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World Bipolar Day

What is bipolar disorder?

Nurses General Nursing Article   posted

Specializes in LTC, assisted living, med-surg, psych.

A day set aside to increase world awareness of bipolar disorders and help eliminate the stigma that surrounds these mental illnesses.

World Bipolar Day
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This Thursday, March 30th, is the fourth annual World Bipolar Day. The date was chosen because it is also the birthday of Vincent Van Gogh, who is widely believed to have had bipolar disorder. It was established in 2013 as the brainchild of the Asian Network of Bipolar Disorders (ANBD), the International Bipolar Foundation (IBPF), and the International Society for Bipolar Disorder (ISBD).

If you've never heard of World Bipolar Day, you're not alone. Mental illness is still very much in the closet, so to speak, and other than celebrities like Patty Duke and Carrie Fisher (both of whom are no longer with us), few sufferers willingly discuss their condition in public. There remains a good deal of stigma despite efforts to decrease it. Even in this day and age, mental illness is routinely assumed to be present whenever there is a mass shooting or a crime spree.

Much of it is subtle. I battle bipolar I disorder and I've had healthcare providers who wanted to talk about my psychiatric history instead of the complaint I came in for, like the time I broke my right great toe and the urgent care doctor spent 15 minutes quizzing me over my medication list, with strong emphasis on the psych meds. Another time I stopped by the hospital lab to have blood drawn for a thyroid panel on order of my psychiatrist, and when the friendly check-in lady saw the reason for it on the paperwork, she suddenly fell silent and looked at me as if I'd sprouted three heads. On the other hand, I now have a family nurse practitioner who has never judged me because of my illness and an office staff that is wonderful to me, so there are good providers out there. We just have to find them.

So what does bipolar look like? Well, each person is different, and so are the symptoms. However, the diagnostic criteria include manic symptoms such as grandiosity, pressured speech, racing thoughts, and poor insight; while its opposite number, depression, can cause sleep disturbances (either too much or too little sleep), feelings of hopelessness and worthlessness, and can even lead to suicide attempts. There is also a less-intense version of mania called hypomania, which can either stand by itself in bipolar II or as a precursor to full-blown mania in bipolar I. In addition to the classic forms of BP, there are two other types, one of which is bipolar NOS (this basically means that the condition looks like bipolar but doesn't meet the criteria for BP I or II), and cyclothymia, a milder illness whose highs and lows are nonetheless persistent.

To say the least, bipolar disorder is a serious disease which usually requires medication and/or therapy. Most patients require more than one medication to stabilize mood; I myself take a "cocktail" of six drugs, and that's not particularly rare. Meds also have to be adjusted every so often as they may lose their effectiveness over time, and the side effects can be brutal. For example, I once gained 25 pounds in the first six weeks after I was put on Zyprexa, which is notorious for weight gain and the development of diabetes and hyperlipidemia. Some drugs may even cause the dreaded tardive dyskinesia, EPS, and Stevens-Johnson Syndrome, as well as a laundry list of other side effects that can be temporary or permanent.

Therapy can be very helpful, as are strict routines for sleep and ADLs. A healthful diet and exercise are known to prevent depression or make it less severe. Fish oil and vitamin D supplementation may also help, though this has not been scientifically proven (but they're good for us anyway). But treatment supervised by a psychiatrist or mental health nurse practitioner is a must; while our primary care providers are invaluable, they are not trained in psychiatry and relying on them to treat a complex illness such as bipolar disorder is like rolling dice.

This is only the tip of the iceberg. There is still much to be learned about bipolar disorder, and indeed all mental illnesses. But the world won't get there without education, and that's why World Bipolar Day exists. After all, mental illness only looks scary in the dark; it's when it is brought out into the light that fear dissolves and understanding begins.

Let's do this together. And while we're at it, hug a bipolar person you know and love.

I'm a Registered Nurse and writer who, in better times, has enjoyed a busy and varied career which includes stints as a Med/Surg floor nurse, a director of nursing, a nurse consultant, and an assistant administrator. And when I'm not working as a nurse, I'm writing about nursing right here at allnurses.com and putting together the chapters for a future book about---what else?---nursing.

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OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Love this article!

I was so embarrassed but at the same time relieved when I was diagnosed with bipolar disorder. Thank goodness it has been kept under control ever since I have been diagnosed.

It has been hard to keep myself stable since I just had a baby. I haven't exactly been able to get enough sleep since my second son was born. It has been rough & I have been worried I would go off the rails like I did when I had my first son, but so far so good.

I always hate mentioning I have bipolar disorder when there is no need for it. Like when I would go to the ER when I was pregnant, I never wanted to mention I had bipolar disorder. I didn't want the already judgemental ER staff, judging me even more.

I will never forget this one trip to an ER out of town. I was taking a high level of Lithium & all of a sudden I couldn't speak. I could think but the words couldn't connect from my brain to my mouth. It was the *weirdest* thing. After running a bunch of tests the ER doctor believed I was faking it because he couldn't find that side effect in any book. I was so mad & upset, because I wasn't. I took that high dose of Lithium twice a day. But thankfully the Pharmacist knew what I was talking about. When I got home I did my own research & came upon person after person who had the same thing happen to them.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych.

Yes, I've heard that can be a symptom of lithium toxicity. I hope they adjusted your dose. Are you on meds now?

OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

VivaLasViejas said:
Yes, I've heard that can be a symptom of lithium toxicity. I hope they adjusted your dose. Are you on meds now?

I'm only on Zoloft now. I need to find a new psychiatrist. I was gonna go back to MHMR but it's like pulling teeth trying to get seen. I'm actually doing really well!

fawnmarie, ASN

Specializes in Psychiatric Nursing.

Great article! My Dad was diagnosed with classic bipolar 1 disorder in 2005, when he went through a devastating divorce, attempted suicide, and spent a week in a psychiatric hospital. He was in his early 50's at the time, and although I'd always suspected he had a mental illness, he refused to acknowledge it or seek treatment. As a little girl, I remember feeling terrified when he would fly into a rage, set off by the tiniest, most trivial little thing...both my mother and myself endured years of his verbal abuse and unpredictable mood swings. When he was prescribed, and began taking Seroquel, he finally gained some insight into his illness. Within a few weeks of being started on Seroquel, he confided in me that he noticed his thoughts had become more organized and he no longer felt "all over the place." I'm so proud of him for finally admitting that he has a condition, and for sticking to his medication regime.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych.

fawnmarie said:
Great article! My Dad was diagnosed with classic bipolar 1 disorder in 2005, when he went through a devastating divorce, attempted suicide, and spent a week in a psychiatric hospital. He was in his early 50's at the time, and although I'd always suspected he had a mental illness, he refused to acknowledge it or seek treatment. As a little girl, I remember feeling terrified when he would fly into a rage, set off by the tiniest, most trivial little thing...both my mother and myself endured years of his verbal abuse and unpredictable mood swings. When he was prescribed, and began taking Seroquel, he finally gained some insight into his illness. Within a few weeks of being started on Seroquel, he confided in me that he noticed his thoughts had become more organized and he no longer felt "all over the place." I'm so proud of him for finally admitting that he has a condition, and for sticking to his medication regime.

I think that's the hardest part of this illness...admitting one even has it. Sometimes I still play with the notion that I'm really only experiencing an existential crisis instead of a lifelong mental disorder. But I take my meds faithfully, and I've been stable long enough that the extreme mood swings I used to have are only a memory.

Good for your Dad. It's amazing how medication can improve one's quality of life. :yes:

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