An Insight into Bipolar Disorder

By Chiara Marcello

Bipolar Disorder (BD) is a psychiatric condition that is primarily recognized for its effects on mood. To obtain a better understanding of Bipolar Disorder, Dr. Kinneret Fleiman, an Outpatient Psychiatrist at Humber, has offered her insight into the disorder and the importance of raising awareness.

What is Bipolar Disorder (BD)?

Though we know that people with Bipolar Disorder are most likely to experience depression if they are having a mood episode, BD is defined by having had at least one hypomanic or manic episode in one’s lifetime, without this being due to another medical illness or substances. A hypo/manic episode is characterized by:

  • A distinct change in mood for a few days or more
  • To be either highly irritable or euphoric, as well as a marked increase in energy
  • At times, to the point where one barely feels any need to sleep for a few days or more

There are additional symptoms we look for to see if someone meets criteria for a hypo/manic episode. These can include:

  • The experience of racing thoughts; people may even have a hard time putting their thoughts together
  • Very fast speech
  • A distinct increase in impulsivity and risk-taking
  • A very inflated sense of confidence, to the point where their thinking is not in touch with reality, such as thinking “I’m a famous DJ even though I have never been a DJ, have no background in music, and so on.”

Why is it important to talk about Bipolar Disorder?

In our day-to-day world, people incorrectly label others as “bipolar,” such as when the person is being moody. Unfortunately, this perpetuates a misunderstanding of the disorder, and in my opinion, minimizes it. BD can wreak havoc in people’s lives. Since it usually begins during youth – when one is trying to finish school, start work, establish one’s identity and healthy relationships – BD can disrupt one’s trajectory in an important and already difficult time in their lives.   Untreated, it can also lead to regretful decisions, such as significant overspending.

Like other serious illnesses, one might have to pause what they are working towards, so that they can focus on identifying the right treatment, and on their wellness and recovery. At the same time, with a correct diagnosis and effective treatment, people can do very well and thrive. Therefore, an appropriate understanding of BD, inside and outside the medical field, is very important.

What resources are available to those struggling?

If you are wondering if you have Bipolar Disorder, it is important to speak with someone who is qualified to assess for and make that diagnosis. In Canada, that would usually be a physician, nurse practitioner, or a qualified clinical psychologist. You may need a referral to a psychiatrist for further assessment.

There are also a variety of treatments that can help people remain stable and well. First off, studies have shown us that medications are a crucial and necessary component, and usually, these would be needed lifelong to prevent future episodes. Usually, these medications would include mood stabilizers, antipsychotics, or both. For healthcare providers, I always recommend the CANMAT Bipolar Guidelines, as they have a very thorough summary of literature and what treatments/medications can be used, depending on the patient’s symptoms. There are various psychotherapies that are known to be of benefit as well, as long as someone is not in a severe mood episode, such as Cognitive Behavioural Therapy.

I am a big believer in understanding oneself and one’s illness. Understanding the illness and how it affects you, gives you the tools to understand what you can do to stay well, beyond taking medications. This can include:

  • Avoiding disruptions to your sleep
  • Avoiding substances like cannabis and alcohol
  • Avoiding overstimulation in certain situations
  • Read more about Bipolar Disorder
  • Seek out peer support- the Mood Disorders Association of Ontario has free peer-support groups that are specific to BD