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Bipolar Disorder - Causes, Signs and Therapy
With each change the feelings: A person has slept poorly, raves off his partner at breakfast, after a coffee he feels comfortable and apologizes. Bipolar disturbed live through these changes in the extreme.
contents
- Hypomania
- The mania
- sex addiction
- flight of ideas
- Madness and waste
- The Depression
- The reasons
- therapies
- friends and family
- What can affected people do??
- Grandiose bipolar
Hypomania
Hypomania behave hyperactive or irritated for at least four days. They are uneasy, speak incessantly, without listening, can not concentrate, sleep, are lustful, take risks unchecked and need company. They develop a surplus of ideas and sometimes they do an extraordinary amount. Hypomania usually does not cause social problems.
Characteristic of bipolar disorder is the change of manic and depressive phases. (Image: pathdoc / fotolia.com) The mania
The mania is more violent than hypomania. At least for a week the high spirits stop; Those affected get massive problems in the workplace, in public and in everyday life.
In the manic phase, sufferers are far more efficient than usual for the time being. The unusual behavior manifests itself as a fluent flow without a contextual connection, the ideas overturn, the thoughts race, social taboos do not matter; Manic values overestimate themselves, are easily distracted, their actions change constantly; they behave recklessly and sexually driven. They barely eat and sleep a little. They lose the distance to the environment as well as their self-criticism.
In the irritable version, those who are disturbed behave extremely aggressively: they constantly provoke, insult, and attack other people - both physically and verbally. One of the triggers is that others do not take their castles in the air seriously. Serious mania is transformed into a psychosis: those affected have delusions.
The future shimmers in the most colorful colors. Social norms do not exist. They break down all borders and so slide into disaster: they destroy relationships, they end up in financial ruin, and they lose their jobs.
They address strangers without any distance - the topics are often beyond social acceptance. The needs of others do not interest Manic. They make sexual advances in the presence of the partner, they expose the (real or supposed) problems strangers in public, they take what they need at the moment. Non-manicists know such behavior in alcohol or cocaine intoxication.
In an ascending mania, others are partly inspired, partly they are confused. In the appropriate milieu, the manikin finds his audience: adolescents like his taboo breaks, in clubs he is sometimes sexually successful, timid amazement at his talkativeness. The manikin does not slow down. When those present immediately set limits, he offends them. Manikers almost inevitably start conflicts.
Sometimes they are lucky because outsiders realize that "something is wrong with them", and that's why they do not become palpable, or friends divert the manikin. But often manic are involved in brawls. They fly out of pubs and they end up at the police station.
Manicans often behave completely alien to their "normal personality". For their friends, this is extremely stressful, and the attacks destroy bonds - including years of friendships. The affected people slip so ever deeper into social isolation.
sex addiction
The mania increases the desire. A concerned person says about himself: "I am not only manic, but also nymphomaniac." Every cashier in the supermarket, every waiting person at the stop becomes a "dream woman" for the manikin. Limits such as age or non-sexual friendship are overridden. Affected behave sexually suggestive, even overbearing. The delusions of grandeur also extend to one's own attractiveness: every desired partner wants to have sex with him - in the imagination of the manicurist. He does not calculate his passion like the "classic gigolo", because secret meetings with frustrated wives are not his thing. The affront connects with the irritability: The manic approaches a woman who lives in a fixed relationship; the partner intervenes, and in the manic imagination breaks out a gang war in the district.
Their sexual constructs not only invent victims during acute mania, but sometimes defend them for months. Old friends and therapists can tell from the reality content and the number of the condition of the person concerned: If he just says that he finds the new neighbor erotically interesting, he claims that she jumps into bed with him tonight or he runs her already the door?
flight of ideas
Manicists hunt from one idea to the other. If the mania sets in, those affected wander off the topic and have problems finding their way back. In a "full-grown" mania, however, the thoughts run amok. The disturbed can answer no further questions, because he does not know the beginning of his remarks. But individual thoughts can follow each other logically. His words overturn, so that others hardly understand what he says. The irritable sees this lack of understanding as an attack and strikes - verbally or nonverbally.
