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Bipolar
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“Bipolar mood disorder is a nice way of saying that you will feel so high that no street drug can compete and you will feel so low that you wish you had been hit by a Mack truck instead.”
Previously known as manic depression, bipolar mood disorder (BMD) is defined by alternating periods of severe depression, mania or hypomania, and relative stability. Mood fluctuations and sub-clinical symptoms can persist even during stable periods. The depressed and manic states are not the ordinary ups and downs of life; they are extreme in both intensity and duration.
Time spent in the depressed phase generally outweighs time spent manic. Episodes last weeks in Bipolar Type I and days in Bipolar Type II. Mixed episodes, in which high and low states co-exist, are particularly distressing. Cyclothymia refers to a milder form of the disorder.
Although genetic factors play a substantial role, 30 to 50 percent of adults diagnosed with bipolar disorder report traumatic childhood experiences. Perfectionism and compromised self-esteem have also been identified as contributing factors. These findings point to the importance of psychotherapy within the treatment plan, particularly given its positive effect on mood stabilisation during manic episodes.
Therapy supports the management of bipolar disorder by addressing the early experiences and self-related vulnerabilities that contribute to its course, building the capacity to recognise the early signs of mood shifts, and strengthening the ability to remain anchored through the cycles the condition imposes. It works alongside, rather than in place of, appropriate medical treatment.
References
Alloy, L., Reilly-Harrington, N., Fresco, D., & Flannery-Schroeder, E. (2006). Cognitive vulnerability to bipolar spectrum disorders. In L. Alloy & J. Riskind (Eds.), Cognitive vulnerability to emotional disorders (p. 93–124). Lawrence Erlbaum Associates Publishers.
Bentall, R., Kinderman, P., & Manson, K. (2005). Self-discrepancies in bipolar disorder: Comparison of manic, depressed, remitted and normal participants. British Journal of Clinical Psychology, 44(4), 457–473.
Brietzke, E., Kauer Sant'anna, M., Jackowski, A., Grassi-Oliveira, R., Bucker, J., Zugman, A., Mansur, R., & Bressan, R. (2012). Impact of childhood stress on psychopathology. Rev Bras Psiquiatr., 34(4): 480–488.
Havens, L., Ghaemi, S., (2005). Existential despair and bipolar disorder: The therapeutic alliance as a mood stabilizer. American Journal of Psychotherapy, 59(2): 137–147.