The Race to Good Health

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Bipolar Disorder: Symptoms and Treatment Options

Exploring ethnicity and Bipolar Disorder

What is Bipolar Disorder

Bipolar disorder is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives. 

Statistics

  • Bipolar is about a third as common as depression and less than half as common as Attention-Deficit Hyperactivity Disorder
  • Diagnosed in about 2.6% of adults and 0-3% in youth
  • 48.8% receive treatment

While the rate of bipolar disorder is the same among African Americans as it is among other Americans, African Americans are less likely to receive a diagnosis and treatment. Ethnic minorities with bipolar disorder are likely to be misdiagnosed with schizophrenia, conduct disorder or antisocial behavior (APA, 2012). Several factors have contributed to African Americans not receiving help for bipolar disorder and other mental illnesses. Some of the reasons are: 

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  • A mistrust of health professionals, based in part on historically higher-than-average institutionalization of African Americans with mental illness; and on previous mistreatments, like such tragic events as the Tuskegee syphilis study.
  • Cultural barriers between many doctors and their patients.
  • Reliance on family and religious community, rather than mental health professionals, during times of emotional distress.
  • A tendency to talk about physical problems, rather than discuss mental symptoms, or to mask symptoms with substance abuse or other medical conditions.
  • Socioeconomic factors which can limit access to medical and mental health care.
  • Continued misunderstanding and stigma about mental illness.
  • Symptoms of Bipolar Disorder

People with bipolar disorder experience intense emotional states that occur in distinct periods called "mood episodes." An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode. 

Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.

A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home. 

Treatment Options for Bipolar Disorder 

There is no cure for Bipolar Disorder. The best treatments for bipolar disorder focus on smoothing out the highs and lows in mood and energy. Additionally, treatment works best when it is ongoing, instead of on and off. Treatment options may include: 

Medication. Different types of medication can help. People respond to medications in different ways, so the type of medication depends on the patient. Sometimes a person needs to try different medications to see which are best.

Medications can cause side effects. Patients should always tell their doctor about these problems. Also, patients should not stop taking a medication without a doctor's help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse. 

Therapy. Different kinds of psychotherapy, or "talk" therapy, can help people with bipolar disorder. Therapy can help them change their behavior and manage their lives. It can also help patients get along better with family and friends. 

There are several different psychotherapies that have promising results. These include cognitive behavioral therapy to pay attention to automatic positive thoughts as potential triggers for hypomania or mania; dialectical behavior therapy for improving emotion regulation; psychoeducational therapy to understand triggers and ways of managing the illness; family-focused therapy to improve communication and reduce intense emotional conflict; and interpersonal social rhythm therapy that emphasizes regular sleep and activity patterns. Therapy has a lot of promise as a way of preventing progression of bipolar disorder, delaying relapse and improving functioning in between episodes. 

Other Treatments. Some people do not get better with medication and therapy. These people may try "electroconvulsive therapy," or ECT. This is sometimes called "shock" therapy. ECT provides a quick "shock" that can sometimes correct problems in the brain.

Sometimes people take herbal and natural supplements, such as St. John's wort or omega-3 fatty acids. Talk to your doctor before taking any supplement. Scientists aren't sure how these products affect people with bipolar disorder. 

Many talented and productive people have successfully dealt with bipolar disorder, so a goal of treatment should not just be symptom reduction, but helping the person to make the most of their gifts and abilities. If you’re interested in seeking help, locate a local psychologist or mental health professional in your area. The APA Psychologist Locator and the SAMHSA are is two resources for help. 

 

Copyright 2013 Erlanger A. Turner, Ph.D.

 

You can follow Dr. Turner on Twitter @DrEarlTurner for daily post on psychology, mental health, and parenting. Feel free to join his Facebook group, “Get Psych’d with Dr. T” to discuss today's blog, or to ask further questions about this posting.

 

References: 

American Psychological Association (2012). Myths and Realities About Bipolar Disorder, Retrieved March 2013 from http://www.apa.org/news/press/releases/2012/10/bipolar-disorder.aspx 

Bipolar Disorder, National Institute of Mental Health. Retrieved March 2013 from http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml 

Mental Health American (2013). Bipolar Disorder and African Americans. Retrieved March 2013 from http://www.nmha.org/index.cfm?objectId=C7DF8995-1372-4D20-C85ABFB47A928F11

Erlanger Turner, Ph.D., is an assistant professor of psychiatry at the Virginia Commonwealth University School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry.

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