Bipolar Disorder

Finding balance in one’s life, according to philosophers and psychologists is a state of joyful living, bringing an internal, satisfying calm. Buddha, Aristotle, the Dalai Lama, Deepak Chopra – even Oprah – are all disciples of its promises.

So imagine a life without balance. Take an individual who is extremely euphoric one moment, or for several days, or weeks, buying and spending excessively, creating great works of art, or composing musicals or novels. But suddenly for no apparent reason, this person cascades into social withdrawal, sullenness, anger, a state where even getting out of bed and showering becomes impossible.

This person suffers with bipolar disorder (BD), and balance remains an abstract concept, simply a philosophical tenet without any practical application in his or her life, a tenet that can’t be achieved without mental health counseling, and in many cases, medications for depression.

These individuals are the tightrope walkers who miss a step, stumble, and plunge deeply and despairingly. Or they are in the first car of a roller coaster, sitting precipitously at the top of the highest drop, stalled, unable to move, wanting to plunge yet not wanting to, the thrill too intoxicating.

This analogy of extreme imbalance might seem exaggerated, and for most individuals living with bipolar disorder, also called manic depression, it does stretch the point. However, for those with the most severe cases of the disorder, this analogy and the feelings it conjures acutely resemble their lives.

Falling into despair and depression – hopefully into a safety net of strong support such as a knowledgeable mental health practitioner, and educated family members and friends – is one aspect of the disorder. Minutes, days, and weeks of depression occur, similar to unipolar or major depressive disorder, causing many of depression’s symptoms of overwhelming sadness, loneliness, anger, irritability, weight irregularities, and sleep disturbances, among others.

Unlike unipolar depression, however, bipolar bounces individuals between extreme lows and highs. Sitting in that first car of a roller coaster teetering over a drop off, for hours, days, and even months, in a state of mania taxes the body beyond fatigue into damaging states of exhaustion. After a manic episode, individuals often crash, their emotions exhausted, their physical health suffering, as well as hurting their personal finances, careers, and relationships.

It’s these manic episodes that add to the mystique – and stigma – of the disorder. Mania often astounds people with its energy and talent, turning individuals into take charge people, highly determined, fast thinkers, and rapturous. Indeed, many who suffer with BD are highly creative and intelligent individuals. Many believe that Vincent Van Gogh suffered with the disorder, as did the poet Sylvia Plath, author Ernest Hemingway, and Ludwig van Beethoven, among many other artists.

But mania also means skipping sleeping because there’s too much to accomplish, spending money as if there’s an endless supply, or the feeling of invincibility. It also makes individuals have a sense that they are always right, the best at everything, and have no limits. In the most extreme cases, mania is accompanied by paranoia, delusions, and psychoses.

A Difficult Diagnosis

This split symptomology of both mania and depression makes bipolar disorder one of the most difficult diagnoses for mental health providers.

Patients show up for counseling or therapy only when they’re feeling down or depressed, describing typical symptoms such as sadness, a loss of interest in normal activities, agitation or restlessness, insomnia or excessive sleeping. Therapists often hear nothing of the times – or episodes – of feeling an exaggerated form of happiness and euphoria.

Of course, when feeling full of energy, getting things done, experiencing periods of extended creativity or work productivity, patients rarely see a problem and don’t head to the therapist’s office. Patients can have four episodes a year, or cycle several times during a single day. In addition, they can experience euphoria and depression simultaneously – called a mixed episode.

The variability of this disorder adds to the complexity of its diagnosis. For some, they struggle most with depression, having less episodes of mania. This is usually classified by therapists as bipolar disorder II. Others, however, have long, intense episodes of mania followed by deep lows, which is the most extreme condition, called bipolar disorder I.

For others, they don’t experience such extreme highs or lows, but do have exaggerated mood swings, a condition called cyclothymia. For more information on the different types of bipolar disorder, see the article types of depression.

Treatment for Bipolar Disorder

Despite this disorder’s dual personality and taxing symptoms, even the individuals with the most extreme cases of bipolar disorder are able to effectively cope and establish balance in their lives with the proper treatment. Medication is often a necessary component of bipolar disorder, but not the only component. Psychotherapy teaches and educates individuals and their families about this disorder, how to recognize symptoms of depressive and manic episodes, and how to reduce the severity of an attack.

Psychotherapy also teaches individuals how to manage their medications since medications play a major role in staying ahead of manic or depressive episodes. Cognitive behavioral therapy (CBT), a structured, goal-directed therapy has been found to be especially beneficial for those suffering with depression, and a growing number of empirical studies support its use for bipolar disorder as well.

Another type of therapy called Interpersonal and Social Rhythm Therapy (IPSRT) has also shown promising outcomes. This therapy focuses on helping individuals maintain regular schedules, including sleeping and eating schedules – known to help sufferers of bipolar disorder maintain a better life balance. For more information on therapeutic interventions for bipolar disorder, see the article treatments for bipolar disorder.

If treating individuals with bipolar disorder interests you, helping individuals set in motion positive changes that establish balance in their lives, a balance that hopes to correct rapid mood changes and behaviors, consider a career as a mental health counselor.

Usually a master’s degree or PhD is required to practice therapy, and different licensing requirements apply for each state.

Contact schools offering degrees in mental health counseling for more information on working toward a degree in this field.