This flight of ideas is also reflected in the creative achievements. Manic painters, for example, are becoming more and more immersed in their image, repeating themselves over and over again, until the structures lose their overall context. The fragments may be ordered. A cafe operator, who buys pictures of a concerned friend, says: "I tear them out of his hands, otherwise he would destroy them."
Madness and waste
The ego breaks through all boundaries of reality in mania. Some sufferers continue to delusional fantasies when the manic phase is long gone, and they are otherwise considered stable. An affected person, for example, ended up in psychiatry in an acute phase; he claimed that conspirators were after him - including members of a karate club. Years later, he had no more manic episodes, he was considered healthy, but still told, "that with the karate club has nothing to do with the mania. They were really after me. "
Concerned ones fix themselves on the pleasant - to the excess. Body hygiene is at the back, sleep disturbs, and food keeps them from their intoxication. They throw money around themselves, give away valuable things, "let the dolls dance"; some even get into debt. If the intoxication, the mania, is over, they are ashamed.
The Depression
The depressive follows the manic phase. The "happier" feel depressed, the more seriously impaired. They lose interest in hobbies, are very tired, restless and can not sleep. You have pain in the chest, stomach, head and heart; they feel dizzy; they lose weight. The thoughts circle into the negative. You can not make the simplest decisions. You lose weight; Sex is not interested anymore. They feel guilty and ashamed. They imagine diseases. They do not dare to do anything anymore. They think of death and suicide; many try to kill themselves. So the exact opposite of mania - common to both phases is that they bring massive problems in work and relationships.
The reasons
Biological causes such as disorders in the messenger substances of the brain or altered hormones trigger the disease as well as social factors: stress, separations, trauma and abuse. These psychological stresses can spark bipolar impulses in a major event.
Both things go hand in hand. The "chemistry" in the brain triggers the disorder - so it's physical. The behavior of the manic-depressives, however, refers to their social environment and their experiences. Mania is often the potential of oppressed desires, depression their prison. The normality between them could never develop as a fulfilling structure. Bipolar people are immature to "average people" even in advanced age - as old grown-up teenagers, specifically outside the pathological stages. Concerned play for example the "story uncle" in the youth center or make themselves a "name" as enfant terrible in a small town.
A typical case is an afflicted person who came from a strict Catholic home, worked as a servant at thirteen, and internalized the catechism; at puberty, he joined the political left and got to know free sexuality. In that very time he had his first manic relapses. For one thing, he walked through his hometown and said that he was St. Francis, on the other hand he questioned the church. When he was 40, he wrote a letter about finally leaving God. His disorder seems like an attempt to free himself from the prison of his dogma and environment, which as a manic, so unconscious outbreak but is doomed to failure and therefore ends up in depression.
A psychotherapist talks extensively with a patient to see if there is bipolar disorder. Relatives should be there because they have a different view of what the person concerned describes.
Blood analyzes (and other studies) rule out that this is another disease.
therapies
Bipolarity has long been considered not controllable by the person concerned. Today we know better; The patients can balance the rash between sky flight and decline by their own behavior much better than previously thought.
Psychotherapies work very well. The relatives should be involved, the situation in the family must know exactly the therapist, because it is often the trigger for mania and depression. Drug and psychotherapeutic treatment complement each other.
Unfortunately, many sufferers in an acute mania show no insight into the problem. Then only a compulsory admission to psychiatry on the basis of a judicially confirmed own and third party risk. Psychiatry should shield the patient from irritation.
Some sufferers also reflect their problem in mania and compensate for it by extreme productivity. You need a suitable medication and a balanced life structure - especially enough sleep.
In the acute phase of mania, medications work to stabilize the mood. Antidepressants are less used than in pure depression. Lithium stabilizes mood as lithium deficiency accompanies the disorder. Those affected often have to eat for a lifetime.
