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Bipolar disorder
Important!
If a person suspects that he or she or a loved one is suffering from bipolar disorder, it is important to remember that the condition is treatable and seek the help of a professional as soon as possible.

GENERAL

What is bipolar disorder?

Bipolar disorder (formerly known as bipolar depression or manic-depressive disorder) is a condition that is often misunderstood.

One can conclude that bipolar disorder launches an attack on your MOTHER and can sometimes leave you so depressed that you cannot function normally. Care should be taken not to confuse it with major depression, even though professional therapists sometimes struggle initially to diagnose bipolar disorder due to the complex nature of the symptoms.

Bipolar disorder is therefore a diagnosable psychological condition characterized by large fluctuations in a person's state of mind, from extreme depression (low mood) to extreme mania (excessive, inappropriate moodiness).

Bipolar disorder was formerly known as manic-depressive disorder due to mood swings and periods of normality in between. Persons suffering from this disorder are usually well aware that they are struggling with their mood due to the abnormally high emotional fluctuations. It is also common for these individuals to have difficulty functioning in society, especially during a manic phase, and often feel guilty about their behavior during that phase.

Research into this condition is still ongoing, but a combination of medication and psychotherapeutic treatment (to see a psychologist) can greatly ease the symptoms and improve quality of life.

For someone to be diagnosed with bipolar disorder, the symptoms cannot be the result of the abuse of alcohol or other drugs, nor should it be due to another condition.

DIAGNOSIS

Why is it so difficult to diagnose bipolar disorder?

The first occurrence of bipolar disorder may show features of both phases (extreme depressed, alternating with excessive excitement). After this, years can pass during which the person does not experience any symptoms. What further complicates a diagnosis is that some of the symptoms, especially during a manic phase, often correspond to those of other conditions. If one then looks at the symptoms of bipolar disorder in isolation, without considering all the factors, you can easily make the wrong conclusion and consider that the symptoms indicate the following:

Confusion can occur due to similar symptoms and can lead to inaccurate diagnoses, such as. the disorders below:

  1. personality disorders
  2. antisocial behavior
  3. addiction disorders
  4. depression
  5. general anxiety
  6. psychotic symptoms
  7. schizophrenia
  8. (when someone believes that they are more important than they really are.)
  9. persecution (When someone believes that different people or groups are working on a "plot" to fulfill him or her.)
  10. paranoia (When someone is extraordinarily suspicious of the intentions of others; for example, they believe that there is a hidden meaning behind someone else's words and actions.)

One can therefore understand that it will be more difficult for a professional to diagnose bipolar disorder than some other psychological conditions.

SYMPTOMS

What are the symptoms of bipolar disorder?

The following symptoms are indicative, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5), which is widely accepted as the most authoritative source worldwide. Please note Please note that an official diagnosis may only be made by a qualified person.

Bipolar 1 disorder

For someone to be diagnosed with bipolar 1 disorder, a manic phase must occur. It can be preceded or followed by a hypomanic or depressive phase. Although a manic phase occurred only once, even years ago, it is sufficient for diagnosis.

The manic phase / episode is characterized by:

  1. A period of extreme cheer or irritability and an increase in goal-directed activity or energy that lasts for at least one week and is present for most of the day, almost every day.
  2. During the phase of mood disturbance and increase in energy or activity, come at least three of the following symptoms (four, if the mood is irritated only), for:
    1. exaggerated self-confidence or delusion;
    2. need for sleep that is noticeably decreasing;
    3. the person is more talkative than usual and is clearly under pressure to keep talking.
    4. idea flights - the person jumps from one “wonderful” idea to the next, thinking that his or her ideas are creative and resourceful;
    5. attention is easily divertible, without the person generally having a problem with attention distractibility; and / or
    6. exaggerated involvement in enjoyable activities, but activities that pose great personal risks. Examples may include: indiscriminate sexual escapades, reckless investments, sudden gambling, sudden participation in dangerous sports without the person having previously been interested in it, etc.
  3. The symptoms are severe enough to impair the person's functioning, or necessitate hospitalization to prevent harm to the person or others. There may even be psychotic symptoms present.
Note
Bipolar disorder sometimes also occurs in another form, called bipolar 2. This is much less common. Here the manic phase is not experienced as excessively excited and exuberant, but nevertheless more intense than usual, and of a more “irritated” nature. This form of bipolar disorder is even more difficult to spot from the outset, as the person's normal social or work activities are not necessarily negatively affected. For a diagnosis of bipolar 2, the criteria for a hypomanic episode (current or past) must be met, as well as the criteria for a depressive episode (current or past).

