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Sarah Evans

Prof. Richardson

ENG 1201 Online

24 March 2019

Treating Bipolar Disorder

Mental health is all too often looked over in modern society. With the world focusing

more on social media and politics, mental health comes with a stigma. It’s something no one

wants to talk about. Mental illness affects one in five Americans in a given year. 43.8 million

Americans suffer in silence a year (“Mental Health by the Numbers”). About 5.7 million of these

people are struggling with bipolar disorder (Doheny, Kathleen). Treatment for bipolar disorder is

still being understood. For decades, patients were being misdiagnosed with schizophrenia

(Leuchter, Andrew). This is due to the manic episodes bipolar disorder brings along. The two

modern approaches for treatment include medication and psychotherapy. Medication has been

proved effective, therapy only works for some patients. A combination of the two approaches has

been proven effective as well.

Treatment for bipolar disorder is important for many to understand, especially those who

are personally affected by it or have loved ones who have been affected. Bipolar disorder affects

many of my loved ones and some of my peers. I chose this topic because researching it has

become very important to me. My grandma received electroshock therapy for her bipolar

disorder when she was young. This was due to the misunderstanding between bipolar disorder

and other mental health disorders. This contributed to her early death. Electroshock therapy

increased the amount of white matter in her brain. This caused her to get early onset dementia.

Mistakes like these have affected millions of Americans. However, it’s brought attention to the
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treatment of this disorder. My family has affected by this for years. Genetically it has been

passed on her to kids, my aunts and uncles. “Approximately 80 percent of individuals with

bipolar disorder have a biological relative with some form of mood disorder” (Gooding, Diane

C.). This means those who are diagnosed have a high likelihood of having offspring with mental

illness.

I have a friend who I personally know very well and I have been close up with her

treatment and struggles with her disorder. Her manic episodes have caused major changes in her

life. Manic episodes can be characterized by impulsive actions, euphoric mood and extreme

optimism and grandiose plans for the future. My friend was actually led to moving from her life

in Oklahoma all the way to Ohio. She was spending lots of her money and changed her friends

and environment completely around. Her specific case is characterized by a high volume of

manic episodes. She loses sleep during these episodes and sleeps her whole time during her

depressive episodes. I am able to recognize her depressive episodes by her isolation. She will

isolate herself for days which is out of her usual character. This disorder hasn’t affected my own

brain but it has affected many of my loved ones. This is why I chose to research and argue on

this topic. Helping the ones I love is very important to me and this research has enabled me to

better understand what they are experiencing and how they can experience relief. Everyone in

America should educate themselves about bipolar disorder and its warning signs and symptoms

in order to decrease the amount of ignorance to it.

Bipolar disorder is one of the most misunderstood mental illnesses in America. Many

misconceptions exist for this disorder. People are led to believe this disorder is much simpler

than it is. Many characterize it by the depressive state of the disorder. However, bipolar disorder
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is a complicated state of depression and mania. Depression is only half of this complicated

disorder.

Those who suffer with bipolar disorder commonly have other mental disorder as well that

makes their condition worse. Anxiety and depression are commonly seen with this disorder. The

depressive state of this disorder is made much worse in individuals who already have preexisting

depression. Depression to this extent can lead to a complete disinterest in all activities and

possibly suicide, if the condition is not controlled. The manic state of this disorder may be

exaggerated if the individual also has anxiety. This may cause an overwhelming feeling in the

individual leading to a state of hopelessness. It is said that “approximately 50 percent of people

with bipolar disorder attempt suicide at least once during their lives”(Gooding, Diane C).

Therefore, individuals with this disorder must seek treatment as soon as possible to avoid any

risk of suicide.

