Bipolar Disorder: Understanding the Highs and Lows
Episode Description
Although the term ‘bipolar’ is sometimes used as slang to describe someone who is moody or indecisive, true bipolar disorder is a complex and sometimes severe mental health disorder that affects the way a person thinks, feels, and behaves. In this episode of Mind Your Mind, host Tim Unsinn discusses bipolar disorder with nurse practitioner Amanda Daggett, touching on what the disorder is, what its symptoms look like, and how it can be treated.What to Expect
- Symptoms of bipolar disorder
- Mania & depression
- Bipolar 1 vs bipolar 2
Resources: Learn More
- “What Are Bipolar Disorders?” (American Psychiatric Association)
- “Mood Stabilizing Medication” (Center for Addiction and Mental Health)
- “An Unquiet Mind: A Memoir of Moods and Madness,” by Kay Redfield Jamison
Things to Think About
- Because many individuals with bipolar disorder don’t seek help until they’re experiencing a depressive episode, they are often misdiagnosed as having depression. When seeking a diagnosis, it’s important to see someone highly qualified for diagnosing bipolar disorder.
- When diagnosed with bipolar disorder, it’s important to keep a steady routine. Try to eat at the same time each day, go to sleep at the same time each night, and limit your stress levels.
About the Hosts
Amanda Daggett is a board-certified Mental Health Nurse Practitioner. She diagnoses and treats mental health disorders in children, adolescents, and adults. She strives to provide competent, high-quality, patient-centered, holistic care—which includes therapy and medication management—and work with a team of professionals to help patients achieve optimal wellness.
Transcript
Bipolar Disorder: Understanding the Highs and Lows
Featuring Amanda Daggett, APRN, PMHNP-BC, Dakota Family Services
Tim Unsinn:
Welcome to Mind Your Mind, a podcast presented by Dakota Family Services, an outpatient behavioral health clinic located in Minot, Bismarck, and Fargo, North Dakota. In this podcast, I will talk with our experts about understanding and nurturing our mental health and wellness. I'm your host, Tim Unsinn. Join me each episode as we explore the intricacies of our minds, decrease the stigma of mental illness, learn practical tips for managing our mental health and wellbeing, and recognize when it's time to ask for help. Join me now to mind your mind. Welcome to this episode of Mind Your Mind. Our guest is Amanda Daggett. Amanda is a nurse practitioner with Dakota Family Services. Amanda, it is great to have you on Mind Your Mind. And before we get to today's topic, which is bipolar disorder, I've got a question I ask all of our guests and that is, why do you do what you do?
Amanda Daggett:
One big reason that I do what I do is because I enjoy helping people, I enjoy interacting with clients. It's just something that brings me joy.
Tim Unsinn:
Our topic is bipolar disorder. So what is bipolar disorder?
Amanda Daggett:
Yeah, so bipolar is a mood disorder and there's two main mood episodes to bipolar disorder, but also there's some symptoms in between. So it's a very complex and often misunderstood disorder. So we're all very familiar with major depressive disorder where you know, people have really depressed mood, they have very low energy, it affects their sleep. They have a lot more negative thought. It affects appetite. So we'll often have a picture of somebody that's, you know, very low energy and it's hard to get out of bed. So that's a little bit more understood. But when we hear a lot of people talk about bipolar disorder or they'll even kind of use it as kind of a slang term where they'll just say it with a normal mood like just I'm a little bit moody or irritable or they change their mind back and forth and they'll be like, I'm so bipolar.
Amanda Daggett:
But it's so much more complex than that. So in bipolar disorder we have those depressive episodes, but we also have the other end, which is elevated mood. And in bipolar one we have mania. In bipolar two we have hypomania. So it's the opposite of that depression, where in bipolar disorder we have elevated or expansive mood. So some people can be really, really happy and really energetic. And then you can also have people that are really, really irritable or angry with that mood. And then on the opposite of, you know, depression, you're either sleeping too much or it's just hard to sleep in mania or hypomania, you don't sleep or you sleep very little and you don't need it, you don't feel tired, you have tons of energy. And in hypomania this is at least four days or more. In mania it's a week or more. So could you imagine going a week with like about two hours of sleep per night or not sleeping for several days and still having tons of energy and feeling really happy?
