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Home , Bipolar disorder, Bipolar II disorder, Bipolar I disorder, Cyclothymia, Hypomania, Mania

You’ve Just Been Diagnosed with . . . What Now?

I’ve always had swings. I used to throw huge What is bipolar disorder? Bipolar tantrums when I was a kid. As I got older, People diagnosed with bipolar disorder have Bipolar depression is a very common occurrence the highs got higher and the lows got lower. I lost mood swings involving both lows (bipolar in both bipolar I and bipolar II; such periods several jobs and ruined a whole bunch of depression) and highs (called if severe or are referred to as major depressive episodes. Most relationships. Finally, I decided nothing could be worse if mild). people who have a do than living like I was, and I went to get some help.” not have bipolar disorder. However, bipolar Some people with bipolar disorder can experience depressive episodes look and feel identical to other what’s called a mixed state. When this happens, depressive episodes, and virtually everyone It was like my brain played a cruel joke on me. My people have symptoms of both depression and who has bipolar disorder at one time or another. and were the things I relied mania at the very same time. They have all of the In fact, people with bipolar disorder tend to spend on and when I became depressed they were completely negative feelings that come with depression, but more time depressed than manic. In both types of gone, as was most of my will to live. There was they also feel agitated, restless, and activated. the illness, bipolar depression (the lows) is more no way I could snap out of it. The depression was common than mania or hypomania (the highs), stronger than I was. I’m so grateful that my There are different types or patterns of bipolar and the depressions can be quite severe, even treatment has helped me get back to living my life.” disorder, such as rapid cycling (more than four dangerous. Even more than typical depression, mood episodes in one year), (mild bipolar depression is likely to be accompanied highs and lows), and bipolar not otherwise by and suicidal thinking and behavior. I thought was going to make me weird or an specified (NOS), which is an inexact term for One thing that all types of bipolar disorder have addict. But after a few months, I wasn’t really aware I people whose symptoms don’t quite fit the other in common is this: people with the illness spend was taking it. There was no high, but I now feel a lot less categories. However, the two most common types the majority of their symptomatic lives below depressed. As long as I keep taking my pill every morning are bipolar I and bipolar II. baseline, in the low, depressed phase. Because and go to therapy regularly, I’m able to cope with life. depression can be the more common or more Things that used to make me cry and want to go hide, I’m Bipolar I obvious part of bipolar disorder, some people able to deal with now.” is the classic form of the illness, who have bipolar disorder may get treatment in which the individual experiences extreme for depression only, and the diagnosis of bipolar “ highs (mania) and lows (bipolar depression) in disorder can be overlooked for years. Just diagnosed with bipolar mood. Sometimes the manic symptoms can be disorder? You’re not alone. so severe that people can hear voices or see things Symptoms of Bipolar Depression f you’ve just been that are not there, or they might firmly believe in  Sad, empty, irritable, or tearful mood nearly diagnosed with ideas that are not true. Sometimes these beliefs every day bipolar disorder, you are uncomfortable (like the firm conviction that  No interest in or pleasure from activities once enjoyed Iare not alone. Bipolar particular people are out to get the individual).  Major changes in appetite or body weight disorder affects more than Sometimes these beliefs are actually enjoyable  or sleeping too much “ nine million Americans. (like people believing that they are divine or  Feelings of restlessness or agitation It is treatable, and you have special powers); ironically, these seemingly  , exhaustion, or lack of energy are not weak, flawed, or pleasant beliefs can be the most dangerous of all.  Feelings of worthlessness or excessive crazy. One of the best  Difficulty concentrating or making decisions things you can do to help Bipolar II  Thoughts of or yourself in your recovery is to learn all you can Those with bipolar II disorder don’t have such about your illness. extreme highs or manic symptoms as in bipolar Symptoms of Mania / Hypomania I disorder. Instead, they experience mild highs,  Feeling overly energetic, high, better than good, What’s happening to me? or hypomania. The symptoms of hypomania or unusually irritable for at least one week “Bipolar disorder is a physical illness that affects the are similar to those of mania, but are much less  Very high self-esteem; feeling all-powerful brain. The exact cause is not known, but itis known intense and severe. In fact, people who experience  Decreased need for without feeling tired that an imbalance in brain chemicals plays a role. hypomania might not feel impaired at all. For  Talking more than usual or feeling pressure to Bipolar disorder also has a genetic component, example, people who are hypomanic might be more keep talking meaning it can run in families. It’s not caused by talkative than usual, but their speech makes ; many ideas coming all at once , as some people think, but the course of bipolar and seems to follow a logical pattern. They don’t  Distracted easily; thoughts or statements disorder can be affected by biological and social experience or . Hypomania jumping topic-to-topic stresses in your life. It is not your fault, and you might make them appear more energetic or  Increase in goal-directed activity; restlessness shouldn’t be ashamed. There are many things you can productive. But if their illness goes untreated, they  Excessive pursuit of pleasure (e.g., financial or do to mange how bipolar disorder affects you. can become severely depressed. sexual) without thought of consequences

