The Stress Of A Bad Breakup Or Failed Marriage
A number of people with bipolar disorder especially those with a history of severe manic episodes have failed marriages. If youre going through a divorce, working with your therapist through what is often a drawn-out and extremely stressful process can help.
You might consider a durable power of attorney that allows someone else to make major decisions for you, such as financial ones, when you are going through an episode of depression or mania in relation to or during a breakup.
In fact, assigning a durable power of attorney could be useful for anyone who might be experiencing an episode of bipolar disorder.
Trigger #: Goal Attainment And Positive Events
While many bipolar disorder triggers center around stressors, goal attainment and other positive events can also elicit mood episodes, particularly mania or hypomania. Events such as winning an award, getting a promotion, falling in love, or even going on vacation may act as triggers, initiating a dangerous cycle. Some researchers believe that this is caused by dysregulation of the behavioral approach system, which promote increases in positive affect, energy, goal pursuit, and attention toward cues of reward. In other words, people with bipolar disorder have particularly high reward responsiveness. For some, this heightened responsiveness translates into manic or hypomanic episodes.
If you or those around you notice symptoms of mania or hypomania following a positive event, it is important to talk to your doctor about it as soon as possible. While this kind of mood episode may appear to be a positive experience initially, it can ultimately be destructive both in and of itself and due to the risk of switching to a depressive episode once the mania or hypomania resolves. This does not mean you should not enjoy your successes, but it does mean that you should be sure to take care of your health at the same time.
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Symptoms Of Depressive Episodes
Depressive episodes can also emerge without warning. Some of the triggers for these depressive periods include lack of sleep, excessive stress, or a negative life event, but often there is no known cause for the depression. The depressive episodes must be carefully monitored, as there is an increased risk of suicidal behavior during these phases.
Symptoms include:
- Feelings of despair and hopelessness
- Intense fatigue
- Loss of interest in activities once enjoyed
- Chronic pain with no known medical cause
- Trouble concentrating
- Suicidal thoughts
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What Age Does Bipolar Start
The onset age of bipolar disorder varies from person to person, however, the age range is from childhood to 50.
Though most of the cases start at the age of 15-19 and the second most age range varies from 20-21.
However, there are also some cases where a person older than 50 years develops manic episodes.
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What Is The Treatment For Mania Hypomania And Depression
You can check what treatment and care is recommended for bipolar disorders on the National Institute for Health and Care Excellence website.
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at:
The NHS doesnt have to follow these recommendations. But they should have a good reason for not following them.
What medications are recommended?
Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms.
The mood stabilisers we talk about in this factsheet are:
- Certain benzodiazepine medication
Mania and hypomaniaYou should be offered a mood stabiliser to help manage your mania or hypomania. Your doctor may refer to your medication as antimanic medication.
If you are taking antidepressants your doctor may advise you to withdraw from taking them.
You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:
If the first antipsychotic you are given doesnt work, then you should be offered a different antipsychotic medication from the list above.
If a different antipsychotic doesnt work, then you may be offered lithium to take alongside it. If the lithium doesnt work you may be offered sodium valproate to take with an antipsychotic. Sodium valproate is an anticonvulsive medication.
Sodium Valproate shouldnt be given to girls or young women who might want to get pregnant.
- Fluoxetine with Olanzapine
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Trigger #: Negative Life Events
Negative life events, such as interpersonal conflict, loss of a relationship, job loss, financial stress, or death of a loved one can be both stressful and profoundly painful even for people who do not struggle with a mental health disorder. For people with bipolar disorder, however, they can have serious psychiatric consequences negative life events are tied to the emergence of depressive episodes and may increase the severity of existing depression. According to one longitudinal study of 149 participants diagnosed with bipolar I disorder, for example, negative life events predicted increases in depressive symptoms over several months even after controlling for baseline levels of depressive symptoms. It is also possible that negative life events may trigger or augment mania or hypomania. While this may appear to be counterintuitive, some theorize that the mechanism behind this phenomenon is manic defense, which posits mania as a flight from painful feelings.
Trigger #: Seasonal Changes
Seasonal changes are most commonly associated with unipolar depression, but they can also have a significant impact on experiences of bipolar disorder. In fact, according to some research, seasonal fluctuations are more common in people with bipolar disorder than in those with unipolar depression. For those whose mood episodes are triggered by these seasonal changes, winter is typically associated with depressive episodes and manic or hypomanic episodes are more prevalent in the spring and summer, possibly due to both the effects of sunlight and seasonal behavioral differences. However, mood episodes do not necessarily follow these patterns. For some, summer triggers depressive episodes and winter triggers mania or hypomania.
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What Are The Side Effects Of Bipolar Disorder Medications
Side effects of bipolar disorder medications are common and vary by medication. Its important to talk with your healthcare provider about what you can expect when taking certain medications. Its also important to tell them if youre experiencing side effects.
