Npd and bipolar

The Relationship Between Bipolar Disorder and Narcissism

Bipolar is a mood disorder, characterized by see-sawing highs and lows. Narcissistic personality disorder rises from childhood neglect, leading individuals to overinflate their capabilities to compensate for feelings of inadequacy. And yet, when people with bipolarity are in manic mode, they may feel as powerful, talented, and special as those with narcissism.

What else do these two have in common and how may they be linked?

Connection Between Bipolar and Narcissism

While bipolar disorder and narcissistic personality disorder remain separate mental health issues, researchers have noted shared symptoms of setting excessively high goals and impulsivity.¹ Other shared traits may include showing a lack of empathy, sleep deficiencies, and mood shifts.

And, according to several studies, in addition to sharing some symptoms, a number of people display both disorders at once.

A 2005 study found that 8% of 100 individuals with bipolar disorder also showed signs of narcissistic personality disorder, while among those with bipolar II disorder, rates of narcissism were as high as 5%. Though narcissistic personality disorder in bipolar disorder is most likely to be diagnosed during manic episodes, rates of narcissism remained as high as 4.5% in those in remission from mania.²

Yet there are differences, including the origin of each disorder.

“One critical area of distinction between the two pathologies is that for people with bipolar [disorder], symptoms such as energy and grandiosity are seen specifically in episodes of elevated mood, whereas narcissism represents an underlying personality style that endures over time,” says Russ Federman, PhD, a Virginia psychologist and co-author of Facing Bipolar. “For those with bipolar [disorder], there are many periods of time where an elevated mood is not present, which means that the narcissistic personality style is stable where bipolar symptoms are episodic.”

What is Bipolar Disorder?

For people with untreated bipolar disorders, life is a ride from one mood to the next. In the case of bipolar I that means shifts between manic and depressive episodes that can stretch from one to two weeks and that may lead to hospitalizations. For those with bipolar II, moods vary between hypomania—a less extreme version of mania—and frequent depressive states.

While the precise causes of these mood swings are not precisely understood, bipolar is a biologically based disorder, caused by brain structure, genetics, and the environment. Unlike narcissism, it is not driven by psychology.

“Bipolar disorder is a brain disorder with a strong genetic component, with individuals who have a clear presence of mood disorders in their genetic background having a higher likelihood of developing the disorder,” says Federman. “Someone with bipolar disorder can be raised in a psychologically healthy family environment and still experience the onset of the illness.”

While most people understand the depressive part of the disorder, it’s important to recognize that while depression can lead to sadness, manic or hypomanic states should not be equated with happiness, but more as “increased energy and intensification of mood,” according to Federman.

“During periods of this increased energy, people with bipolar disorder need less sleep and have increased directed activity which can include disinhibited behavior and impulsivity,” he says. “Other bipolar symptoms during these times can include a heightened libido, greater interpersonal activity, and an extreme and positive perception of self.”

While these behaviors may initially appear positive, individuals may find it increasingly difficult to keep it together as a rise in neural activity during mania can make them less stable, less organized, and dysfunctional.

Symptoms of a manic episode can include:³

Feelings of elation
Extreme energy
Irritability
Requiring less sleep
Sense of grandiosity, including feeling important, talented, or powerful
Risky and impulsive behaviors, including overeating or drinking, spending, or giving away sums of money, or reckless sexual encounters

Symptoms of a depressive episode include:

Feeling sad, hopeless, or worthless
Feeling lonely or isolated
Talking slowly and feeling like you have nothing to contribute
Having little energy
Oversleeping
Over- or undereating
Lack of interest in usual activities or inability to perform normal activities
Thinking about death or suicide

Narcissistic Personality Disorder

Unlike primarily biologically based bipolarity, narcissism rises from the interpersonal environmental influences that form personality.

“We come into the world with our own dispositions,” says Federman. “Observation of multiple infants on an obstetrics floor will easily illustrate that people are different, even during the first days of life. However, interpersonal influences during childhood play a substantial role in the development of personality.”

Personality disorders, such as narcissism, are often the result of childhood neglect. When a child doesn’t receive the care he or she needs or is tasked with too much responsibility too early, the child may inflate his or her sense of self to compensate for what is unavailable, says Federman.

