The author, Kristina Nord, MSW

Bipolar disorder affects approximately 1 percent of the population, usually developing in one’s late teens or early 20s, though it can develop in childhood or later in life. It affects males and females equally. 

Bipolar disorder can take years to diagnose properly, sometimes taking 10 years or longer, as it is often misdiagnosed or underdiagnosed. According to the World Health Organization, bipolar disorder is the sixth most disabling disease worldwide, and is the most costly mental health disorder for private health plans.

Bipolar disorder is characterized by two mood states: mania and depression. Mania is expressed by changes in both mood and behavior. Common symptoms include feeling “high” or euphoric, feeling unusually confident, and having more energy. Sometimes it can be associated with extreme irritability or feeling impatient. Common changes in one’s behavior can include rapid, loud speech, having less need for sleep, restlessness, starting a lot of projects, and behaving impulsively (spending sprees, increased sex drive, risky behaviors). 

Depression is the other end of the mood spectrum. Like mania, it affects one’s thoughts and feelings as well as behaviors. Common symptoms of depression include feeling an overwhelming sadness and hopelessness, feeling guilty, irritable and worthless. 

Individuals often have less energy, experience difficulty sleeping (insomnia or excessive sleeping), changes in appetite, experience less or no pleasure out of activities they usually enjoy, and isolate. 

While there are two mood states associated with bipolar disorder, one can experience varying levels of severity in each. There is a mild/moderate form of mania called hypomania, which is associated with a subtype of bipolar disorder, called bipolar II disorder (bipolar I is associated with full manic episodes). Sometimes people with bipolar disorder can exhibit symptoms of both depression and mania, experiencing what is called a mixed episode.

Individuals with bipolar disorder often have other co-occurring illnesses. Substance use is very common affecting approximately 60 percent of people with the disorder. Anxiety disorders are also common. Individuals with bipolar disorder are at higher risk for some medical conditions such as diabetes, obesity, and cardiovascular disease.

The first step in seeking a diagnosis and treatment for bipolar disorder is seeing your doctor. He or she can conduct a physical examination, lab tests, etc., to rule out a physical condition that might be contributing to your mood. 

When seeing your provider, come prepared with information about what symptoms you have been experiencing and for how long they have been occurring, stress you have been experiencing, and list of current medications you are taking. Your doctor may then refer you to a mental health professional for additional evaluation and treatment.

While there is no cure for bipolar disorder, treatments are available to help one manage his/her illness. Because bipolar disorder is a chronic condition, long-term treatment is usually needed in order to manage the illness. Treatment plans usually include both medication and psychotherapy. There are many medications now approved to treat bipolar disorder. Psychotherapy is an important component of bipolar care, with some common treatments including cognitive-behavioral therapy, psychoeducation, and interpersonal and social rhythm therapy. 

Things individuals can do to self-manage their bipolar disorder include discussing early mood symptoms with their health and mental health care providers, getting early assessment of physical illnesses, and maintaining routines, including minimizing changes in sleep routine.

Packard Health is committed to integrating behavioral and primary care. In addition to the mental health services provided in collaboration with the county, Packard Health is one of five sites in the country participating the research study, Bipolar Disorder Recovery-Oriented Collaborative Care (B-ROCC) Study. The principal investigator is Amy M. Kilbourne, PhD, MPH. This is a NIMH-funded multi-site study through the University of Michigan. This study is implementing and disseminating an evidence-based, consumer-centered program (Life Goals Collaborative Care) that been shown to increase functioning and quality of life in community-based mental health practices. Individual participation includes attending group self-management educational sessions and follow up care management contacts.

This article was written by Kristina Nord, MSW, who is the Packard Health social worker who works with the Bipolar patients as a part of this study. She is a graduate of the University of Michigan with a Master of Social Work (MSW), Interpersonal Practice/Mental Health concentration in 2009. She has an undergraduate degree from the University of North Carolina-Chapel Hill, wiht a major in psychology and in anthropology. Her clinical interests are serious and persistent mental illness, primary care and mental health integration, crisis intervention, mental health services utilization.

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