The first half of this disorder is understanding the manic state. Mania is characterized by

over commitment, irritability, and extreme euphoric mood. An extreme case of this state can lead

to delusions and psychotic acts, such as streaking in public. This is what leads to the

misdiagnosis of bipolar as schizophrenia. A manic state can last for hours, weeks, months, and

sometimes even years. During a manic episode, one may have extreme spouts of creativity and

feel very optimistic. This feels good at first. However, this can lead to detrimental effects on the

individual’s life. A manic episode can lead to reckless behavior such as spending too much

money, inappropriate sexual activity, and even investments into useless businesses. If others

don’t agree with the individual's plans or if they try to come in between their plans, the

individual may lash out and become extremely irritable with everyone around them. It is
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important to recognize a manic episode in order to avoid reckless acts and behavior that could

negatively impact one’s life and wellbeing.

The other half, the more commonly recognized part of bipolar disorder, is the depressive

state. Bipolar depression is different than regular depression. Bipolar depression involves slower

speech, loss of sleep, weight gain, irritability, and guilt. There is also a possibility of bipolar

depression forming into psychotic depression, which causes the one affected to lose touch with

reality and cause “major problems in work and social functioning” (Smith, Melinda, and Jeanne

Segal). Bipolar depression is not always fixed with antidepressants. In fact, antidepressants can

make this disorder worse by causing episodes of mania.

In order to understand bipolar, one must also understand the different types. “According

to the Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (2013), the diagnostic

manual of the American Psychiatric Association, there are several types of bipolar

disorder.”(Gooding, Diane C). Bipolar I is the typical form of manic depression, characterized by

manic episodes/a mixed episode and a depressive episode. Bipolar II is characterized by a form

of mania that makes the individual functional in day to day life. Bipolar II is characterized by

severe depression and hypomania. Hypomania is described as “a less severe form of mania”

(Smith, Melinda, and Jeanne Segal). Therefore, Bipolar II is considered less intense. The other

face of this disorder is Cyclothymia. Cyclothymia is characterized by mild depression and

hypomania, making it the least intense form of bipolar disorder out of the three. The graph,

Figure 1, shows the cycles of different forms of this disorder. According to the visual, Bipolar I

has the most intense mood swings and the others dip further down into depression. These types
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of bipolar are important to understand so those who are trying to educate themselves understand

that bipolar does not look

the same in every

individual.

The diversity of

this disorder requires

special care when it

comes to treatment.

Figure 1: Fiedorowicz, Jess. Medication has been used

to decades to treat this disorder. Once more people started to understand this disorder and how it

affects the brain, medication was produced. Mood stabilizers is the most popular form of

treatment of this disorder. Mood stabilizers should be used to treat all known cases of bipolar

disorder because they have been proven over time to work well, they can reduce debilitating

systems, and they are effective in helping both the manic and depressive episodes of this

disorder.

A major factor in determining the efficiency of a drug is the long term effects on the lives

of those who take it. Medication is proven the most effective and quick fix for this disorder.

Lithium is the most famous medication for bipolar disorder. This was the first major mood

stabilizer used widely for diagnosed patients. Lithium is an example of a mood stabilizer. Mood

stabilizers control manic, hypomanic, and/or depressive, mild depressive episodes in the

individual struggling with bipolar disorder. Lithium works by targeting certain cells in the brain

and “exerting neuroprotective effects” (Eunsoo Won, and Yong-Ku Kim) that help overall brain

function. Lithium is described by this author as “the treatment of choice” (Eunsoo Won, and
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Yong-Ku Kim) for all types of bipolar disorder. This is due to “the fact that lithium has

withstood several ordeals, such as the concerns on its possible fatal toxicity and difficulty of use,

and has stayed strong as the treatment of choice for BD for over six decades, proves lithium to be

a goodie.” (Eunsoo Won, and Yong-Ku Kim). The long term effectiveness of this medication

increases the quality of life for individuals affected by this disorder by keeping them level and

able to function in day to day life. For less extreme types of bipolar disorder, this medication is

also effective since it can be taken in lower doses. Lithium, the most commonly used mood

stabilizer for this disorder, has proven its efficiency over time. Therefore, mood stabilizers are

efficient in treating this disorder in individuals with all different types of this disorder.

