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Symptoms of Bipolar Disorder
Bipolar disorder is complex medical condition that, like any mental illness, relates to your individual genetics, background, and brain chemistry. A consistent characteristic of bipolar is the fluctuation between two opposing states (i.e. mood swings): depression and mania or hypomania.
The difference between bipolar I disorder and bipolar II disorder is found in the separation between manic episodes and hypomanic episodes. With bipolar disorder, it can be hard to reach out for help. This is because bipolar disorder is a needlessly stigmatized mental illness, causing people to deny their condition. Perhaps more critical though, most people with bipolar disorder deal with inaccurate diagnoses for an average of 10 years before being properly diagnosed.
An episode of mania normally lasts about 3-6 months. In order to have a diagnosis of bipolar I, you have to have had at least one manic episode within your life. A relational period of depression, which often last much longer–at about 6-12 months–must have occurred just before the manic episode or just after.
The symptoms of a manic episode tend to be so intrusive to one’s daily life that there is little doubt that something is wrong.
Hypomania is characterized by infrequent mild mania, and it often goes undetected. Many people with bipolar II are misdiagnosed with major depressive disorder. About 20% of patients complaining to their doctor about their depression actually have bipolar disorder. About half of those diagnosed with bipolar I and II have seen three or more professionals before getting an accurate diagnosis.
The symptoms of hypomania are actually similar to the symptoms of mania, but the period and severity of mania is less than a full-blown manic episode. However, even though the mania is less severe, your behavior will still differ from your “normal state,” enough so that others may notice.
The symptoms, as they pertain to hypomania, are still elevated mood, inflated self-esteem, decreased need for sleep, etc. but they do not significantly impact a person’s daily function and never include psychotic symptoms. The hypomanic phase is far shorter. Some people with bipolar I experience both mania and, during their depressed periods, some levels of hypomania. A person with hypomania wouldn’t have to take time off work during an episode or require hospitalization, whereas a manic person may. Though hypomania is less severe, it is still debilitating.
Hypomania can later develop into full-blown mania. Cyclothymic disorder is hypomania with periods of mild depression and is common in young people who later are diagnosed with bipolar I or bipolar II. The symptoms are milder but, for many, cyclothymic is merely early symptoms of bipolar. As with bipolar I, in bipolar II depressive symptoms would last longer than the hypomanic phases, but even more so in this case.
Bipolar Depression Symptoms
Here’s the hard part. Bipolar depressive episodes can look a lot like major depressive disorder, which is why people with both forms of bipolar have often been misdiagnosed and have experienced frustrating delays in diagnosis. Antidepressants can actually push bipolar people into mania. Mood stabilizers are chemically different from antidepressants and antidepressants cannot treat bipolar.
Commonly, as stated above, depression phases are longer than manic phases; however, in cases a patient does not receive treatment for their bipolar disorder, it is possible for them to experience rapid cycling. Rapid cycling means you experience four or more episodes of manic or depressive episodes–which would fluctuate without any or much time of stability.
There is no single, all-encompassing cause for bipolar disorder. As far as we now understand neurology and genetics, we believe certain people are genetically predisposed to bipolar disorder. If you have a familial connection and worry you meet five or more symptoms for each depression and mania or hypomania, you should inform your doctor or a mental health professional. However, not everyone with an inherited higher likelihood develops bipolar, meaning genetics are not a cause but rather a factor that raises the potential..
Brain scans show physical changes in the brains of people diagnosed with bipolar disorder. Some research points to neurotransmitter imbalances, abnormal thyroid function, circadian rhythm disturbances, and high levels of the stress-related hormone cortisol.
Environmental and psychological factors are believed to be related to the actual development of bipolar disorder. The common metaphor is of a gun and a trigger. If genetics load the gun, environment and brain chemistry choose whether or not to pull the trigger. In the daily lives of people with bipolar, there are more general triggers–though they can be attached also to earlier mental and emotional development. Triggers differ by individual. They can instigate new episodes of mania or depression or make a current episode worse. However, many bipolar episodes occur without an obvious trigger.
There are, however, a few more general triggers (many of which cannot be avoided, just lessened): stress, substance abuse, medication, seasonal changes, sleep deprivation. Stressful life events can trigger the onset of bipolar disorder, in someone with a genetic predisposition, or trigger individual episodes. These stresses tend to involve quick life changes, good or bad, such as marriage, college, mourning and loss, job termination, or moving.
Substance abuse cannot cause bipolar, but it can worsen an episode or bring one on. Due to the reckless and impulsive nature of mania, substance abuse is not uncommon among people with bipolar. Certain medication, particularly antidepressants, can induce mania. Mania can also be caused by cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid medication.
It is fairly common for mania and depression to shift with the seasons. Mania is more common in the summer and depressive symptoms are more common during the fall, winter, and spring. Sleep deprivation is also a common trigger.
CBD and Bipolar
Prescribed drugs often aren’t as effective as they need to be in controlling bipolar. Self-medicated cannabis use is common in patients with bipolar, and many anecdotal reports suggest some patients use cannabis to handle both mania and depression. Studies show there are possible therapeutic effects of cannabis for bipolar patients. The cannabinoids Delta(9)-tetrahydrocannabinol (THC) and cannabidiol (CBD) may cause sedative, hypnotic, antidepressant, or antipsychotic effects.
However, in contrast, some studies have shown that cannabis is only effective for the treatment of depressive symptoms and not for manic symptoms. It is likely that it is an individual case-by-case basis. People with bipolar more often than not have other mental illnesses–many specifically have anxiety. Cannabis use might make some feel relief and some feel more paranoid, or anxious, or manic; it is all relatively dependent. Like all medications there is no single cure all. You cannot diagnosis yourself with bipolar disorder and should speak to healthcare professional if many of these symptoms apply to you.