Formerly known as manic depression, this disease is characterized by two phases (hence the bipolar designation), i.e., the manic phase and the depressive phase. Mania is characterized by an expansive or irritable mood, as well as a high level of activity that is uncharacteristic of the person.
The depressive phase is characterized by a depressed mood and/or a loss of interest or enjoyment, as well as other symptoms described below.
For example, a person suffering from a bipolar disorder may experience an episode of mania, followed by a balanced period that lasts from a few hours to a few weeks, before falling into depression, and finally returning to a balanced mood again.
Without treatment, a manic episode can last from a few days to a few weeks, even months; the subsequent depression usually lasts a little longer.
• The person is unusually euphoric, expansive, or irritable.
These other symptoms may also be observed:
• Marked increase in self-esteem or delusions of grandeur
The person feels as if they can achieve anything, and entertains delusions of grandeur that make them believe they are destined to greatness.
• Decreased need for sleep
The person gets little sleep, sometimes only 2 to 3 hours a night. Often, the person will get up in the middle of the night to carry out various activities one would normally undertake during daytime, e.g., household chores, maintenance, etc.
• Increased rate of speech
The person feels an increased need to talk, talks faster or louder than usual, and moves swiftly from one topic to another without necessarily finishing their idea or sentence.
• Numerous realistic and unrealistic ideas and projects
The person undertakes various projects, multiplies commitments, and dedicates way more time and energy than usual in pursuing them. Often, projects undertaken during a manic phase are given up along the way, never to be completed.
• Attention disorder or distractibility
The person is easily distracted, and their attention is easily captured by irrelevant external stimuli (for example, a noise, or a movement spotted out of the corner of their eye). They may also have a hard time remembering what they have just said.
The person is constantly moving, has difficulty sitting down and remaining calm, and feels overexcited.
• Increase in risky activities
For example, unprotected sexual activities with other partners, reckless driving, impulse buying.
The person experiences:
• A depressed mood most of the day, almost every day
The person expresses feelings of sadness or emptiness, tends to cry easily, or feels like crying but cannot.
• Markedly diminished interest or pleasure in nearly all activities
The person is unable to enjoy activities that used to be pleasurable, or loses interest in work, leisure activities, and people.
These other symptoms may also be observed:
• Significant weight change without dieting
More often than not, the weight loss occurs with no conscious effort to lose it, however weight gain is also a possibility.
• Insomnia or, less frequently, hypersomnia
Insomnia: Difficulty falling asleep; the person wakes up frequently during the night or very early in the morning (4 or 5 a.m.), or unrefreshing sleep.
Hypersomnia: Good quality sleep over long periods (typically more than 10 hours per night) with few night-time awakenings. People suffering from hypersomnia may sleep very long nights or have frequent naps of several hours. Usually, these naps are not refreshing.
• Restlessness or psychomotor retardation
Restlessness: The person affected is constantly on the move, has difficulty remaining calmly seated, or feels overexcited.
Psychomotor retardation: More often than not, the person’s thoughts and movements will slow down. Their speech will be slower, their answers will be delayed, their voice will become flat, and they will move less or less quickly.
• Fatigue or loss of energy nearly every day
The person affected feels unable to carry out their regular daily tasks without becoming excessively tired. Getting out of bed can become an ordeal in itself.
• Feeling of worthlessness or excessive/misplaced guilt
The person feels useless, incompetent, worthless, or a burden to others. They may feel responsible for unpleasant events even if they did not cause them.
• Difficulty thinking, remembering certain things, concentrating, or making decisions
The person is indecisive about things for which they used to be able to make a choice; for example, choosing between two pleasurable activities, two dishes they enjoy. The person has difficulty organizing their thoughts, and needs more time to express them.
• Recurring thoughts of death or suicide
If you believe someone close to you is preoccupied with death or is contemplating suicide, it is important that you clearly ask them if they are planning to act on these thoughts. Contrary to popular belief, asking such a question will not push them closer to the edge. In fact, it could actually save their life. Don’t hesitate to ask for support, if needed, from a specialized resource, such as JEVI Centre de prévention du suicide – Estrie at 1-866-APPELLE.
The symptoms of mania and depression cause significant suffering for the individual and impair their ability to function socially and professionally.
There are two important aspects to treatment:
• Getting enough quality sleep
• Having a regular routine
Regular meals, bedtime and waking hours, physical activity, etc.
• Avoiding drugs and alcohol
• Stopping or reducing your consumption of coffee, tobacco, and other stimulants
This includes cola-based drinks, chocolate, energy drinks, etc.
• Learning to manage stress
Relaxation activities, meditation, yoga, psychotherapy, regular practice of a sport, and having a good support circle all promote better stress management.
This is essential to get symptoms under control.