Mood stabilizers can be combined with other medications to alleviate other symptoms

that come along with bipolar disorder. However, the side effects of these mood stabilizers have

become of concern to many. According to “Bipolar Disorder Statistics”, “Nearly 9 out of 10

consumers with bipolar disorder are satisfied with their current medication(s), although side

effects remain a problem”. Medication for bipolar disorder is proven satisfactory for most

patients, however their side effects still remain a problem. Difficulty sleeping is a major

hindrance in the lives of those with this disorder. Lack of sleep can cause manic episodes to

strengthen. It increases the difficulty to focus which leads to increased irritability. Therefore, in

combination with mood stabilizers, benzodiazepines (benzos) are often prescribed to help with

sleeping issues. This combination allows to optimum functioning for these individuals. The

mood stabilizer allows for a stable mood throughout the day. The benzo allows for one’s mood

to calm down. It decreases anxiety and allows for peaceful sleep. Sleep hygiene is crucial for

those struggling with bipolar disorder. Mood stabilizers helps individuals with bipolar disorder
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stay calm throughout the day. This allows for a more peaceful state of mind when entering bed

time. Therefore, benzos are not required for many patients.

Another form of medication that is commonly used in bipolar disorder is antidepressants.

Antidepressants help with the depressive state of this disorder by bringing one’s mood up,

however, antidepressants can actually make things worse. The elevated mood that

antidepressants trigger can cause mania in individuals. Mania, again, can lead to detrimental

effects on one’s life. Mood stabilizers are often prescribed along with antidepressants. Therefore,

antidepressants are not the best route for everyone with bipolar disorder, especially those with

Bipolar I disorder, as they experience more intense mood swings. The more intense mood swings

causes a higher sense of mania when taking antidepressants. However, antidepressants helps with

depression. Many cases of bipolar disorder have depression as a prevalent state. The

antidepressant is not effective by itself since it can trigger mania. Therefore, mood stabilizers

must come into play to balance antidepressants out. Mood stabilizers should be used in the first

place in order to avoid the increased sense of mania.

Another path of treatment involves cognitive behavioral therapy. In this form, mental

health professionals teach the patients how to control and recognize their distorted perception of

their surrounding environment/situations. Patients are taught how to control their thoughts little

by little in hopes of reducing the intensity of mood swings. Patients are also able to improve their

relationships with those around them with this type of therapy. “Family members and friends can

be the strongest supporters and advocates for those who have bipolar disorder or other

psychiatric illnesses” (Gooding, Diane C). Family members and friends have a big impact on

those with bipolar disorder. They have the power to help them through their mood swings.

However, this form of therapy is only effective if the patient is aware of their symptoms of
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bipolar disorder and are accepting of it. Due to the fact that many are uneducated on this topic,

this form of treatment will not be effective on many.

Cognitive behavioral therapy also does not take away the symptoms of this disorder. This

particular disorder is hard to function normally. Especially when one is delusional and in a

severe manic state. Therefore, all the learning tools used in this therapy will not be effective

when the mind of a victim of bipolar is racing back and forth. This disorder takes so long to

identify that the victims are usually used to their old ways the finding new methods of behavior

is very hard to adapt to in an individual. This type of therapy may only be effective for a short

amount of time. In the long run, this specific type of therapy is not effective.

A newer form of treatment is currently under investigation. According to James Phelps,

MD, “mild elevations in thyroid stimulating hormone (TSH) were associated with rapid cycling

in bipolar disorder”. Therefore, he and his colleagues are investigating how the thyroid could be

manipulated for helping with bipolar disorder. This form of treatment, however, is so new and

there is not enough studies on it currently to prove any effectiveness.

The proven most effective treatment for bipolar disorder is mood stabilizers. They have

been around for the longest amount of time and have proven, many times, even in the modern

day, to have the best results on individuals struggling with bipolar disorder. Mood stabilizers

allow for there not to be a manic or depressive state present. These medications allow for proper

functioning in individuals for them to live a happy life.