“They make themselves bigger, stronger or more capable than they actually feel to manage feelings of insufficiency,” says Federman. “Narcissistic personality disorder can be viewed on a spectrum, where the upper end shows a person who is self-centered and boastful, someone who can’t acknowledge their insufficiency or their inadequacy.”

While there is a genetic component to the development of narcissism, “it is less likely that we see the presence of a personality disorder when one has experienced psychologically healthy family interactions,” says Federman.

Symptoms of NPD include:⁴

Reacting to criticism with rage, shame, or humiliation
Taking advantage of people to achieve goals
Having excessive feeling of self-importance
Exaggerating achievements and talents
Preoccupation with fantasies of success, power, beauty, intelligence, or ideal love
Have unreasonable expectations of favorable treatment
Requiring constant attention and admiration
Disregarding the feelings of others, little ability to experience empathy
Obsessive self-interest
Pursuit of mainly selfish goals

Additional traits can include arrogance, a striving for power, a feeling one is special or entitled, a lack of sympathetic connection, a need for admiration, and an envy for what others have.

Differences Between Bipolar and Narcissism

A quick skim of the lists above reveals a few similar symptoms. But while that may lead to comorbidity—having both conditions at once—close reading of individuals may reveal subtle differences that can help health professionals distinguish between one disorder and the other.

For example:

Increased Interpersonal Connections

While individuals with bipolar disorder may experience a boost in socialization and interpersonal relationships during periods of mania or hypomania and narcissists also often show this heightened mingling, their motivations may differ.

People with bipolar may be exhibiting heightened social activity during a manic or hypomanic state, while those with narcissism may be looking to exploit or manipulate others.

“While individuals with narcissistic organization may have a good degree of personal charm and skills used to manipulate others in order to gratify one's own needs, these interpersonal aspects are not necessarily inherent to bipolarity,” says Federman.

Sleep

Individuals with bipolar disorder and narcissistic personality disorder may share shortened sleep schedules, but as the days of reduced slumber tick by, they react differently.

“While people with bipolar disorder whose baseline sleep duration is eight hours may be only getting four or five hours nightly, they awaken feeling energized and not fatigued,” says Federman. “This can go on for one to two weeks before sleep deprivation eventually catches up to the individual and begins to adversely impact their functioning.”

In contrast, if an individual with narcissistic disorder is excited and highly engaged in some endeavor, his or her sleep needs may decrease for a brief period, but they will show evidence of fatigue.

Lack of Empathy

“Lack of a strong capacity for empathy is one of the hallmark ongoing features of narcissistic personality,” says Federman. “We can also see something similar in bipolarity though it is largely a function of episodic symptoms interfering with empathic connection. At either end of the mood continuum where one is experiencing strong depression or strong mood elevation, the strength of accompanying symptoms may interfere with an individual's capacity for empathy. ”

However, once again, due to the episodic nature of bipolar symptoms, the lack of empathy in bipolar individuals tends to be short lived.

Mood Swings

Mood swings can occur in people with narcissistic personality disorder, but they are often in response to criticism or disappointment or depression which may lead them to uncomfortably confront their own vulnerability.

For those with both bipolar disorder and narcissistic personality disorder, episodes of depression, if accepted as part of a bipolar diagnosis may help a narcissistic person “distance from feelings of insufficiency,” says Federman.

Can Bipolar Disorder Change Your Personality?

When it comes to personality, the largest change in people with bipolar disorder is often overall functioning before and after the onset of the diagnosis. Some people are relatively asymptomatic until the point at which the illness is activated, often between mid-teens and the mid-20s.

“Once the illness becomes activated, particularly if symptoms have frequent recurrence, then, of course, we will likely see the broader personality become affected by the illness,” says Federman.

But he notes that even in that situation, personality style tends to be relatively consistent and enduring. “Therefore, in most instances, you won't see personality undergo significant transformation or change because of the onset of bipolar disorder.”

Treatment for Bipolar and Narcissism

People with bipolar disorder can benefit from medications, including mood stabilizers and anti-depressants, and psychotherapy. In some cases, electroconvulsive therapy (ECT) which shocks the brain to change brain chemistry and may help certain mental illness, may be indicated.

Psychotherapy has also been shown to help those with narcissistic personality disorder, although sometimes these patients may reject therapy, since it implies feelings of inadequacy, which they struggle to avoid. Opening to a therapist also may leave them vulnerable, which they may also find difficult to accept.

