Bipolar Disorder

There have also been links to high functioning, notably regarding hypomania ('below mania') and creativity. More often than not, people with bipolar disorder are above average in creativity, perseverance, and sometimes intelligence Miles Agha [3]. Countless writers, musicians, artists, scientists, performers, poets, and other creative talents have been diagnosed with some form of bipolar disorder, and some even attribute it to their creativity. Both the natural drive for success and flight of ideas in the state of mania and hypomania are linked directly to many creative motives. Some people who suffer from bipolar disorder have mixed states often, where they feel depressed and 'blue', but unlike clinical depression one in a mixed state may still feel 'always high'. It is one of the signature characteristics of bipolar disorder. They may have creative energy, racing thoughts, but a constant negative feeling. These two extremes combined can often lead to anxiety. This is one of the reasons that many people with bipolar disorder also suffer from panic disorder.

Bipolar Disorder is commonly categorised as either Bipolar I or Type I, where an individual experiences full-blown mania, or Bipolar II or Type II, in which the "highs" do not go beyond hypomania (unless triggered in to mania by medication). The latter is much more difficult to diagnose, since the hypomanic episodes may simply appear as a period of successful high productivity. Psychosis can occur, particularly in manic periods. There are also 'rapid cycling' subtypes. Because there is so much variation in the severity and nature of mood-related problems, the concept of a bipolar spectrum is often employed, which includes cyclothymia. There is no consensus as to how many 'types' of bipolar disorder exist. Many patients with bipolar disorder suffer from severe anxiety and panic when in a manic state, while others are euphoric. Some do not experience full-blown mania, and will display milder symptoms, known as hypomania. Depression medications are often contraindicated for patients with bipolar disorder, as these medications may induce mania and worsen the disorder. In addition, many patients with bipolar disorder are inaccurately diagnosed with unipolar depression (clinical depression), further complicating diagnosis. In fact, it often takes more than a decade before patients are accurately diagnosed and treated for their bipolar disorder. Bipolar disorder (sometimes known as Manic-Depressive Disorder) differs from Clinical Depression in that clinical depression in itself is a form of unipolar disorder (with mania being the flipside to that coin), while bipolar disorder causes, amongst other things, severe mood cycling throughout the lifetime of a person suffering from the disorder. Mood cycles can last from months to years in duration, with periods of relative "normalcy" in between episodes, and as a general rule, episodes almost always begin in either the spring or fall months, when the amount of daylight is either increasing or decreasing (daylight and sleep patterns have great effect on bipolar cycles). Some indicators of the onset of a bipolar episode include changes in sleep patterns, activity level, social rhythms and cognitive functioning, and in the most severe states of mania, hallucinations and delusions can occur. Signs and symptoms of the depressive phase of bipolar disorder include (but in no way are limited to): persistent feelings of sadness, anxiety, guilt, anger, isolation and/or hopelessness, disturbances in sleep and appetite, fatigue and loss of interest in daily activities, problems concentrating, loneliness, self-loathing, apathy or indifference, depersonalization, loss of interest or a sudden increased interest in sexual activity, shyness or social anxiety, irritability, chronic pain (with or without a known cause), lack of motivation, and morbid/suicidal ideation. [1]

Certain kinds of severe depression may be accompanied by symptoms of psychosis, mainly escapism (creating mental diversions to 'escape' from perceived unpleasant aspects of stress) and delusions (false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person's cultural concepts). [citation needed] Bipolar depression may involve heavy feelings of anxiety with no one cause. [citation needed] Delusions in a depressive person often take the form of intense guilt for supposed wrongs that the patient believes he or she has inflicted on others. Hypomania is a less severe form of mania which can lead to mania if not recognized and dealt with in a timely fashion. Hypomania is generally a less destructive state than mania, and people in the hypomanic phase generally experience less of the symptoms of mania than those in a full-blown manic episode.

People with hypomania can be perceived as being energetic, euphoric, charismatic, confident, and overflowing with new ideas. However, irritability or aggression can also be associated with hypomania. Individuals experiencing hypomania are genereally capable of normal or above-average participation in everyday activities, or experience a period of particular productivity or creativity. Some suggest people in a hypomanic state may possibly benefit from the mental stimulation in certain situations. Hypomanoia always carries the risk(s) (both positive and negative) associated with mania. Therefore hypomanic episodes are usually dealt with accordingly with medications and other medical treatments. In the context of bipolar disorder, a mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously (for example, agitation, anxiety, aggressiveness or belligerence, confusion, fatigue, impulsiveness, insomnia, irritability, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, racing thoughts, restlessness, and rage).[2]

Mixed states can be the most volatile of the bipolar states (as negative moods can easily be triggered or rapidly swing), and can involve panic attacks, substance abuse, and suicide attempts. Oftentimes the emotional pain felt by a patient in a long-term mixed state increases in severity to the point at which it becomes physical pain, leading many patients to self-mutilating behaviors such as cutting, burning, or inflicting pain on themselves in other ways, solely in order to distract themselves from the severity of the physical/emotional pain they are suffering. Suicide rates are also highest in mixed states.