Tim Unsinn:
That just seems so unhealthy.
Amanda Daggett:
It really is, it's really bad for your brain to remain in that state. So that's why treatment is really important. And early treatment. So with bipolar disorder, we know that if treatment is delayed and you have frequent episodes that are untreated, the disease progression and severity is more likely to be elevated. So it's harder to treat with more subsequent episodes.
Tim Unsinn:
How is it diagnosed?
Amanda Daggett:
You wanna make sure that you go to somebody that is very qualified to diagnose bipolar disorder, 'cause this is a very complex disorder that can often be confused with other disorders and missed or misdiagnosed. A lot of times people will get diagnosed with depression, especially people with bipolar two because could you imagine how good it would feel to have all this energy and get a bunch of stuff done? So people often don't go in for help during their hypomanic or manic episodes 'cause they feel wonderful and they go in for help once they're depressed because that doesn't feel so good. So people are getting diagnosed with depression and then they'll oftentimes get started on an antidepressant. Well, antidepressants can actually be really harmful in bipolar disorder, especially if you take that without a mood stabilizer, and it can actually switch you into that opposite episode of mania or hypomania. And there's actually some studies showing that people with bipolar disorder who have been on an antidepressant are more likely to have what's called rapid cycling bipolar disorder, which is where you're going into those varying mood episodes a lot more frequently.
Tim Unsinn:
So I can see why it is so important. I mean of all that you've said already, the most important thing that stood out to me was find somebody that is qualified to make a diagnosis of what's going on.
Amanda Daggett:
Absolutely. And if you suspect that you or a loved one has bipolar disorder, early diagnosis in treatment is really important for outcomes,
Tim Unsinn:
How is it treated?
Amanda Daggett:
So mood stabilizers are the biggest treatment in bipolar disorder. The gold standard for treatment is something called lithium. So this is a unique mood stabilizer and actually it's one of the only psychotropic medications that has been shown to reduce risk of suicide. So it's a protective factor for suicide, which is a huge risk in bipolar disorder. So what this does, what bipolar disorder is, is your brain isn't regulating the cycle of release of neurotransmitters. So it often affects our sleep. So sleep is a cycle too, like our, our circadian rhythms and it's not regulating those cycles, right? So once we get in a really elevated mood, our body isn't bringing that mood back down. Once we're not sleeping, our body isn't regulating that sleep again. So it's really important to keep a good routine with like everything in bipolar disorder. Like make sure that you go to bed at about the same time every day, wake up at about the same time every day, even eating. Eat at the same time every day. Really limit stress. Because stress can be a trigger of mood episodes. So routine is very important in maintaining regulation of mood, sleep activity.
Tim Unsinn:
So you get outta the routine that adds stress.
Amanda Daggett:
Yeah.
Tim Unsinn:
Okay.
Amanda Daggett:
And one thing to be aware of with the difference between bipolar one and bipolar two, and a lot of people will confuse and and think that bipolar two is just a less severe diagnosis to bipolar one, but they're actually very different illnesses. In bipolar one we talked about that there's mania rather than hypomania. Just because it's hypomania doesn't mean it doesn't affect your functioning. It really does. It can really affect your ability to function at work or with your loved ones. But what we'll see in mania is not only does it last at least seven days or more, but also we can have psychosis with it. So you will have, you know, either delusions or hallucinations, really common delusions that we'll often see as paranoia and hallucinations that can be, you know, auditory or visual hallucinations. So the other thing with what differentiates mania from hypomania, is it's severe enough that you need a hospitalization.