“Narcissism can be treated, but an individual requires strong motivation and must be open to recognize the maladaptive aspects of his or her personality,” says Federman. “We can treat bipolarity, but with narcissism it's a very slow and very gradual talk therapy.”

“Personality is years in the making, and so is treatment,” says Federman.

Frequently Asked Questions About Bipolar and Narcissism

Can bipolar disorder change personality?

The biggest impact on personality from bipolar disorder is usually when it first makes an appearance, often between the mid-teens and mid-20s. If the person affected has been relatively asymptomatic until that point, the onset of the illness, particularly if symptoms have frequent recurrence and overwhelming incidence of mood swings, the broader personality may become affected by the illness.  But even in that situation, personality style tends to be relatively consistent and enduring.  Therefore, in most instances, you won't see personality undergo significant transformation or change because of the onset of bipolar disorder.

Is there a link between bipolar and narcissism?

While bipolar disorder and narcissistic personality disorder are two distinct mental health diagnoses, researchers have long noted a link between the two, including symptoms of setting excessively high goals and impulsivity. Other shared traits may include a lack of empathy, sleep deficiencies, and mood changes.

How can you tell the difference between bipolar and narcissism?

One indicator is the impact of a lack of sleep. Individuals with bipolar disorder and narcissistic personality disorder may share shortened sleep schedules, but their energy levels will differ, an important distinction. For example, when a person with bipolar disorder in a manic phase who has shifted from getting eight hours of sleep to four or five, they will away feeling energized and not fatigued. This may continue for two weeks before an individual begins to feel sleep deprivation in a way that impacts their daily functioning.

Do people with bipolar lack empathy?

While people with bipolar disorder may exhibit a lack of empathy when in the throes of a manic or hypomanic mood swing, this is usually an episodic condition. On the other hand, lack of a strong capacity for empathy is one of the hallmark ongoing features of narcissistic personality.  People with bipolar disorder may also exhibit a lack of empathy, but it tends to be an episodic symptom of mania or depression interfering with empathic connection. At either end of the mood continuum where one is experiencing strong depression or strong mood elevation, the strength of accompanying symptoms may interfere with an individual's capacity for empathy.

Carver, C.S., et.al. Commonalities and differences in characteristics of persons at risk for narcissism and mania J Res Pers. 2008 Dec; 42(6): 1427–1438. doi: 10.1016/j.jrp.2008.06.002
Carver, C.S., et.al. Commonalities and differences in characteristics of persons at risk for narcissism and mania J Res Pers. 2008 Dec; 42(6): 1427–1438. doi: 10.1016/j.jrp.2008.06.002
Bipolar Disorder. Medline Plus. https://medlineplus.gov/bipolardisorder.html.
Narcissistic Personality Disorder. Medline Plus. https://medlineplus.gov/ency/article/000934.htm

References

(The writer gained permission to draw on Federman’s work)

The Relationship Between Narcissism and Bipolar Disorder. https://www.psychologytoday.com/us/blog/bipolar-you/201310/the-relationship-between-narcissism-and-bipolar-disorder

Webinar: The Relationship Between Narcissism and Bipolar Disorder: Diagnostic and Treatment Considerations. https://www.youtube.com/watch?v=MGL3xzV5RqU

Notes: This article was originally published July 12, 2022 and most recently updated November 28, 2022.

Ilene Raymond Rush

Ilene Raymond Rush is a journalist, essayist, and fiction writer who graduated from the Iowa Writer’s Workshop. Although she has lived with depression since age 18, it wasn’t until her early 30’s that she was diagnosed with bipolar 2 disorder.

The Relationship Between Bipolar Disorder and Narcissism

What else do these two have in common and how may they be linked?

Connection Between Bipolar and Narcissism

And, according to several studies, in addition to sharing some symptoms, a number of people display both disorders at once.

Yet there are differences, including the origin of each disorder.

What is Bipolar Disorder?

