Bipolar disorder is so named, because it has two key characteristics: mania and depression. In the past, people also referred to this illness as manic-depressive. Bipolar disorder is one of the most common mental illnesses in Germany. However, many cases go unnoticed. Signs of bipolar disorder include extreme changes in mood, which occur either for no particular reason, or in response to a certain situation. The affected person swings between feelings of euphoria (mania) and despair (depression). This process can look different for everyone; manic/depressive episodes can last days, weeks, months, or even years, and in between there might be periods during which the affected person experiences no problems at all.
Mania (fom the Greek „mania” = anger, frenzy, madness) manifests itself as a feeling of intense elation, high spirits, and increased motivation. The affected person feels exceptionally creative and inventive – they are euphoric. The difficulty here is that a manic person will persistently deny that they have a problem, and then potentially be committed to a closed ward against their will. Elation can quickly turn to irritability, and the patient also usually has the urge to speak a lot to others and may lack awareness of personal space. Other features of this illness include mental leaps and acting erratically: they may start lots of things but barely finish any of them. Moral barriers may also fall away: often the affected person will behave very differently than they would normally.
Depression is the opposite of mania, and manifests as a feeling of dejection, loss of interest, joylessness and expressionlessness. Motivation is greatly reduced. Emotions fade and thoughts, behaviour, and body are affected. Additional key symptoms could include the affected person brooding a lot and having a pessimistic outlook on the future. Loss of appetite is possible, but the converse can also occur. People who are depressed have great difficulty concentrating and have attention deficit. Additionally, they have difficulty making decisions. Eventually, feelings of worthlessness and guilt set in. Suicidal thoughts are possible, which can make this episode of bipolar disorder very dangerous.
When treating bipolar disorder, it must be established whether the case is severe, and whether it is suited to maintenance therapy or relapse prevention. In severe cases, it is a question of reducing the affected person’s level of suffering and restoring their understanding of the illness. Maintenance therapy further stabilises the patient’s situation in order to prevent relapse. Relapse prevention is planned long-term and is intended to prevent further episodes of illness. During acute treatment, the affected person is given medication such as antidepressants. Long-term, mood stabilizers such as lithium are used. Psychotherapy should focus more on the here and now (the illness) rather than on the ‘Why’.
The novel „Die Welt im Rücken“ (The World at Your Back) by writer Thomas Melle, received a lot of praise from critics. In it, Melle describes his own bipolar disorder and how he has managed it in his day-to-day life. The literary approach and Melle’s eloquence allow a new, fresh, and nuanced perspective on bipolar disorder. Many famous creatives suffer or have suffered from bipolar disorder, including for example the actress Carrie Fisher (Star Wars). During manic episodes, these individuals thrive and are creative and inventive. Sadly, this is then eventually followed by a fall into depression.