Amanda Daggett:
So with mania, when you have psychosis, it's really important to treat with antipsychotics to address that psychosis because it's very serious. So it's important to consider antipsychotics and those antipsychotics we can actually use without psychosis as mood stabilizers. One of the biggest things to be aware of with antipsychotics is a lot of them there is a risk for metabolic side effects. So like weight gain, high cholesterol, diabetes. So when you're already predisposed to those things, it's important that you and your healthcare provider be aware of that and you choose medications with a lower risk for those things. So there are certain antipsychotics that do have a bit of a lower risk for metabolic side effects like Geodon, Abilify, Latuda. So you wanna consider those things when choosing a medication and that's why it's really important that you go to somebody that's specialized in psychiatry for treatment.
Tim Unsinn:
Early diagnosis.
Amanda Daggett:
Very important.
Tim Unsinn:
And somebody that's qualified.
Amanda Daggett:
Yes.
Tim Unsinn:
That's important stuff. Any other things that we need to know about bipolar disorder? And I know, I know we could go on for hours on this very topic. Anything? Any final thoughts in wrapping up?
Amanda Daggett:
Yeah, one thing that I really recommend with bipolar disorder is that not only you get as much education as you can and how to manage it because it takes more than medications alone to manage bipolar disorder like we talked about with keeping a solid routine and limiting stress, but also our loved ones should be educated and there comes a lot of guilt and shame with bipolar disorder, especially from mania or hypomania because in these episodes people will often do things that are highly out of character for them. You know, especially with the risk taking behavior that comes along with that. People will spend excessive money that they don't have or do things that maybe are illegal or outside of their moral values. So there can be a lot of guilt with that and it can really affect, you know, your personal life. Maybe you'll lose relationships, you know, romantic relationships or family or friends. So I think it's important to separate what's the illness, what's bipolar disorder from the person and that our loved ones be able to understand that and also recognize those signs and symptoms in people and encourage them to get help. A lot of times people will recognize those changes in us before the individual with the illness does and that's very common in bipolar disorder.
Tim Unsinn:
Amanda, you do a great job and again, very insightful and all the stuff you've shared with us, it's a big topic. I know we'll be talking about it more in future podcasts on Mind Your Mind. So again, thank you for being with us Before we wrap up. Final question and that is, what do you do personally to mind your mind?
Amanda Daggett:
Just adding on what we talked about, I try to keep a daily routine, so I try to go to bed and wake up about the same time every day. I try to keep habits that keep me on my routine and it really helps to limit stress.
Tim Unsinn:
Amanda, thank you so much again for being with us on Mind Your Mind. Thank you for sharing your time and talent with us. Thank you for joining us for Mind Your Mind, a podcast presented by Dakota Family Services. You can't have health without behavioral health. Remember to mind your mind. For more information, links to additional resources, contact information, and much more. Go to Dakotafamilyservices.org.
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Fear is powerful. It can cause us to avoid problems, people, and even opportunities in our life. But it can also be overcome. In this episode of Mind Your Mind, host Tim Unsinn speaks with Falan Johnson, a therapist at Dakota Family Services, about the function of fear and how to face it. Learn where fear comes from, how to identify it, and how to calm down and build confidence when you’re feeling afraid.;
The Three R's: Regulate, Relate & Reason
In this episode of Mind Your Mind, our host Tim Unsinn talks with Dakota Family Services therapist Jessie Mertz about the “3 R’s”—Regulate, Relate, and Reason. They discuss what each term means, how they build upon each other, and how this approach can help you calm others who are experiencing distress.;
What is Schizophrenia?