Symptoms of a manic episode can include:³

Feelings of elation
Extreme energy
Irritability
Requiring less sleep
Sense of grandiosity, including feeling important, talented, or powerful
Risky and impulsive behaviors, including overeating or drinking, spending, or giving away sums of money, or reckless sexual encounters

Symptoms of a depressive episode include:

Feeling sad, hopeless, or worthless
Feeling lonely or isolated
Talking slowly and feeling like you have nothing to contribute
Having little energy
Oversleeping
Over- or undereating
Lack of interest in usual activities or inability to perform normal activities
Thinking about death or suicide

Narcissistic Personality Disorder

Unlike primarily biologically based bipolarity, narcissism rises from the interpersonal environmental influences that form personality.

Symptoms of NPD include:⁴

Reacting to criticism with rage, shame, or humiliation
Taking advantage of people to achieve goals
Having excessive feeling of self-importance
Exaggerating achievements and talents
Preoccupation with fantasies of success, power, beauty, intelligence, or ideal love
Have unreasonable expectations of favorable treatment
Requiring constant attention and admiration
Disregarding the feelings of others, little ability to experience empathy
Obsessive self-interest
Pursuit of mainly selfish goals

Additional traits can include arrogance, a striving for power, a feeling one is special or entitled, a lack of sympathetic connection, a need for admiration, and an envy for what others have.

Differences Between Bipolar and Narcissism

For example:

Increased Interpersonal Connections

People with bipolar may be exhibiting heightened social activity during a manic or hypomanic state, while those with narcissism may be looking to exploit or manipulate others.

Sleep

Individuals with bipolar disorder and narcissistic personality disorder may share shortened sleep schedules, but as the days of reduced slumber tick by, they react differently.

Lack of Empathy

However, once again, due to the episodic nature of bipolar symptoms, the lack of empathy in bipolar individuals tends to be short lived.

Mood Swings

Can Bipolar Disorder Change Your Personality?

“Once the illness becomes activated, particularly if symptoms have frequent recurrence, then, of course, we will likely see the broader personality become affected by the illness,” says Federman.

Treatment for Bipolar and Narcissism

“Personality is years in the making, and so is treatment,” says Federman.

Frequently Asked Questions About Bipolar and Narcissism

Can bipolar disorder change personality?

Is there a link between bipolar and narcissism?

How can you tell the difference between bipolar and narcissism?

Do people with bipolar lack empathy?

Carver, C.S., et.al. Commonalities and differences in characteristics of persons at risk for narcissism and mania J Res Pers. 2008 Dec; 42(6): 1427–1438. doi: 10.1016/j.jrp.2008.06.002
Carver, C.S., et.al. Commonalities and differences in characteristics of persons at risk for narcissism and mania J Res Pers. 2008 Dec; 42(6): 1427–1438. doi: 10.1016/j.jrp.2008.06.002
Bipolar Disorder. Medline Plus. https://medlineplus.gov/bipolardisorder.html.
Narcissistic Personality Disorder. Medline Plus. https://medlineplus.gov/ency/article/000934.htm

References

(The writer gained permission to draw on Federman’s work)

The Relationship Between Narcissism and Bipolar Disorder. https://www.psychologytoday.com/us/blog/bipolar-you/201310/the-relationship-between-narcissism-and-bipolar-disorder

Webinar: The Relationship Between Narcissism and Bipolar Disorder: Diagnostic and Treatment Considerations. https://www.youtube.com/watch?v=MGL3xzV5RqU

Notes: This article was originally published July 12, 2022 and most recently updated November 28, 2022.

Ilene Raymond Rush

Children with NPD - how to recognize the signs of NPD

Narcissistic Personality Disorder or NPD is an extremely common mental health problem in today's society

Like most mental disorders, the cause is unknown. It is most likely a combination of genetic experience, early life experience, and possibly psychological factors. Risk factors at an early age include: excessive exposure of children to abuse, abuse at an early age, living under high emotional stress, living with an unhappy partner, living in an unhealthy environment, depression and other emotional problems. nine0005

The definition of NPD is an inability to accept responsibility, a grandiose sense of self and egocentrism. This has been called a "love addiction" as it has been reported that some people with NPL have actually turned to drugs and/or alcohol to cope with feelings of shame and guilt. In fact, people with NPL may actually feel that they are not good enough, incompetent, or simply incapable of succeeding in any endeavor. They see themselves as having a special role or position and are convinced that others will view them that way. nine0005

As I said earlier, no definite cause of NPD has ever been found. However, people with this disease have a number of common symptoms. The main symptoms of NPD include a grandiose sense of self-esteem, a constant need for approval, unrealistic expectations of success, constant blaming, constant denial of one's own weaknesses, extreme egocentrism, a distorted idea of one's own worth and worth, and bad relationships. with family and friends, with a deep need for admiration and a willingness to sacrifice. These symptoms are quite common in people who have a bad relationship with their parents. nine0005

If you suspect your child has NPL, do not hesitate to seek professional advice. In fact, it could be a sign that your child is suffering from a more serious mental disorder such as bipolar disorder or schizophrenia. If your child is experiencing any of these or similar symptoms, you should make an appointment with the doctor as soon as possible.

