@DeadCat's comment on 'The Definitive Bipolar Post'

EFFORTPOST The Definitive Bipolar Post

As you probably know by now, I'm a sick, sick man. I am diagnosed with Bipolar II disorder along with OCD. This has affected my life negatively, but I'm still alive which more than many can say. Today, I'm going to explain the ins and outs of Bipolar Disorder. I hope you enjoy the short read.

What is Bipolar Disorder

Bipolar disorder is a mental disorder characterised by mood swings. In other words, the sufferer may have periods of great euphoria followed by an irrational manic-depressive episode. During the upswing, a Bipolar patient will experience the following:

euphoria
high motivation
irritability
risky behaviour
heightened sexual activity

I am currently in an upswing and I have very little need for sleep. Five hours or less is enough for now, which is partially why I have time for this shit. I also feel highly productive and cannot stop myself from producing something. I wish I was a genius so I could channel this energy into something other than rdrama posts that 12 people will upmarsey and cause 3 people to block me. After the upswing comes the downswing which consists of depression, suicidal thoughts, a lack of motivation, and self-harm. How much self-harm? It is estimated that 30-40% of folks with Bipolar Disorder will engage in self-harming behaviour. Upswings and downswings are usually not congruent with what is going on in the person's life. For example, someone with a good life may find themselves in a downswing while others may experience a euphoric downswing as they ruin their life.

Quick notes from Holly!

Holly says to take benzos, avoid sleep, play The Last of Us Part 2, and listen to Cocaine 80s. In between these activities, make shitposts on rdrama.

How quickly do these mood swings occur? Well, it depends on what kind of Bipolar disorder one suffers from. With Bipolar I and II, each upswing and downswing can last weeks to months. However, there exists rapid cyclic bipolar which is typically characterised as a series of 4 or more upswings or downswings occurring within a 12-month period. Symptoms typically begin to manifest in one's early twenties, though signs may appear during teen years or it could onset in one's late twenties.

Difference between Bipolar I and Bipolar II

Though Bipolar I and II share many similarities, there are some key differences. Most notably, one can only be diagnosed with Bipolar I if they experience a manic episode. A manic episode is characterized by psychotic symptoms such as visual and audio hallucinations. Other symptoms include:

racing thoughts
disinhibited social behaviour
hypersexuality
feelings of grandiosity
pressured speech

For example, someone may feel that they are receiving messages from God, hear divine voices calling their name, believe they can change the world, or are on a special mission. With the propensity for risky behaviour comes increased drug use and risky sexual behaviour. Such individuals typically end up requiring involuntary institutionalization, and they demonstrate decreased activity in the lingual gyrus region of the brain and decreased activity in the inferior frontal cortex. In contrast, Bipolar II patients suffer from hypomania which is more subdued and less likely to ruin someone's life, but is nonetheless still highly disruptive. They do not experience the psychotic aspects of mania and do not usually require hospitalization during a hypomanic episode.

What goes up must come down. When the mania or hypomania is up, we get to the depressive stage. This is usually a period filled with great regret, melancholy, and a downswing in one's mood. This period is usually longer than the hypomanic or manic phase and this is when the self-harm and suicidal ideation slips in. Activities that were once enjoyed now feel dull, and constant sleep is common. During one of my downswings this year, I had to be hospitalized after severe self-harming.

But wait! There's a third option! Some people suffer from mixed affective state. This is when a person experiences an upswing and downswing simultaneously. This is common in patients with rapid cyclic bipolar where the mood swings occur so quickly, they don't have time to resolve.

What causes Bipolar Disorder

It is currently not known precisely what causes Bipolar Disorder though it is estimated that it is 70-90% genetic with a minimal environment factor. For example, an abusive childhood can aggravate the condition or a significant life event such as the loss of a loved one.

Scientists have zoned in on variants within the genes CACNA1C, ODZ4, and NCAN, and polymorphisms in BDNF, DRD4, DAO, and TPH1. The end-result is dysregulation in the dorsolateral prefrontal cortex portion of the brain.

Treatment of Bipolar Disorder

Bipolar disorder is treated through a combination of therapy and medication. Currently, I am on lithium (a controversial mood stabilizer) and Abilify (an antipsychotic). Previously I have also been on sodium valproate and serdep. And of course, I have been given a plethora of benzodiazepines. Typical therapy methods include CBT (cognitive behavioural therapy) and DBT (dialectical behavioral therapy).

It is difficult to treat Bipolar disorder because those with the illness are often in denial about it and resistant to treatment. This is especially true during manic episodes. Hence, more than 75% of individuals with BD inconsistently take their medications for various reasons.