Guest Post by: Lori Edelson, LMSW, ACSW, BCD, LMFT and CEO/Owner of the Birmingham Maple Clinic
Since Mariah Carey’s acknowledgment about her diagnosis of Bipolar Disorder and the struggle she experienced for many years before accepting the diagnosis as true, many have questioned how to know whether one has the disorder, how the disorder is properly diagnosed and what treatment might include.
There are different degrees of Bipolar Disorder, each slightly different from one another:
• Bipolar I: “The Classic Type” characterized by the most severe mood extremes of depression and extreme, severe relentless episodes of mania
• Bipolar II: “The More Common Type” characterized by mood extremes of depression with less severe manic episodes
• Cyclothymia: “Unofficially called Bipolar III” characterized by mood swings that are less severe than Bipolar I or II, and do not meet criteria for severe depression or mania
• Severe Mood Dysregulation: May be mistakenly labeled ‘Bipolar Disorder,’ due to the mood intensity and ‘out of control’ behaviors but does not meet the formal criteria for Bipolar and is typically characterized by rages, tantrums, and/or aggressive behavior in specific settings
Diagnosis and Symptoms
Bipolar Disorders and Severe Mood Dysregulation must be diagnosed by a mental health professional. The manic episodes are characterized by feeling overly happy or “high” for long periods of time, decreased need for sleep, rapid speech and racing thoughts, extreme restlessness and/or impulsivity, highly distractible, excessive spending, grandiosity, promiscuous behavior and other high-risk behaviors.
The depressive episodes are characterized by feeling hopeless for long periods of time, withdrawing from friends and family, loss of interest in activities that were once enjoyed, significant change in appetite and sleep, extreme decrease in energy, problems with memory, concentration, and decision making, preoccupation with death, and thoughts, plans or attempts at suicide.
Treatment for Children and Adults
Bipolar Disorder includes a combination of medication and psychotherapy. Medications are effective and include Lithium and/or anti-psychotics. The most major problem with medication is patient non-compliance. Typically, patients with Bipolar Disorder do not take their medication consistently either because they do not believe they need it, or they prefer their extreme mood states.
Psychotherapy helps the person understand the disorder, including how to identify triggers and reduce symptoms that precede the onset of extreme mood swings, understand the importance of medication compliance and other self-care techniques to moderate and stabilize moods to create better emotional regulation.
Treatment for a child struggling with a Bipolar Disorder is most effective when it includes the entire family. Parents are often ashamed, grieving, exhausted, overwhelmed and experiencing their own stress at work and in other relationships as a result of their chaotic home lives. Other family members that live or help take care of the child often become symptomatic due to distress and confusion about the child’s diagnosis, behavior and treatment.
Given that Bipolar Disorder has been reported to occur in higher rates within the creative population (musicians, artists, actors and performers), it is common that many of their diagnosis or need of treatment goes unnoticed for long periods of time. It is important to note that Bipolar Disorder is a lifelong condition that is manageable with consistent medication and psychotherapy as needed.
If you any questions regarding the various Bipolar Disorders and potential treatment options, please contact Lori Edelson and her team at the Birmingham Maple Clinic.
• The Bipolar Child: The Definitive and Reassuring Guide to Childhood’s Most Misunderstood Disorder, Demitri F Papolos and Janice Papolos, 1999 and 2002, Broadway Books
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