If your child has one or more of the following symptoms of NPD, you should talk to a qualified psychologist or psychiatrist about the possibility of NPD. First, your child may be overly self-centered and overly interested in their appearance and lifestyle. Often your child may have unrealistic expectations about how they can improve their appearance or self-esteem. These are usually unrealistic claims based on their own perception of their appearance. This behavior can also become very problematic in a relationship. nine0005

Your child may also show signs of NPD due to inappropriate behaviour. They can be extremely rude, arrogant and domineering at times, display aggressive behavior, often argue and appear very selfish. Your child may also show an inability to take criticism or admit their own mistakes. Such behavior may include immaturity in relationships with children, friends, work colleagues, or superiors. Other warning signs include sullenness, envy of others, and criticism of others in the presence of others and/or in the family circle. nine0005

Children with NPL can be extremely impulsive and manipulative and will have unrealistic expectations of relationships with adults. They are often very difficult to get along with and can be manipulative with children and peers. They are also often fixated on one or two issues and have a hard time admitting their own mistakes.

A child with NPD may also be overly concerned with money. They may have unrealistic expectations about the amount of money they want from you and may constantly beg for money. Your child may also exaggerate their importance and believe that they are more important than others, which leads to arguments. It is also possible that they may feel that they do not deserve your attention and that their parents and other people do not care about them. The last thing you want to see is a self-centered, arrogant and manipulative child who seems to have little respect for others. nine0005

All About Bipolar Affective Disorder

What is Bipolar Affective Disorder?

Bipolar affective personality disorder, or manic-depressive psychosis, is a complex, mental illness characterized by constant mood swings. This is not an ordinary mood change that happens to every person, but a systematic psycho-emotional drop with a short-term normal state. It is the episodes from depression to an extremely agitated state that are called affective. In Russia, 1% of the population is affected by this disease. As a rule, it is observed among young women aged 20 to 30 years. However, men are also prone to bipolar disorder, and they begin it earlier than women. And if in women it begins with a depressive phase, then in men it starts with a manic phase. The appearance of symptoms of bipolar disorder in women is often associated with hormonal disorders and the characteristics of the menstrual cycle. nine0005

Bipolar affective disorder can destroy personal relationships, impair the quality of work, reduce academic performance, and in some cases even lead to suicide. Therefore, it is so important to diagnose it in time and prescribe appropriate treatment.

Causes of bipolar affective disorder

To date, doctors cannot answer the question about the exact causes of this disease. It is known for certain that it can be genetically transmitted, but sometimes it is in "sleep mode" until it is triggered by some stressful event. Also, pushing factors for the development of BAD can be: nine0005

chronic fatigue;
overwork;
emotional burnout;
dissatisfaction with personal life;
death of a loved one;
financial problems;
dissatisfaction with life;
sensitivity and susceptibility to things;
melancholic character;
head injury;
use of drugs and alcohol.

Disease pathogenesis

The pathogenesis of bipolar affective disorder, that is, the onset and development of the disease, is currently not fully understood. At 95%, we can only say that it is transmitted genetically and is associated with neurochemistry. According to studies, in 80% of cases the nature of the disease is associated with the environment of the patient and only 20% is transmitted genetically. The causes of manic phases are increased tone of the central nervous system, as well as hyperfunction of the thyroid gland and pituitary gland.

Symptoms or how the disease manifests itself

As a rule, signs of bipolar affective disorder are observed in patients in the autumn-winter and winter-spring periods. And the point is not only in climatic features, but also in weakened immunity at the indicated times of the year.

