racing thoughts in those afflicted, leading toward hyperactive, irrational behavior, impulsive decision-making, and decreased sleep. The affected may even experience varying forms of delusion or hallucination, as well as paranoia (Duckworth, Bipolar Disorder).
In the midst of these episodes, one’s sense of reality is distorted into an amalgam of grandiosity and illogic. In a whirlwind of hyperactivity, the manic-depressive individual may begin to dress in a different manner, attempt to take on unrealistic tasks, and generally have no consideration or understanding of the consequences of their bizarre activity. Overtaken by this influx of energy, actions are engaged without pretense, and nonsensical thoughts turn into uninhibited words. This is known as a “flight of ideas” in the mental health community. The manic attack moves at an overwhelming pace, and the inexhaustibility of someone in this state is amazing (Berger & Berger, 1991).
Contrary to these symptoms are those of the depression phase, which can incorporate feelings of severe sadness, decreased energy, and increased sleep. With the mania phase of bipolar representing the highest of the high, and inserting a feeling of overconfidence, depression is the lowest of low. Whereas mania gave them outlandish ambitions and endless motivation, depression may make it difficult for someone to muster the self-esteem to deem themselves worthy of even the slightest day to day tasks, such as brushing one’s teeth (Endicott & Quitkin, 1992).
During an episode of depression, a person’s life may seem empty, and the concept of their eventual recovery may seem hopeless at the time. Because of this, it is important that signs of a possible attempt at suicide be observed. Studies suggest that, although the “success” rate of attempts is about fifteen percent, more than half of those who have bipolar disorder have made at least one attempt at suicide. Some common signs include general loss of interest in people and activities that once were found enjoyable, and refusal to get out of bed (Berger & Berger, 1991).
With the proper treatment a person can reduce the frequency of manic-depressive cycling, allowing them the ability to live a relatively normal life. Lithium, which acts as a mood stabilizer, is a popular choice in medical treatment, as it can counteract both depression and mania, as well as be coupled with antidepressant medication.
In cases of acute mania the individual will require hospitalization as part of their treatment, if their impulsiveness is deemed so extreme that they are considered a danger to either themselves or those around them (Endicott & Quitkin, 1992).
In addition to medicine and temporary hospitalization, various forms of therapy, including those employing the interpersonal and cognitive-behavioral approach, as well as family therapy, is a powerful tool for coping with daily stresses that could possibly trigger an episode of both mania and depression (Duckworth, Bipolar Disorder).
A More Personal Look At Bipolar
In an effort to better understand how this illness affects an individual, I conducted a personal interview with “Mary Hawkins,” a woman who has been living with bipolar disorder for over thirty years. Mary’s father showed symptoms of bipolar disorder, and many of her siblings have experienced varying degrees of mania and depression. According to her, several take an active role in accepting and treating their illness, like herself, while others remain in denial and live a tumultuous life, untreated.
When asked when her illness first appeared and what brought it on, Mary revealed that it was first apparent “In the 1980’s, at age 20, when I got stressed out by commuting one hundred miles per day to school, and working five days a week.” Her answer is cognizant with my research that illustrates that those with a family history of bipolar are prone to the disorder themselves, and that it is often brought out due to personally stressful events.
Experiencing her first manic episode was a frightening thing, as the normally shy Mary found herself increasingly more talkative and heading toward “mental and physical burnout.” As a result of her radical changes in behavior, she was hospitalized for the first time. When asked about further treatment for the disorder, Mary informed me that it was during this time she began seeing a therapist and psychiatrist, who prescribed lithium to stabilize the chemical imbalance that was occurring in her brain.
I then asked Mary about her experiences with hospitalizations over the years. She mentioned that attending group therapy and studying your illness play a key role, and that, while being hospitalized during a severe attack of mania or depression is necessary, the system is not perfect; “Sometimes you’ll get locked inside and are not allowed out for even a walk until you’re discharged. It can make you feel like you’re being held in a zoo.”
Having lived a relatively normal life since her diagnosis in the 1980’s, I asked Mary if over time it has gotten easier to identify her own symptoms of manic-depression. She stated that she “Can’t really tell when a high or low is coming on” and that if despite medication, she still is experiencing symptoms of an episode, she has to rely on people that are familiar with her normal personality to assist her.
Following up on this, I wondered if she has noticed any changes in her symptoms with age. Mary said that “The symptoms seem to come more often as I get older. My manic attacks have happened closer together this year.” She is describing rapid-cycling, a state of bipolar where people may experience several episodes in a relatively short period of time. It has been noted that this more commonly occurs in women (Endicott & Quitkin, 1992).
I then asked how typical daily living has changed for her since being afflicted with her illness; “I have trouble waking up and have more difficulty concentrating on things like household tasks. It’s also been more difficult to focus on working. Other than that, the biggest change has been having to remember to take my medication every day in order to remain stable.”
In closing of our interview, Mary talked about how, after diagnosis, she made an effort to learn more about her illness, and has since been active in The National Alliance On Mental Illness, which is “The nation’s largest grassroots mental health organization” (NAMI, About NAMI).
Opinions / Viewpoints
In researching bipolar disorder, I have found it to be at once a treatable illness one can coexist with, and a hellacious burden for not only those that go untreated, but their family and friends. It is a disorder that is commonly misunderstood by the public, often wrongfully labeled as “madness” or confused with vaguely similar mental illnesses like lesser forms of schizophrenia. Despite the existing social stigma of talking about and openly living with a “mental illness,” there is hope, thanks to championing organizations like The National Alliance On Mental Illness educating the public and reaching out to those affected, and individuals like “Mary Hawkins” helping illustrate that, although at times challenging, it is possible to live a happy and productive life with bipolar.
What has become apparent to me is that bipolar disorder is a biologically based brain disease, and should not be looked at any differently than a physical disease, like cancer. At the time of “Mary Hawkin’s” diagnosis, she was an overworked college student, juggling many responsibilities, much like many in the MassBay community. This stress ultimately triggered the one thing she could not control, and ironically the thing that would become her biggest responsibility of all; living with bipolar disorder.
The brain is a supremely complex entity, and we may never unravel the mysteries of mental illnesses completely, but with the wealth of information I shifted through in research, it is evident that information is continously advancing. Despite each brain being different and the degree of condition varying in the individual, it is encouraging. What is also encouraging is to know there are people out in the world, who regardless of such a daunting, life-altering diagnosis as bipolar, have found the courage to go on with their lives, and share their story. Although researching the illness was informative, I found the personal aspect of utilizing an interview as a social science method most impactful. It is necessary to realize that although bipolar is an illness, studied alone, it is the person and people it affects that are truly important.
Duckworth, Ken. About Mental Illness : Bipolar Disorder. National Alliance On Mental Illness. Retrived 10 Nov. 2007. <
Endicott, Jean & Quitkin, Frederick M. (1992). Depression and Other Mood Disorders. In L.B. Morris (Ed.), Columbia University College of Physicians and Surgeons( Complete Home Guide To Mental Health ( pp.108-124). New York:Henry Holt and Company, Inc.
Berger, D. & Berger, L. (1991). We Heard The Angels Of Madness. New York: William Morrow and Company, Inc.
About NAMI. National Alliance On Mental Illness. Retrived 10 Nov. 2007. <