Never stop taking your medication unless your healthcare provider tells you to do so. Abruptly stopping medication can cause severe side effects and trigger severe episodes.
The most common side effects of bipolar disorder medications include:
- Akathisia feelings of restlessness and agitation with a compelling need to move, rock or pace.
What Are The Types Of Bipolar Disorder
There are four types of bipolar disorder, including:
- Bipolar I disorder: People with bipolar I disorder have experienced one or more episodes of mania. Most people with bipolar I will have episodes of both mania and depression, but an episode of depression isnt necessary for a diagnosis. The depressive episodes usually last at least two weeks. To be diagnosed with bipolar I, your manic episodes must last at least seven days or be so severe that you need hospitalization. People with bipolar I can also experience mixed states .
- Bipolar II disorder: People with bipolar II experience depressive episodes and hypomanic episodes. But they never experience a full manic episode thats characteristic of bipolar I disorder. While hypomania is less impairing than mania, bipolar II disorder is often more debilitating than bipolar I disorder due to chronic depression being more common in bipolar II.
- Cyclothymic disorder : People with cyclothymic disorder have a chronically unstable mood state. They experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood , but these periods last fewer than eight weeks.
- Other specified and unspecified bipolar and related disorders: If a person doesnt meet the diagnostic criteria for bipolar I, II or cyclothymia but has still experienced periods of clinically significant abnormal mood elevation, its considered other specified or unspecified bipolar disorder.
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Bipolar Ii Signs & Symptoms
For a diagnosis of bipolar II disorder, a person must have experienced at least one hypomanic episode, during which he or she may feel euphoric or irritable and exhibit abnormal behaviors. Symptoms of these episodes include:
- Flying quickly from one idea to the next
- Making and pursuing grandiose, unrealistic plans
- Rapid, uninterruptable and/or loud speech
- Substance abuse
A hypomanic episode is characterized by higher-than-usual energy levels. These episodes will be noticeable to others but are not as extreme as manic episodes, which may include hospitalization, hallucinations, paranoid thoughts, or other breaks with reality.
Most people with this disorder have also experienced periods of depression. Depressive episodes in bipolar II disorder may include:
- Feelings of guilt or worthlessness
- Loss of interest or pleasure in activities
- Low energy and activity
So Does Bipolar Get Worse With Age
Unfortunately, for most people, bipolar disorder is a mental health condition that can progress with time and age. Complicating matters is that as we age, we can also simultaneously become less able to metabolize the medications that are prescribed to treat symptoms.
Therefore, its essential to get everything you can from all forms of bipolar disorder treatment. This might include routine psychotherapy as well as an effort to stay mindful and make healthy lifestyle choices that help reduce your symptoms.
Finding a therapist who specializes in treating bipolar disorder is always important for long-term symptom management. Working with a therapist who is experienced in either in-person or online therapy can help you develop and implement effective coping skills into your daily routine. While medication is often used as a frontline defense for bipolar, its smart to use several techniques for symptom management.
Living with bipolar disorder isnt simple, and it might be easy to feel like its cruel to not be able to control your own emotions. However, bipolar is a treatable condition. You can still live a rewarding, contented life. It takes some deep work but armed with information and support, its possible.
Reviewed On: May 24, 2022
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What If Im Not Happy With My Treatment
If you arent happy with your treatment you can:
- talk to your doctor about your treatment options,
- ask for a second opinion,
- get an advocate to help you speak to your doctor,
- contact Patient Advice and Liaison Service , or
- make a complaint.
There is more information about these options below.
How can I speak to my doctor about my treatment options?
You can speak to your doctor about your treatment. Explain why you arent happy with it. You could ask what other treatments you could try.
Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you arent given this treatment, ask your doctor to explain why it isnt suitable for you.
Whats a second opinion?
A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.
You dont have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.
What is advocacy?
An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.
There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like. NHS complaints advocates can help you if you want to complain about the NHS.
Coping With Bipolar Disorder Triggers Through More Advanced Treatment
Bipolar disorder is a chronic condition that must be continuously monitored and managed over a lifetime. Even if you have achieved remission and are high-functioning, it is critical to remain vigilant to identify and cope with potential triggers and work closely with your treating clinicians to maintain stability. However, if you find that your mood episodes are not being effectively managed with outpatient care, it may be time to consider residential bipolar treatment.
At Bridges to Recovery, you will have the time and space to fully devote yourself to healing in a warm, intimate environment. By working closely with a group of expert clinicians, you can examine your symptoms, identify your triggers, and develop the insight and skills necessary to more effectively manage your condition. This includes not only implementing an appropriate medication plan, but deeply exploring your emotions, thoughts, and behaviors through a range of therapies designed to address your individual needs. With the support of compassionate mental health professionals and peers who understand what you are going through, you can open up the door to more durable relief from symptoms and a restored sense of wellness.