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DBSAlliance.org • (800) 826-3632 Depression and Bipolar Support Alliance People who live with bipolar disorder can also You can also go online and use our free DBSA Do I need to see more than one experience related problems. Wellness Tracker, an interactive tool designed to care provider?  Drinking/using substances chart your moods, symptoms, lifestyle, medication, Bipolar disorder is best treated by  Overeating and overall physical health. It allows you to generate professionals. Primary care physicians have some  Cutting or hurting yourself reports to see trends or patterns in your health that familiarity with treating individuals with depression,  Obsessions (can’t stop thinking about you can share with your health care provider. Find the but most will readily say that, in treating someone something or someone) DBSA Wellness Tracker at www.FacingUs.org/Tracker. with bipolar disorder, they want the help of a  specialist. Sometimes you will need to see one health  What if I start to feel suicidal? care provider for or talk therapy (a  Isolating/hiding from people It’s especially important , , therapist, social worker,  Delusions (strange or bizarre thoughts) to have a plan in place to or other professional) and another provider for  Hallucinations (seeing or hearing things) help yourself if you start to medication (a psychiatrist or sometimes a primary feel suicidal and to make care or other doctor). If you have more than one What is the difference between a mood a promise to yourself that person treating you, let them know how they can disorder and ordinary mood swings? you’ll use it. You can start reach one another. It is best for all of you to Intensity. Mood swings that come with a mood by using the plan on the together to find the right treatment plan for you. disorder are usually more severe than ordinary next page. Make a list of mood swings. the phone numbers of What are the benefits of psychotherapy? Length. A bad mood is usually gone in a few days, trusted friends, health care You may need extra help with unhealthy but mania or depression can last weeks or months. providers, and crisis hotlines you can call if and when relationships or harmful lifestyle choices that When a person suffers from rapid cycling, high you are having trouble. Your life is important, and contribute to your illness. Psychotherapy (talk and low moods can come and go quickly, but the as strong as suicidal thoughts may seem, they are a therapy) can be very helpful for this. Choose a person does not usually return to a stable mood for temporary and treatable symptom of your illness. therapist with whom you feel comfortable and a long period of time. Get help as soon as you start having these thoughts. whose judgment you trust. The goal of therapy is Interference with life. Mood disorders can cause One national crisis hotline you can use is 1-800- for you to develop skills and behaviors that will serious problems. For example, depression can make 273-TALK (8255). You can also check your local help you cope with difficult situations and help you a person unable to get out of bed or go to work, and phone directory or ask your health care providers to become aware of, and possibly prevent, episodes mania can cause a person to go for days without for a local crisis line number. If urgent, call 911. of depression or mania. sleep or spend money he or she does not have. Do I need to take medication? How can I spot my warning signs? My Plan for Life The vast majority of individuals with bipolar Each person has different triggers or that may I promise myself: disorder can benefit from medication. However, the cause their symptoms of bipolar depression or mania If I start to think about suicide or feel I am in decision to take medication is entirely up to you and to get worse. A trigger might be an argument, visiting crisis, I will contact these family members or your doctor. Some people worry that medication a particular place, having too much to do, or a major friends: will change their personality or be addictive; neither life event, such as moving. As you learn more about of these beliefs is true. are prescribed to your illness and your triggers, you will be able to keep your moods stable and keep you from having spot new episodes and get help before they get out of NAME PHONE episodes of depression or mania that would interfere control. Be sure your family and friends know how to with your life. look for signs that you might be having an episode. NAME PHONE What if my medication doesn’t work? Warning Sign Example No two people will respond the same way to Triggering event. Arguing with a loved one. the same medication. Sometimes you and your Your reaction. You get anxious. Your thoughts start NAME PHONE doctor will need to try several different medications to race. You feel like everything you do is wrong. or a combination of