Bipolar disorder – the mental illness with two faces.
Bipolar disor­der – the mental illness with two faces.

Fact #1

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.

Fact #2

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.

Fact #3

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.

Fact #4

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’.

Fact #5

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.