'n Hypomanic phase / episode is characterized by the following:

  1. A period of extreme moodiness or irritability and an increase in purposeful activity or energy that is present for at least four consecutive days and continues for most of the day, almost every day.
  2. During the phase of mood disorder and increase in energy or activity, come at least three of the following symptoms (four, if the mood is irritated only), before. The symptoms indicate a clear change in the person's normal behavior and are present in a noticeable degree:
    1. exaggerated self-confidence or delusion;
    2. need for sleep that is noticeably decreasing;
    3. the person is more talkative than usual and is clearly under pressure to keep talking;
    4. ideas flights - the person jumps from one “wonderful” idea to the next and thinks that his or her ideas are creative and resourceful;
    5. attention is easily divertible, without the person generally having a problem with attention distractibility;
    6. excessive increase in activities, which suddenly gives a new purpose and meaning to the person's life, for example starting out of the seven new community service projects simultaneously, or physical irritability and hustle, and excessive "busy" behavior compared to how the person generally act; and / or
    7. exaggerated involvement in enjoyable activities, but activities that pose great personal risks. Examples may include: indiscriminate sexual escapades, reckless investments, sudden gambling, sudden participation in dangerous sports without the person having previously been interested in it, etc.
  3. The change in behavior is significantly different from what the person would normally act.
  4. The change in mood and behavior is noticeable by other people.
  5. The episode is not serious enough to impair a person's functioning, hospitalization is not necessary and psychosis is not present.
  6. The symptoms are not present due to the use of a drug.

'n Depressive phase or episode is characterized by the following:

To be diagnosable must at least five of the following symptoms, for a period of at least two weeks. One or both of the first two symptoms should occur:

  1. depression (a predominant feeling of sadness or the inability to experience emotion, as experienced or perceived by others - in children and teenagers it may appear as irritability); and / or
  2. a decrease in interest or enjoyment in most daily activities.

Also:

  1. change in appetite, weight gain or loss
  2. sleep problems, such as insomnia or too much sleep
  3. daily physical irritability or physical paralysis
  4. constant physical and / or emotional fatigue and loss of energy (eg feeling "porridge")
  5. feelings of guilt or worthlessness that are intense and frequent
  6. problems with concentration and making decisions
  7. regular thoughts of death and / or suicide (more than usual)

Further:

  1. The symptoms cause noticeable discomfort and have a negative impact on the person's functioning and quality of life.
  2. The symptoms do not occur due to another medical condition or the use of a drug / drug.
  3. The symptoms are not better explained by another psychological condition.
  4. There has never been a manic or hypomanic episode.
Did you know?
Gender does play a role, however, since manic phases occur more often in men than depressive episodes, while it is generally the other way around in women.
A family history of mental disorders and genetic makeup appears to play an important role in the cause of bipolar disorder. People with a family history of this are therefore at a greater risk of developing the disease. However, it is not known to what extent heredity (genetics) combined with environmental factors contribute to the disease.
Clue
Certain people are naturally more likely to be depressed or talkative and confident than others. This does not mean they are diagnosable with bipolar disorder. Symptoms arising from this condition are much more intense than in people who are merely "quiet" or extremely extroverted by nature. Always be on the lookout for pattern change, such as when you or a loved one does not feel, think or act as normal for more than two weeks.

QUESTIONNAIRE

Do you or a loved one have bipolar mood disorders?

Please complete the online questionnaire which serves as a screening test for bipolar mood disorder. The MDQ questionnaire is through Wie is ek? translated into Afrikaans. please note: The questionnaire is only a screening test. A diagnosis can only be made by a professional after a complete examination / assessment.

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THERAPY

Treatment of bipolar disorder?

Why is treatment necessary for bipolar disorder?
Without proper treatment, the symptoms of bipolar disorder can gradually worsen. Bipolar disorder can be compared to other diseases in this respect, for example diabetes. Both conditions require continuous pharmacological treatment (medication) and monitoring by a professional. The results are generally much better if the person regularly receives psychotherapy from a psychologist.

Untreated bipolar disorder can also make a person vulnerable to other psychological conditions eg. addiction.

Important
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that the suicide risk of someone with bipolar disorder is up to 15 times higher than for the general population. So it is extremely important to get help for this disorder.

What role does medication play?
Bipolar disorder is largely caused by a complicated combination of a chemical imbalance, genetic factors and many more. Medication is essential to stabilize the chemical processes that cause the depressive and manic phases. Appropriate medication has been developed to make the mood swings or big jumps in "up" and "down" times less intense.

A combination of the following aspects can play a pivotal role in the lives of diagnosed people and can help to lead them to a fulfilled life:

  1. information
  2. medication
  3. psychotherapy (to consult a psychologist); also
  4. support by next of kin.
Contact your psychiatrist first!
You are strongly ADVISED to release your medication on your own initiative. It is common for psychiatrists to experiment with specific medications several times before finding the right treatment for you as an individual.

How long should I use medication?
This largely depends on the degree of your diagnosis, but generally long-term treatment is suggested. It is an important question to discuss with the doctor who prescribes the medication.

My medication doesn't work for me; what now?
There is no ready-made, prescription treatment for individuals with bipolar disorder. What works for one person may not work for another.

Your doctor will initially try different types of medication until you find the right medication for you. It is extremely important to always consult a professional (a psychiatrist in this case) about medication and keep him or her informed of your experience of it.