Neuroleptics prevent the brain from releasing dopamine like serotonin, thus preventing acute mania. Affected complain, however, that the neuroleptics as a "side effect" to curb the emotional life and dreams. They would not be manic anymore, but they felt like "zombies".
Valproic acid also counteracts mania; Although lamotrigine alleviates depression, it can promote mania. In acute mania, sedatives are helpful in getting those affected to sleep. Lithium salts, carbamazepine, valproate and lamotrigine sometimes even prevent new outbreaks of the disease.
friends and family
Mania and depression double burden friends and relatives. Partners are at risk of becoming co-bipolar. The tighter the attachment to a person with this disorder, the more urgently required professional information.
Lay people do not know how to deal with the disease. Relatives are injured by the attacks and at the same time have to deal with the fact that these attacks are part of the disease. In an acute mania, the relatives must ensure that the person concerned does not handle financial transactions, does not come to "hot spots" like mass meetings, so ideally a week through the woods raging - under supervision, of course.
In the stable times, relatives and sufferers can set the framework to prevent the worst effects of mania. For example, the person concerned may only carry a debit card to a low-credit account and deposit the card for his big money with a confidant who denies him or her in a manic phase.
Friends and relatives should also set up rules for their stable phases with those affected. One can support them or even exhort them to do what they can not do during the ascent and descent - be it ideas that they had in mania, or self-responsibility. Some bipolar are in their illness as a "so it is". In mania, nobody can convince them to "banal things" such as paying the electricity bill or washing the laundry. But he can do that in the more stable phase.
Other people need to learn when to react in the phases of bipolar disorder. When is the affected person still sane, when is not more? When to turn to him, when to demarcate? The relatives are not only overburdened, they are also angry. They must not neglect their own needs, have to create free space and are well advised to seek self-help groups.
Friends should set limits to the affected person in his stable phases - if need be, rigorously. People with mental disorders often circling their thoughts in their thoughts. Some sufferers think much of their stable phase about how manic, hypomanic, depressive or "normal" they are. Friendships then take on a therapeutic character. Firstly, friends must make it clear that they respect the person concerned and confirm that he is currently sane. Secondly, this means that someone who uses the energy of others to circle around themselves behaves egocentrically, leaving his friends alone.
Some sufferers are ashamed of what they do in mania. Then friends help them, saying that they are not to blame for the mania. Others see mania as a potential that can be developed. This can have a positive effect if, for example, they translate this power into art; many artists are bipolar.
Others, again, make their disorder a special status of fool-freedom. They have to show their friends clear boundaries. For example, a person affected three times in one evening only scraped past a brawl because the offended ones saw him as mentally ill. The next day, when he "came down" again, he talked about a heroic deed that confused people and that idiots ran around on this street. His friends behaved correctly: instead of giving the audience for his "exciting experience," they told him that it was no honor to escape even provoked brawls because people behave judiciously, and because one is considered "one Bang "has. The bipolar, now in a decaying mania, shouted, "Do you want to pathologize me?" His friends replied, "Either, others treat you as normal and therefore sane, or they see you as incompetent. But if they treat you as normal, you would rightly have a black eye because of antisocial behavior. You will not get the benefits of both together. "
For friends and family members dealing with bipolar disorders is often extremely difficult. (Image: Photographee.eu/fotolia.com) Friends are also required not to support patients with their false ideas out of friendship. This is often difficult if those affected are still largely reasonable. An afflicted man, in an impending mania, rang a friendly scientist out of bed at 6:00 am Sunday morning and roared around for minutes until the spooky man understood he should give the bipolar a positive opinion for an application. It was about the position of a team leader in a development aid project. The scientist read aloud the request: "Increased self-discipline even in extreme situations," and said, "I can not write you an opinion on it." His friend roared, even louder than before, "Why do I have friends?" The doorbell rang Neighbor stood in front of the door and complained about the noise. "The manic yelled in her face:" Yes, she too. She also "and provided proof that the rejection of the opinion was correct.
