Bipolar Disorder (manic-depressive illness) has been defined as a major affective mood disorder in which one alternates between the mental states of deep and brutal depression and embellished elation.
These mental states can last for months in some bipolar disorder patients. These cyclical episodes are a catalyst for noticeable psychosocial impairment. Also, the episodes of both manic phases as well as depressive ones can last anywhere from weeks to months.
Bipolar Disorder also affect’s one’s cognition, emotions, perceptions, and behavior- along with psychosomatic presentations (such as pain with depressive episodes, for example). It is thought to be due to a physiological dysfunctional brain in one affected with bipolar by many.
The etiology for bipolar disorder is unknown. As many as half of those suspected as having a bipolar are thought to have at least one parent with some sort of mood disorder similar to bipolar disorder, which suggests a genetic predisposition may be present.
Because of the complexity associated with bipolar disorder, greater than 50 percent of those afflicted are misdiagnosed as major depression, or perhaps schizophrenia.
It is also believed that bipolar presents itself with symptoms associated with the definition of bipolar when one is between the ages of 15 and 25 years old. The disorder was entered in the psychiatrists’ bible, the DSM, in 1980, although bipolar disorder is thought to have existed for quite some time.
Also, those with bipolar are thought to be in possession of heightened creativity during their manic phases, as well as they have accelerated growth of their neurons. This is not necessarily a bad thing, it seems. Conversely, those with bipolar disorder experience up to 3 times the number of depressive episodes as manic ones.
Research has determined that as many as 15 to over 30 percent of bipolar patients commit suicide if they are left untreated, or undertreated. Also, as many as half of those affected with bipolar also have at times severe substance abuse issues along with their bipolar as well. Co-morbid medical conditions should be taken into consideration when evaluating one suspect of, or having bipolar disorder.
Bipolar patients are also often experiencing anxiety issues that vary, and are treated often as a result of these medical issues. The disorder varies as far as severity goes- with some bipolar patients being more severely affected than others. In fact, there are at least 6 classifications of bipolar, according to the DSM.
Bipolar patients are thought to be symptomatic half of their lives. As stated previously, the depressive episodes occur more frequently than manic ones. When symptomatic, bipolar patients are thought to be rather disabled, according to some, when in their depressive state in particular. The diagnosis has become more frequent recently. In one decade, the assigned diagnosis of bipolar rose from being about 25 per 100 thousand people to being 1000 per 100,000 people.
Most diagnosed with bipolar are not diagnosed based on solid, comprehensive, or psychiatric review that is often absent of valid or standard diagnostic methods. Some believe as many as 5 percent of the human population may be affected by bipolar disorder- which may include as many as 12 million people in the United States. This is if the diagnostic criteria developed by others were to be fully utilized. An emphasis should be implemented by the health care provider to utilize available clinical evidence, and review this scientific literature.
A subjective questionnaire called the Mental Status Examination is often utilized when diagnosing one suspected has having bipolar disorder. Many believe the diagnosis has increased recently due to the progressive treatment options now available. It is an argument of increased awareness versus over-diagnosis.
Yet the diagnosis is vague, as children and adolescents are often absent in research with bipolar. Also, there is not any objective diagnostic testing to rely upon for bipolar. There is also a mental diagnosis of what is called mixed depressive disorder, which is one with depression who also has minimal manic episodes.
Many younger than 18 years of age are prescribed atypical anti-psychotics as first line treatment, which is largely not recommended as treatment options. In fact, close to half a million of those younger than 18 years of age are prescribed the atypical anti-psychotic Risperdal alone, it has been determined. The class of medications overall is thought to be prescribed to about 10 percent of those non-adults thought to have bipolar.
While not recommended, about a half of all those assessed as being bipolar are prescribed antidepressants, such as SSRIs, as first line treatment. It has been suggested that this class of drugs has decreased the risk of suicide attempts compared with other classes of antidepressants for close to 20 years.
Yet tricyclic antidepressants have been determined to be efficacious in over half of those diagnosed with bipolar - with a greater amount of research behind this class of drugs. Furthermore, therapy with any antidepressants has been associated with what is known as treatment-emergent mania. This is when a bipolar disorder that is in a depressive state rapidly enters a manic phase. This occurrence can be unmanageable by the bipolar disorder patient.
The most recognized treatments for bipolar long term are lithium (Ekalith or Lamictal- along with an anti-convulsant. Sugar intake is thought to vex the symptoms of one with a bipolar disorder as well.
Atypical anti-psychotics have been prescribed for bipolar, which change some aspects of the brain, physiologically, as does the disease itself. In fact, one may argue the brain becomes more efficient due to both the disorder and the treatment with the atypical anti-psychotics. Yet many recommend the utilization of this class of drugs with bipolar disorder only if psychosis is present as well.
As many as 15 percent of bipolar disorder patients diagnosed as such are prescribed an atypical presently. This class of medications may be particularly beneficial for those women who are diagnosed with bipolar who are pregnant, however.
Lithium, which is essentially a very light metal with low density in which the salts are obtained for medicinal treatment, and an anti-convulsant are believed to be standard bipolar treatment, pharmacologically, studies have shown. This is due to Dr. John Cade and his examination with lithium and its benefits with those who have psychotic excitement close to 60 years ago.
Ekalith is believed to be both neuro-protective as well as having an anti-suicidal affect in those believed to be bipolar- and is viewed as a mainstay as far as treatment for bipolar goes with many who treat the disorder. Lithium is thought to regulate the calcium molecule in the brain, so this and valporate are historically the medicinal treatment options preferred for those with bipolar disorder.
Bipolar is difficult to detect, and is often diagnosed as major depression with many affected by this disorder. There is no objective criteria protocol available to utilize when assessing any patient believed to be suffering from any mental disorder. So such mental disorders that are diagnosed are ambiguous, yet that does not conclude that such disorders do not exist, such as the case with bipolar disorder.
Yet perhaps a health care provider should be very thorough and knowledgeable when assessing a patient believed to have a mental condition such as bipolar. As should the health care provider keep in mind that the ultimate goal with this disorder is to stabilize the mood of the one affected.
http://www.dbsalliance.org
Dan Abshear
Author’s note: What has been annotated is based upon information and belief.