BAD is divided into 2 phases: depressive and manic, and can manifest itself equally in both phases. The frequency of the phases and their change is very individual for each individual patient and lasts from 2 weeks to 2 years. However, even the duration of the disease cannot lead to any mental defects, such as schizophrenia, on the contrary, rather, patients with schizophrenia develop a “bipolar disorder”. nine0005

Bipolar affective disorder is characterized precisely by the sequence of the above phases. A patient with mania can be recognized by the following features:

increased hyperactivity;
excitability for more than a week;
fast speech;
great flow of speech and confusion of thought;
rapid change in mood;
increased self-esteem.

The latter entails performing overwhelming tasks that patients cannot afford. Also, the patient is accompanied by irritability, mild euphoria, excessive frankness in conversations and behavior. A person sleeps little, and 2 hours of sleep is enough for him to feel good. In rare cases, the phase is accompanied by delusions of grandeur or persecution, sound and / or auditory hallucinations. At the same time, the symptoms of the depressive phase are slightly different. It: nine0005

laziness and apathy;
depressed mood;
constant desire to sleep;
physical ailment;
anxiety;
heaviness in legs and head;
unwillingness to do something.

At the slightest detection of symptoms and signs of bipolar affective disorder in a patient, an early diagnosis and surgical treatment of the disease is required. This applies to any course of the disease, even if the depressed mood or the sudden change of mood in a person lasts only a few days. Any timely help will be salvation and help for the patient and will help to survive the course of the disease more easily. Painful perception of criticism, shallow depression, anxiety, unreasonable anxiety - all this, too, should alert and serve as an impetus for taking decisive action. As mentioned above, both men and women are prone to bipolar disorder, although they are more common in the latter. This is due not only to menstrual irregularities and hormonal disorders, but also to a severe course during childbirth, the so-called postpartum depression. As a rule, women are more susceptible to the unipolar course of bipolar disorder, when the course of the disease is accompanied by only one of the phases: manic or depressive. The latter is usually more common. nine0005

Bipolar affective disorder symptoms in women are accompanied by rapid cycles and mixed episodes. The prerequisites for them are eating disorders, alcohol or drug addiction, abuse of antidepressants. In addition, women are more prone to migraines, thyroid disorders, diabetes and obesity. It is these external stimuli that become the prerequisites for the development of BAD. Childbirth also becomes one of the factors in the development of the depressive phase, if a woman has already been diagnosed with this disease before them. In this case, the risks of developing the disease increase several times. Women are also more likely to have suicidal thoughts. nine0005

But in men, the symptoms of bipolar affective disorder largely depend on external factors, and the course of the disease is a little milder. The periods between phases are long and get worse over time. With inadequate and untimely treatment, the disease progresses and it becomes more difficult to get rid of it. Mostly in men, a mixed type of disorder is observed, which is accompanied by a short-term remission. In men, more often than women, the ability to do something is lost, concentration of attention decreases, and insomnia appears. And if in women one phase of BAD can last longer than another, then in men the duration is almost the same. nine0005

In addition to external factors that influence the development of bipolar disorder in men, such as unsettled life, problems in personal life and at work, financial difficulties, a common cause of the development of the disease is long-term alcohol consumption.

Mood disorder classification

This disease is classified into different types and phases. So, according to the international classification of diseases (ICD-11), types of bipolar affective disorder are divided into 1 and 2. The classic course, as mentioned earlier, is manic and depressive, and one phase can either last a long time or change abruptly to another. Another phase is due to a sharp transition - from manic to depressive without any interruptions. Frequent, long phases with rapid cyclicity - 4 or more phases significantly affect the patient's condition, his quality of life and are a poor prognosis for the course of the disease. nine0005

Bipolar affective disorder type 1 is accompanied by an aggravation of mania and pronounced depression, which leads to a violation of normal functioning. As a result - frequent hits in hospitals or police stations. Patients have a pronounced apathy, a complaint about themselves, the inability to do any business. The patient, as a rule, begins to blame himself, to consider himself incapable of anything.

And if BAD type 1 is characterized by a phase change, then bipolar affective disorder type 2 is due to the presence of only a depressive episode without mania. The course of the disease is similar to unipolar depression, however, these are two completely different diseases. If in patients in the first case, with prolonged use of antidepressants, everything returns to normal, then in patients with BAD type 2, they are not only contraindicated, sometimes, but can also cause hypomania, which has an extremely negative effect on the course of the disease. The phases last longer, replace each other faster, a mixed state occurs, which a person can hardly endure. nine0005

By phases, bipolar disorder is divided into the following types: manic, depressive, and also, a mixed episode of bipolar affective disorder is distinguished. The latter can be manifested by sudden outbursts of fun in a state of melancholic mood.

