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.