I don’t think this kind of approach is very productive, at least until we’ve made a more serious dent in stigma. Apologizing for behavior we can’t control only strengthens the belief that bipolar disorder is all about weak character.

Doing what we can to clear the damage is another issue, but that’s a question of responsibility, not blame.

Many manic-depressives are also alcoholics/addicts, & making amends plays a key role in that kind of recovery. I just can’t see how it helps with people who already bear tons of blame for a condition they would never have asked for.

I have been living with bipolar for 15 years and I always apologize when something I do in a manic or depressed mood has a negative effect on someone else. It’s not about blame or guilt, it’s about getting along with people. My personal belief is that a bad mood is not an excuse for bad behavior, (it has been since I started getting PMS when I was a teen). Think about it– do you say “excuse me” when you accidentally bump into someone, or “sorry” when something you say without thinking hurts someone’s feelings? To me it’s the same thing. Claiming that people with bipolar have a free pass to do harm does not empower them in any healthy way!

My husband and I both have diagnoses of bipolar disorder. I will never understand how we found each other, but we’ve managed pretty well for twenty years. We did not start our marriage with this information about ourselves. We both have Amish in our backgrounds, and I understand that there was a study finding that bipolar disorder was a dominant trait in one Amish community. I found this in the 1980’s, when searching through Psychology periodicals, trying to diagnose my social awkwardness. Anybody know about the Amish study?

I believe that ‘making amends’ for having a mental illness is absurd, but apologizing for hurting another person, mental illness or not, is the only right thing to do.

I know that during my worst episodes, I offended people with my words and erratic behavior. They knew me and some supposedly loved me, yet they weren’t able to grasp this concept that my brain was not my brain and my words were not coming from the me they had always known.

I refuse to apologize for any of that. I could not control what was happening TO me. It wasn’t something I was doing TO them. My illness is just that–a biological illness. It’s not willful. I could no more control my words than an epileptic could will themselves to not have a seizure. I have nothing to be accountable for other than those things I did at the time with the part of my brain that was working correctly: I went to work, I was diligent in following my treatment protocol, and I stuck to healthy habits that were meant to help me along the road to stability.

For four years, Joe, I have been bitterly expressing what your post says more eloquently. I refuse to apologize because I have done nothing wrong. I got sick. Diabetics get sick. Epileptics get sick. TB patients get sick. Lupus patients get sick. Nobody demands that they apologize for the their illness or for what it does to their body. I, therefore, demand equal consideration for my illness. Apologize? I have nothing to apologize for.