medications in order to provide You stop sleeping. the improvement you need. It is not uncommon What can you do? Take a deep breath. Remind I will also do the following: for a person to need to try several medications or yourself you are worthwhile. Be aware of your  Call my doctor or a suicide hotline, or go to combinations in order to find a treatment package attitude. Discuss this in therapy or support a hospital if necessary. that works for them. This typically takes several group. Spend less time with this person. Take  Remind myself that my brain is lying to me months rather than several weeks. action as soon as you notice your warning signs. and making things seem worse than they are. Don’t wait for an episode to become full-blown and Suicidal thoughts are not based on reality; Don’t lose hope! It may also take some time cause a crisis. Call your doctor or therapist. Ask they are a symptom of my illness. for you to adjust to your medication. Most a close friend or family member to stay with you  Remember that my life is valuable and medications take two to six weeks before a until you are feeling more stable. worthwhile, even if it doesn’t feel that way person feels their full effect. So, though it may right now. be difficult, it’s important to be patient and wait Treatment and Physical Tracking  Stick with my prescribed treatment plan for a medication to take effect. Many of the Charting your moods and tracking your daily and remember to take my medications. medications that affect the brain may also affect activities can help you and your doctor identify  Remember to call my health provider(s) if other systems of the body and cause side effects. patterns and things that cause stress, track your I don’t feel safe or if I’m having problems. Some side effects go away within days or weeks, improvement on different medications, or get an  Get in contact with other people who have while others can be long-term. idea of when new episodes might occur. a .  Stay away from and illegal . If you and your doctor make a change in DBSA offers a printed personal calendar, which allows  Have someone take away anything I could medication, be sure to ask how long you should you to record changes in your mood level, symptoms, use to hurt myself. wait to decide if it is a change for the better. It’s stressful life events, the medication you take, and  Stay aware of my moods, know my important to wait long enough to see the true the side effects you experience each day. Print or warning signs, and get help early. effect of a change. But you don’t want to wait download the calendar at www.DBSAlliance.org.  Be kind to myself. too long if things change in the wrong direction. Tell your doctor about any side effects you are having. It’s  What risks do I need to consider if I want accommodations such as reduced hours or extended always wise to check with your doctor before stopping to become pregnant? time off. In other cases, like with friends and medication or changing the dose. You are the best judge  How will other illnesses I have affect my treatment? family, it can help to explain what they have already of whether medications are helping you or not, but your  How can I reach you in an emergency? recognized as unusually severe mood swings. doctor can give you the best advice if you tell her or him what you are thinking and doing. Tell your doctor before What are some things I can do to manage Some people have a hard time accepting a mood disorder you begin taking any additional medication, including the cost of treatment? diagnosis. They may believe that a person should be able over-the-counter medications or herbal supplements.  Talk to your health care provider(s) and try to to control mood swings or just snap out of it. Do your work out lower fees or a payment plan. best to educate your family and friends by giving them Above all, don’t be discouraged!  Use community or state-provided services, information about mood disorders. Even if they do not many of which offer a sliding payment scale. change their beliefs, keep reminding yourself that getting What can I do to improve communication  Space out your allowable psychotherapy visits treatment is the best thing you can do for yourself. with my health care provider? over time and work on developing skills you can use Everyone deserves to have between visits. It can be very helpful to have someone close to open, trusting relationships  Ask your doctor to contact the pharmaceutical you (your spouse or partner, parent, child, or close with health care providers. company that makes your medication to see if you friend) support you—including coming along to You should never feel are eligible to receive free medication. visits with your doctor or therapist. intimidated by your doctor  Ask if your doctor has any medication samples to or feel as if you’re wasting his give you. There is help. There is hope. or her time. It’s also important that you share all the  Ask your doctor to contact your insurance company Patience is a great help when adjusting to the effects of a information your doctor needs to help you. A complete and ask if they will allow more treatment for you. new treatment, getting to know a new group of people, medical history, including your medication allergies, or waiting for your mind and body to feel better. If prior experiences with medication, and any alcohol or If you are having a hard time getting insurance because you’ve lived with symptoms of bipolar disorder for use, is important to your treatment. Sometimes