If everyone knew the symptoms and warning signs of bipolar disorder, they will be more

aware of the ones around them. Millions of Americans battle mental illness every day. If

everyone knew what those with bipolar battle, they will be able to support and help the ones

around them properly. It would reduce the amount of ignorance to this disorder. People would
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realize how many people actually have this disorder. It could reduce the amount of misdiagnosis.

If those who have bipolar disorder are informed about it, they may be able to express their

thoughts to their counselor in order to receive proper treatment. This could also lead to the

misdiagnosis of other disorders. Some may read the symptoms and misdiagnose themselves with

this disorder even if they are struggling with a different personality disorder. This is why

everyone should be educated on how to treat bipolar disorder, not only to help themselves, but

also in order to help everyone around them.

Mood stabilizers show the best proven results in victims of this disorder. Allowing for

proper treatment will help millions of Americans and allow for others to help their loved ones.

Proper treatment with medication will allow for happier healthier lives for many and contribute

to a happier world.
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Works Cited

“Bipolar Disorder Statistics.” Depression and Bipolar Support Alliance, 2019,

www.dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/.

Doheny, Kathleen. “8 Bipolar Myths: Symptoms, Mania, Diagnosis, Statistics, and More.”

WebMD, WebMD, 2008, www.webmd.com/bipolar-disorder/features/8-myths-about-bipolar-

disorder.

Eunsoo Won, and Yong-Ku Kim. “An Oldie but Goodie: Lithium in the Treatment of Bipolar

Disorder through Neuroprotective and Neurotrophic Mechanisms.” International Journal of

Molecular Sciences, vol. 18, no. 12, Dec. 2017, p. 2679. EBSCOhost,

doi:10.3390/ijms18122679.

Fiedorowicz, Jess. ResearchGate, 2012. https://www.researchgate.net/figure/Prototypical-

Courses-of-Illness-for-Bipolar-Subtypes-in-Contrast-to-Unipolar-Major_fig1_266869236 .

Gooding, Diane C., et al. “Bipolar Disorder.” Salem Press Encyclopedia of Health, 2018.

EBSCOhost,

sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ers&

AN=93871807&site=eds-live.

Leuchter, Andrew. Bipolar Disorder. [Place of publication not identified] : INTELECOM,

[2011], 2015. EBSCOhost,

sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cat01

128a&AN=scc.b1830764&site=eds-live.
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“Mental Health By the Numbers.”NAMI, www.nami.org/learn-more/mental-health-by-the-

numbers.

“My Story With Bipolar Disorder.” NAMI: National Alliance on Mental Illness,

www.nami.org/Personal-Stories/My-Story-with-Bipolar-Disorder#.

Nemade, Rashmi, and Mark Dombeck. “Bipolar Disorder Treatment - Psychotherapy And

Cognitive Behavioral Therapy.” Mental Help Early Childhood Cognitive Development

Language Development Comments, American Addictions Center,

www.mentalhelp.net/articles/bipolar-disorder-treatment-psychotherapy-and-cognitive-

behavioral-therapy/

Otto, Michael W. Managing Bipolar Disorder : A Cognitive Behavior Treatment Program.

Oxford University Press, 2009. EBSCOhost,

sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk

&AN=271163&site=ehost-live.

Phelps, James. “A New Treatment for Bipolar Depression: Part 1.” Psychiatric Times,

ModernMedicine Network, 7 Sept. 2018, www.psychiatrictimes.com/bipolar-disorder/new-

treatment-bipolar-depression-part-1

Smith, Melinda, and Jeanne Segal. “Bipolar Disorder Signs and Symptoms.” HelpGuide, Feb.

2019, www.helpguide.org/articles/bipolar-disorder/bipolar-disorder-signs-and-symptoms.htm/.