Tips for treatment
  1. The chemical composition of all of us differs; therefore, the medication prescribed may not work for you.
  2. It is important not to give up and discuss what is bothering you with your doctor.
  3. Write down everything you feel so you can explain to your doctor how the medication makes you feel, think and act.
  4. Keep working with your doctor until you find the medication that works best for you.
Interesting!
A five to ten year gap often occurs between the age at which the disease began and the age at which it is first reported for treatment.

How do I prepare for my first appointment with a doctor or psychologist?
If your anxiety levels are too high, ask a family member or friend to go with you to the first appointment. You can take the following with you:

  1. A list of signs and symptoms that you are experiencing and how long you have been experiencing them
  2. A list of things you have avoided or stopped doing because of your depression or bipolar disorder
  3. medical information about any physical conditions you may have
  4. A list of the medications (including natural supplements) and doses you are currently taking or have recently taken
  5. A list of questions you want to ask the psychologist

TREATMENT PLAN

What would a treatment plan for bipolar disorder look like?

From an integrated approach, we usually propose a combination of the following strategies:

Diagnosis
An accurate diagnosis is very important. Therefore, first start by requesting a full medical examination from your GP to make sure there is no medical explanation (eg thyroid problems) for your symptoms. If not, the next step is to make an appointment with a psychologist, who can further assess and diagnose you.

Therapies
Assistance and support by a registered (clinical, counseling and sometimes educational) psychologist, registered counselor or even a spiritual leader or trusted, trained counselor in your community can be extremely valuable. It is usually worthwhile in the long term to learn within a therapeutic relationship to understand and manage your diagnosis. There may be events that need to be processed and therapy provides a safe space for this.

Medication
Medication may be prescribed by a psychiatrist. If someone cannot afford private services or medication, they can inquire at their nearest state clinic or hospital.

Support groups
A support group can be invaluable to someone suffering from depression or bipolar disorder. Within the group, people share their “stories” and challenges and learn from each other's skills and experiences. It is not always easy to find a support group in one's area. Online searches sometimes produce good results. Find more information on the SADAG website

Lifestyle
Managing a mood disorder effectively requires a healthy, balanced lifestyle. This means spending time on self-care. Regular exercises or physical activity such as walking or jogging, time to relax and a balanced diet are usually suggested. Certain foods (eg caffeine, processed foods, refined sugars) and drugs (eg alcohol) can aggravate symptoms and should therefore be limited.

SELF-MANAGEMENT

What can I do to manage my illness?

  1. build up knowledge about bipolar disorder (ask your doctor, read about the disease and ask questions until you understand)
  2. Regular physical exercise, as proven by research, is a successful antidepressant
  3. eat balanced
  4. sleep enough
  5. reduce stress factors as far as you are in control
  6. acquire appropriate stress management skills
  7. Psychotherapy with a trained psychologist can teach you important skills to control bipolar disorder
  8. stick to your treatment plan
Important
Watch out for triggers!
Bipolar disorder can sometimes be triggered by intense stress, especially if the person is generally struggling to cope with stress. Therefore, it is always important that a person diagnosed with this disease should keep an eye on him / her when life stressors begin to stress - work pressure, financial pressure and relationship problems are just a few examples of factors that cause stress in individuals.

HELP

If you or a loved one has been diagnosed with a mood disorder, we recommend that you consult a professional as soon as possible. The following options may be considered:

  1. ask your family doctor for a referral to a psychologist or psychiatrist;
  2. approach your nearest hospital for a referral; and / or
  3. Also, try one of the following links for an online search for a psychologist in your area:
    1. Find help
    2. SA Medical Specialists
    3. Medpages
    4. contact Wie is ek?

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Important
All people experience fluctuations or changes in their state of mind. It is normal and part of being human. Sometimes, for example, one is ecstatically happy and then there are times in most people's lives that they can feel very dark and "down". The difference, however, is that the person suffering from bipolar disorder has been exposed to chemical fluctuations that are much more intense than the average person's. The symptoms can sometimes get so intense that the person with bipolar disorder can even lose touch with reality. The mood swings can happen dramatically and suddenly, but in most cases a gradual transition occurs.
Did you know?
  1. Bipolar disorder affects about 3-4% of the adult population
  2. The average age at which symptoms begin to show is 21 years.
  3. Teenage girls and boys are equally likely to develop bipolar disorder and the risk of bipolar disorder also increases as a teenager gets older.
  4. A five to ten year gap often occurs between the age at which the disease began and the age at which it is first reported for treatment.

EMERGENCY MEASURES

If you or a loved one is struggling with mental health problems, we suggest the following options:
  1. call your GP (if available);
  2. go to your nearest hospital emergency room;
  3. call one of the following emergency numbers: SADAG (the South African Depression and Anxiety Group) 24-hour helpline: 0800 12 13 14 or suicide crisis line: 0800 567 567; or
  4. contact Wie is ek?