Other indicators are:

deep melancholy for several hours;

persistent sad thoughts in speech or movement, the patient himself may be agitated;

high spirits against the background of manic behavior.

nine0036

As a rule, the symptoms of this episode last about 1 week or quickly change. Sometimes a patient with a disorder is accompanied by insomnia, suicidal thoughts, lack of appetite. Pronounced symptoms are the reason for the patient's social and professional maladaptation and a significant deterioration in the quality of life.

If we talk about the depressive phase of bipolar affective disorder, then it is caused by several factors and is accompanied by the following symptoms: nine0005

Endogenous depression (permanent depressed mood) accompanied by vitality - feeling alive, able to move, energetic.
In the stage of the depressive triad, when a person does not feel like a full-fledged member of society and melancholy is fully manifested, slowness in speech and movement is observed.
Pronounced change of mood. From the morning bad mood with a feeling of melancholy and anxiety, nothing remains by the evening.
Disorder of appetite. Not a single meal seems tasty to the patient, he begins to lose weight, and in women there may be a violation of the monthly cycle up to complete disappearance. nine0036
May present with psychomotor retardation.
Constant feeling of melancholy.
Complete decrease in sexual desire and loss of maternal instinct.
Periodic occurrence of suicidal thoughts.
Occasionally, some patients experience tachycardia, constipation and mydriasis - dilated pupils.
Rarely, delusions, hallucinations may occur.

It is important to understand that patients are at high risk of suicide during this phase. According to statistics, this phenomenon occurs in 40% of cases. Therefore, it is so important to diagnose it in time for subsequent timely treatment. nine0005

The manic phase of bipolar affective disorder varies in severity from elevated mood to severe mania. In the first state there is no self-criticism, a person is adaptive to the environment. This phase is characterized by the following symptoms:

Manic triad: increased mood, accelerated thinking, movements.
Activity, energy, burst of energy. The patient takes on many things, but does not complete any one. nine0036
Lack of concentration.

This phase has 5 stages:

Hypomanic, which is characterized by increased mood and cheerfulness. Patients experience an increase in appetite and sleep duration.
Expressive, which is accompanied by constant jokes and chatter against the background of short-term outbursts of anger.
A violent state in which a prolonged excited state is accompanied by disorder and incoherent speech. nine0036
Motor calmness.
Reactive with the return of all symptoms of mania to normal. Sometimes in this scenario, patients may experience amnesia and some episodes of mania are simply forgotten.

If the main symptom of the manic phase of bipolar affective disorder is increased excitability, then in the depressive phase, on the contrary, the mood is constantly sluggish. Patients with a manic stage of development cannot soberly assess their behavior or completely deny it. In parallel with euphoria, irritability and anxiety develop. A person is uncomfortable in this state. nine0005

It is possible to make a diagnosis with a prolonged course of the disease - more than 1 week with the preservation of the phase at the main time of the day. Along with irritability, 4 additional symptoms will certainly appear. Symptoms can shift in different directions, turn from hypomania - a mild state, high activity and high spirits, into a manic psychosis. Patients with psychosis are visibly active, behaving erratically, sometimes screaming, sometimes singing. Excitation reaches its climax, the state is not stable, irritability increases, sometimes delusions or hallucinations develop. Manic psychosis is often confused with schizophrenia. nine0005

Mixed bipolar affective disorder is a mixture of two phases that literally drives the patient crazy. On the one hand, he has a pronounced stream of brilliant thoughts, on the other, suicidal thoughts and feelings of guilt. This is a very dangerous phase, which is a prerequisite for suicide. The feeling of anxiety grows even more than in the other two phases, especially if it is caused by alcohol.

A patient with bipolar disorder cannot perceive criticism and does not adequately assess his condition. Any episodes can cause rash actions, unreasonable risks that pose a threat to both him and other people. nine0005

No matter what type a person has and no matter how the course of bipolar affective disorder passes, timely diagnostics will help stop the course of the disease and prevent future complications. It is important to understand that a person's life is divided into several bands with the development of this disease: months of impenetrable darkness and the same amount of time of euphoria. The person himself does not understand that he needs help, and he does not consider himself sick.