you’ve had treatment for mental illness, your state may years, you may have already developed patience from your doctor will also ask for your family history. have a risk pool, which offers insurance for hard-to-insure holding on and waiting for depression or mania to pass. individuals. You may find additional information at www. You deserve the best treatment possible. If, after some healthinsurance.org/risk_pools. Get help before there is a Always remember, you are not alone. There is help and there time has passed, you feel the same way you did before crisis. A brief appointment to talk about how you’re feeling is hope. With treatment and support, you can feel better. treatment or worse, you have the right to ask for a or to adjust your medication costs less than a hospital stay. second opinion from another health care professional. MOOD DISORDER GLOSSARY How do support groups help?  Bipolar I disorder. Characterized by one or more Bring a list of questions with you to your doctor. When you are newly diagnosed, it’s helpful to have manic episodes or mixed episodes (symptoms of Take notes so you can check them later. reliable, knowledgeable people around you who both a mania and a depression occurring nearly know what you are going through. People with mood every day for at least one week) and one or more Ask Your Doctor disorders and their families participate in DBSA groups major depressive episodes. Bipolar I disorder is  What’s the name of my medication and how to share experience, discuss coping skills, and offer hope the most severe form of the illness and is marked by will it help me? to one another in a safe and confidential environment. extreme manic episodes.  What dosage(s) of medication do I need to take? People who go to DBSA groups say that the groups  Bipolar II disorder. Diagnosed after one or more  At what time(s) of day should I take them?  provide a safe and welcoming place for mutual major depressive episodes and at least one episode Do I need to take them with ? acceptance, understanding, and self-discovery; of hypomania, with possible periods of level mood  Do I need to avoid any specific , medications  give them the opportunity to reach out to others between episodes. The highs in bipolar II, called (cough medicines), supplements (vitamins, herbals), and benefit from the experience of those who have hypomanias, are not as high as those in or activities while I am taking this medication? been there; bipolar I ().  What should I do if I forget to take my  motivate them to follow their treatment plans;  Cyclothymia. A milder form of bipolar disorder medication?  help them to understand that mood disorders characterized by alternating hypomanic episodes and  Is there a generic form of my medication do not define who they are; and less severe episodes of depression. The severity of this available? Would it be right for me?  help them rediscover their strengths and humor. illness may change over time.  What side effects might I have? What can I do  . A milder form of depression about them? People who had been attending DBSA groups for characterized by changes in eating or sleeping patterns  How long will it take for me to feel better? more than a year were also less likely to have been and a down, irritable, or self-critical mood that  What type of improvement should I expect? hospitalized for their mood disorder during that is present more of the time than not. People with  Are there any specific risks I should worry year, according to a recent DBSA survey. dysthymia may say that that’s just the way they are or about? How can I prevent them? How can I that they’ve always been that way. recognize them? How do I talk to others about my illness?  Hypomanic episode. Similar to a manic episode,  If my medication needs to be stopped for any Telling others about but less severe. It is clearly different from a non- reason, how should I do it? (Never stop taking your bipolar disorder is depressed mood, characterized by an obvious change your medication without first talking to completely your choice. in behavior that is unusual or out-of-character. your doctor.) Some of your close friends  Major depressive episode. A period of prolonged  How often will I need to come in for and family members may , often with physical symptoms, that medication management? How long will my have already become interferes with life. appointments take? concerned about mood  Manic episode. A period of high, energetic, or  Should I also have talk therapy? What type swings you’ve had, so they might be glad to hear irritable mood that interferes with life. do you recommend? Is it possible that I could you’re getting help. Other people in your life might  Mixed state (also called mixed mania). A period be treated with talk therapy and no medication? have incorrect or hurtful beliefs about mental during which symptoms of a manic and a depressive  Is there anything I can do to help my illness and you may choose not to tell them. episode are present at the same time. treatment work better, such as changing my  Rapid cycling. The expression of four or more diet, physical activity, sleep patterns, or lifestyle? Sharing your illness with employers or co-workers manic, hypomanic, mixed, or depressive episodes  If my current treatment isn’t helpful, what can also be difficult. Sometimes it may be best to say within a 12-month period. For many people, rapid are my alternatives? What is my next step? nothing about your illness, unless you need special cycling is temporary.