In depression, relatives should not overwhelm the patient. He can not do anything - it's not about wanting. If the person says, "I do not want to live anymore," the relatives should inform a doctor. The suicide rate of bipolars in depression is 20-30 times higher than that of the total population.
What can affected people do??
Many bipolars lead a well-regulated life - However, this includes the insight that it is a disorder, taking medications and long-term psychotherapy. Bipolar people are almost always restricted for life.
Bipolar drugs can reduce triggers by allowing them to fall asleep and get up at fixed times, leaving their hands free from alcohol and other drugs, especially cocaine. Cannabis, however, stabilizes the moods - according to reports of those affected. Mood diaries help the bipolar to manage themselves.
If sufferers know each other better and better, they can consult their specialist at the first sign of a mania, increase the medication, sleep a lot and avoid stress or stimuli to prevent the outbreak.
But that works only if they understand the mania as a disorder. The mania is namely a disease phase, which experience the afflicted positive. Some speak of their first manic experience as of a religious awakening; they "fall in love" with them just as they do with a heroin rush. This is especially true for bipolars who are afraid of depression.
Those affected must therefore understand "average" as something positive. This helps them to understand their manic potential as part of themselves. The enthusiasm usually has the affected person before the outbreak of the first mania.
Grandiose bipolar
"Without the manic-depressive component of the population, our culture would be very poor. It would be downright bleak. "Jules fear
Bipolar does not necessarily mean social case. Inclusion means to include people with mental disorders instead of excluding them. However, those affected for many professions are not or only partially suitable; Giving them this clear means not discriminating against them like discriminating against someone who can not drive a car because he needs a driver's license for a job.
Someone who throws in a manic high local rounds, not as a treasurer, and someone whose structure is constantly changing, not as an administrative officer. 3-shift services are problematic because they provide triggers for mania; Stress professions should be avoided, for example in the catering industry.
Some people who did a great job were bipolar: Elias Canetti also suffered as much as his wife Veza; Andrew Delbanco wrote about Hermann Melville, the author of Moby Dick: "His moments of happiness were often followed by depression." Could he therefore develop Captain Ahab, who manically pursues the white whale - until the ship goes down in the end (like the soul in depression).
Or the manic-depressive Ernest Hemmingway, who shot himself, presumably in depression? His "old man and the sea" is just the pattern of a literary implementation of bipolar disorder. An old man goes to sea again, captures a fish giant in a superhuman struggle, brings him under obstacles to the beach. Once there, sharks have eroded the catch to the skeleton - nothing remains, after the mania comes the depression.
Lord Byron was as affected as Virginia Woolf. She killed herself and wrote in her farewell letter to her husband: "Dearest, I have the certain feeling that I'm going crazy again. I feel that we can not go through these terrible times again. And this time I will not recover. I start to hear voices and can not concentrate. So I will do what seems to be the best thing to do. You gave me the best possible luck. "
The sick Kurt Cobain also took his own life in a depression. His illness he shared with Marilyn Monroe and the singer Falco. Gauguin suffered as much as his roommate Van Gogh, who cut off his ear in a mania - and later Pablo Picasso. Brahms, Mozart and Tchaikovsky suffered, Churchill as well as Nixon.
Edgar Allan Poe, the master of tales of dread, suffered from the disorder. Poe's main motive is - probably not coincidentally - the double side of perception. Imaginations, thoughts and feelings turn into their opposite. In the subconscious lurks a doppelganger. Poe's characters are often normal people who go mad, as in "Spirit of Perversity" or "Black Cat," where a decent husband of drunkenness expires, kills his cat and later kills his wife with the ax.
Friedrich Nietzsche also fought against these fluctuating moods. Niezsches most important quote is: "Who always fights against monsters, should be careful not to become a monster itself. Because whenever you look into an abyss, the abyss also looks into you. "He knew what he was writing about. (Dr. Utz Anhalt)