If a person develops bipolar disorder against the background of other concomitant mental illnesses, such as: nine0005

obsessive state;
alcohol or drug addiction;
eating disorders;
attention deficit coupled with hyperactivity;
social phobia;
panic attacks and other diseases, the course of the disease can worsen significantly.

Complications of bipolar affective disorder

Complications of bipolar affective disorder are characterized by the development of non-medical diseases, namely asocial adaptation. Thought processes also change, mental ability and attention decrease, memory deteriorates. In some patients, the worldview changes completely. According to the conducted research, it was revealed that the creative potential directly depends on the course of BAD. People could not make contact with others. This applies, by the way, to both adults and children. nine0005

Patients with a depressive phase and suicidal thoughts are prone to it, which can also serve as a sad outcome for a person. A constant change of mood, a complete change in thoughts and consciousness, the inability to lead a full life, live in a family and raise children, the inability to adequately assess one's condition and others - these and many other possible consequences of bipolar affective disorder that need to be nipped in the bud and prevent the disease from developing .

When to see a doctor?

You need to consult a doctor already if one or two of the above symptoms occur, regardless of the phase, for 1 or more weeks.

When you understand that a person close to you is constantly in a depressed state and immediately becomes cheerful, when a person gets bored with life, his hands drop, or he is energetic, excited, grabs at everything, but does not complete everything to the end, then it is worth sounding the alarm. Only a doctor will be able to diagnose whether it is a disorder, what degree it has, and how the course develops. nine0005

Diagnostics

Diagnosis of bipolar affective disorder is based, first of all, on a survey of the patient himself. After all, he does not admit to the presence of hypomania or mania until he is asked. Questions about suicide, plans for the future, can be good helpers in identifying the disease. The second key point is the delivery of hormones to check the functions of the thyroid gland. Among other things, it is necessary to obtain an anamnesis for the use of drugs and alcohol by collecting urine and blood. nine0005

It is important to periodically evaluate people with schizophrenia for manic symptoms, however, unlike people who have bipolar disorder, they cannot return to normal between phases. Panic attacks, phobias, obsessive-compulsive disorders can make the diagnosis much more difficult.

Treatment

Treatment of bipolar affective disorder is possible both with the help of therapy and medication.

Treatment consists of several stages: nine0005

Relief and control of symptoms.
Long-term treatment until remission is achieved.
Treatment maintenance and prevention. Trying to keep remission.

The choice of medicines is a little complicated by their possible side effects, moreover, no medicine can be called universal. It is important to apply the drugs previously prescribed to the patient, which gave a positive result. If the treatment will take place for the first time, then the appointment of drugs depends on the history of the disease and symptoms. Treatment of severe forms may be accompanied by the appointment of specific antidepressants, the effectiveness of which, however, has not been proven. nine0005

Among the drugs for the treatment of bipolar affective disorder, mood stabilizers and antipsychotics of the 2nd generation are distinguished. They can be used both separately and in combination with each other. For a more effective recovery, the patient needs to independently work to improve his condition. Hospitalization is possible, but only in a manic episode with type 1 bipolar disorder. At the same time, treatment can be both voluntary and compulsory. Staying in the clinic during this period is a long stage, as full outpatient treatment is carried out. nine0005

In addition to drug treatment, therapy for bipolar affective disorder is used. This can be phototherapy during the bipolar season of any type. However, this method is concomitant. The main treatment is medication and symptomatic relief.

It is also important to correctly predict the further course of the disease, because the quality of treatment depends on this. Among all types of phases and periods, a fast-cyclic disorder can be predicted the worst, since it is often diagnosed incorrectly, which entails subsequent incorrect treatment. nine0005

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Prevention or advice in case of illness

There are no clinical guidelines for bipolar affective disorder as such. It is important not only to maintain therapy, but also to exclude factors that can cause the development of the disease and eliminate all negative factors:

exclude alcohol and any psychotropic substances;
observe sleep and food intake;
lead a healthy lifestyle; nine0036
actively communicate with colleagues and friends;
try not to be alone;
find some hobby outside of work.
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