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What Are Bipolar Disorder Risk Factors
When someone develops bipolar disorder, it usually starts when they’re in late adolescence or young adulthood. Rarely, it can happen earlier in childhood. Bipolar disorder can run in families.
Men and women are equally likely to get it. Women are somewhat more likely than men to go through “rapid cycling,” which is having four or more distinct mood episodes within a year. Women also tend to spend more time depressed than men with bipolar disorder.
Bipolar disorder usually develops later in life for women, and theyâre more likely to have bipolar disorder II and be affected by seasonal mood changes.
A combination of medical and mental issues is also more common in women. Those medical issues can include thyroid disease, migraine, and anxiety disorders.
Some things that make you more likely to have bipolar disorder include:
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Having a family member with bipolar disorder
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Going through a time of high stress or trauma
-
Drug or alcohol abuse
-
Certain health conditions
Many people with the condition abuse alcohol or other drugs when manic or depressed. People with bipolar disorder are more likely to have seasonal depression, co-existing anxiety disorders, posttraumatic stress disorder, and obsessive-compulsive disorder.
The Brain And Bipolar Disorder
Experts believe bipolar disorder is partly caused by an underlying problem with specific brain circuits and the functioning of brain chemicals called neurotransmitters.
Three brain chemicals — norepinephrine , serotonin, and dopamine — are involved in both brain and bodily functions. Norepinephrine and serotonin have been consistently linked to psychiatric mood disorders such as depression and bipolar disorder. Nerve pathways within areas of the brain that regulate pleasure and emotional reward are regulated by dopamine. Disruption of circuits that communicate using dopamine in other brain areas appears connected to psychosis and schizophrenia, a severe mental disorder characterized by distortions in reality and illogical thought patterns and behaviors.
The brain chemical serotonin is connected to many body functions such as sleep, wakefulness, eating, sexual activity, impulsivity, learning, and memory. Researchers believe that abnormal functioning of brain circuits that involve serotonin as a chemical messenger contribute to mood disorders .
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What Is Schizoaffective Disorder
Schizoaffective disorder is a condition on the schizophrenia spectrum, but it is not the same condition as schizophrenia. You may think of schizoaffective disorder as a combination of schizophrenia-like symptoms such as paranoia, hallucinations, and social isolation, as well as mood symptoms that may resemble either bipolar disorder or depression.
Schizoaffective disorder symptoms can look different from person to person. People who have bipolar disorder often have psychotic symptoms, so there can be a lot of overlap between the two conditions. Therefore, one person with schizoaffective disorder may have a more severe mental illness than a different person with bipolar disorder. This is not a hard-and-fast rule, as bipolar disorder, especially when it includes psychotic symptoms, can be quite severe.
Schizoaffective disorder is a diagnosis that combines psychotic symptoms and mood symptoms into one label. Its important that your doctor rules out other conditions such as bipolar disorder, depression, drug use, and schizophrenia before diagnosing you with this condition.
What You Can Do: Daily Habits Make A Difference
These healthy lifestyle habits, along with professional treatment, can help manage the symptoms of bipolar disorder:
Treatment Works. SAMHSA Can Help You Find It.
Effective treatments for bipolar disorder are available in your area. The earlier that you begin treatment, the greater likelihood of a better outcome. For confidential and anonymous help finding a specialty program near you, visit SAMHSAs Early Serious Mental Illness Treatment Locator.
If you, or someone you know, need help to stop using substances whether the problem is methamphetamine, alcohol or another drug call SAMHSAs National Helpline at or TTY: , or text your zip code to 435748 , or use the SAMHSAs Behavioral Health Treatment Services Locator to get help.
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Do The Symptoms Of Bipolar Get Worse With Age
Yes, it does, and I can attest to this. The symptoms of bipolar get worse with age, and studies back this up, I for one, have been experiencing this as I approach my fifth decade. In the space of five years, I have had several severe depressive episodes and two hypomanic spells. Im currently in my sixth depressive episode.
It has been shown via research that the depressive episodes are more prevalent the older you become and unlike other mental illnesses where the symptoms may improve with age, bipolar does not in fact, it can even age you based on studies of DNA telomeres, the longer the length of the telomere the better, but with bipolar they shorten quicker, and this can bring on earlier ageing than the average person.
Telomeres act as protective caps on the ends of DNA strands. Each time a cell divides, the telomere becomes shorter, until it is so short that the cell can no longer replicate.
With earlier ageing, this can make bipolar worse. It is an aspect of the illness that I find difficult and explains why I could have many spells of normality in my youth. Still, as I am middle-aged now, I fear I have a lot more to come in the way of mental instability, especially if my psychiatrist cannot balance my medication.