I always apologize when I am aware that I have said or done something inappropriate. Unfortunatley, the awareness is often the problem with me. I tend to speak and not realize that what I said could be (and often is) construed as inappropriate. When I was finally diagnosed at around 38 years old it was huge weight lifted off my shoulders. I breathed a sigh of relief that finally it all made sense. When I was talking to an Aunt about my progress and what I had learned and mentioned a few of the things (that didn’t make sense) I did over and over again she just summed it by saying - “that was just you.” My family and some of my closes friends just figured I was a bit excentric and accepted me for that.

Interstingly, when I was in high school I had a suicide attempt and my best friend since elementary school dropped me so fast I didn’t see it coming. Now almost 40 years later we are good friends again and when I shared with her about my disorder and how I have learned to manage it SHE APOLOGIZED TO ME. She admitted to why our friendship ended (I never knew why) and apologized for walking away from me at a time that I obviously needed a friend more than anything.

Yes, sometimes the disorder is

I’ve said sorry for hurtful things I’ve said during an irritability stage of a manic/mixed state.

I still find myself snapping at someone when I’m under a lot of stress, and then apologizing about it. I now am more self aware and recognise the reasons behind my actions a lot sooner.

I don’t like hurting anyone I love, and sometimes an apology is what it takes for them to know their was no ill intent.

Hello today,
* Interesting question= APOLOGY?
- i am over 50 years old now i take Lithium for Bipolar since i am 21 and had been MISDIAGNOSED MANIC-DEPRESS… Yes! and it is not rare!

* In real facts, i have FIBROMYALGIA and when i got Sleep Disorders, pain, not eating correctly… more a week the result seems for docs then (1978) = i was looking “lost” similar like to a manic person. So, i got fast that diagnosis.

But all my life in this: NEVER I HAD THE IDEA TO APOLOGIZE any time , BECAUSE I NEVER DID REALLY SOMETHING WRONG TO ANYBODY !! - because, i was just in my bed full of fibro-pain+problems related!

The doctors were telling i was a “nice & soft person” not agressive, not dangerous… for sure i was FIBRO not MANIC !! And NOT Depressed also!

- Best Salutations & Good Luck! specilally, i wish you all to find the right doctor-specialist really able to CORRECTLY DIAGNOSE YOU… not 30 years later like happened to me…

* i don’t mean Fibro is better for me compared to Manic!
* but i am Physiologist Ph.D. and the study of Brain, neuro-transmitters and the reason of my pain without stop, all symptoms like: GERD, IBS, & else, were not considered in my health state before.

- I have really no choice i take my Health in my OWN hands, combining actual medicine and alternative medicine. My best help & tools are in the daily Nutrition, i call it ” Therapeutic Nutrition” !! Mainly 1st raw foods when i have Fibro-crisis, later slowly i can start eating veggetarian and lot from mediterranean inspirations!

as a side affect, if you will, of bipolar disorder I have hurt people in my life and as I have said” I was sorry “for things I dont even remember, they still want to hold me accountable, maybe even more so since I am of the mind to feel guilt I dont know..maybe it just shows the circle of the illness how so many of us were abused or something in our childhood and then it lingers in adulthood..maybe it is if i steal something {while sane} i could give a reason for why i stole something. but when i try to kill myself I dont know why, i dont know what got me to that point..or anything I have done while at my sickest. I have a friend who had cancer and while she was so sick she was irritable and sometimes would say mean things but it was excused becasue she was sick, and becasue the chemo makes you feel bad.i really am beginning to believe mental illness will never be seen as an illness. I guess my answer is if you are in a conversation with somebody and your heart says to apologize then maybe do it..as i have to my kids[ i have apologized for the way i hurt them but assure them i dont understand how hurt they are}..but to go out and do it like the 12 steps suggest I just dont think so.It wont benefit anybody in my experience

I often apologize out of politeness; I want to attempt to maintain good relationships even with people who don’t understand. I have often hurt my husband - to the point that I sometimes feel like our relationship is irrepairable. I agree with many of you that bp is not something we do to other people, but something that is being done to us. However, we cannot deny that it does have an affect on others.

If I had some other physical ailment like Diabetes or Cancer and had to be cared for, I would at least thank my caregiver. I guess maybe instead of apologizing, we should be thanking our loved ones for tolerating us and caring for us despite the sometimes cruel ways we may behave.

bipolar, clinical depression, anxiety disorder, drug abuse (includes alcohol), diagnosed and documented with all. i no longer treat any of these with medication. seems, for me, 12 steps, are more effective than anything i had ever tried. 30 years of meds very little relief. making amends along with the rest of my attempt principled life have been far more effective fo several years now