Schizophrenia is a chronic, complex mental health disorder that affects around 1% of people in the United States. In this episode of Mind Your Mind, host Tim Unsinn and psychiatrist Dr. Wayne Martinsen discuss the symptoms and implications of schizophrenia, touching on its many effects on individual and family life. Learn about how schizophrenia is treated, how it affects physical health, when it tends to develop, and how it is perceived between cultures.;
How to Have a Conversation About Mental Health
Although the stigma surrounding mental health is gradually disappearing, it can still be tricky knowing how to talk about it. In this episode of Mind Your Mind, host Tim Unsinn and psychologist Megan Spencer explore how to have a conversation with someone about their mental health, including signs that you should talk to them, how to start the conversation, and some possible reactions to expect from the other person.;
The Benefits of Being Outside
Are you feeling cooped up indoors? Join host Tim Unsinn and therapist Lucas Mitzel in this episode of Mind Your Mind as they discuss the importance of getting outside on your mental health. Learn about the benefits of green and blue spaces, activities you can do while outside, and how being outside can help improve symptoms of different mental health diagnoses.;
Dealing With Burnout
In this episode of Mind Your Mind, Tim Unsinn talks with psychologist Dr. Hannah Baczynski about the signs of burnout, how to prevent it, and how to know if your burnout is related to general life stressors or a mental health disorder. They also talk about the difference between fatigue and burnout, as well as how to support yourself and alleviate burnout when you’re experiencing it.;
Living with Chronic Illness
Many of us know someone who has been diagnosed with a chronic illness, or have been diagnosed with one ourselves. In this episode of Mind Your Mind, host Tim Unsinn talks with therapist April Morris about how chronic illness can impact daily living and mental health, as well as how to seek support if you have been diagnosed with a chronic illness.;
Social Media: Managing Emotions & Setting Boundaries
How much time do you spend each day looking at your phone? An hour or two? Multiple hours? In this episode of Mind Your Mind, host Tim Unsinn meets with therapist Christy Wilkie to discuss how social media use can impact our mental health, relationships, and behavior. Learn tips for monitoring your child’s internet use, as well as how to manage your own time spent on social media.;
Understanding OCD
While OCD is sometimes perceived as simply a desire to keep things neat and organized, it can actually have much more severe symptoms for those who experience it. In this episode of Mind Your Mind, host Tim Unsinn meets with psychologist Dr. Megan Spencer to talk about who Obsessive Compulsive Disorder affects, what its signs and symptoms are, and how to seek help if you or a loved one has been diagnosed with OCD.;
Breaking Bad Habits
Bad habits can be easy to start but sometimes very difficult to stop. In this episode of Mind Your Mind, host Tim Unsinn and therapist Falan Johnson talk about breaking bad habits, including where habits come from, how to know if a habit is bad, and steps you can take to stop it.;
Finding a Therapist
Are you looking for some help on your mental health journey? In this episode of Mind Your Mind, host Tim Unsinn and therapist Jessie Mertz talk about how to find a therapist, including what you should know when searching and what questions to ask when you meet a therapist for the first time. They also touch on what the letters after a therapist’s name mean, and how they apply to the type of services or treatment you might be looking for.;
Coping with Rejection
Whether it’s from asking someone on a date or applying for a job, we all experience rejection at some point in our lives. In this episode of Mind Your Mind, host Tim Unsinn talks with therapist April Morris about how to cope with rejection, including the common coping stages, the importance of acceptance, and how rejection can impact people differently.;
Borderline Personality Disorder
Like other personality disorders, borderline personality disorder is a commonly misunderstood and stigmatized mental illness. In this episode of Mind Your Mind, host Tim Unsinn talks with Lucas Mitzel, a therapist at Dakota Family Services, about what BPD is, how it affects someone’s behavior, and where to seek treatment if your child has been diagnosed with BPD.;
Psychological Assessments: What to Expect
Do you think you might be suffering from an undiagnosed mental disorder? If so, a psychological assessment might be able to help. In this episode of Mind Your Mind, psychologist Dr. Hannah Baczynski and host Tim Unsinn talk about what to expect from a psychological assessment, including what an assessment might include, what information you might receive from the psychologist, and what you should communicate with your psychologist before and after receiving an assessment.;
Supplements in Psychiatry
In this episode of Mind Your Mind, host Tim Unsinn and Amanda Daggett explore the topic of using supplements for mental health. In addition to talking about some of the most commonly used supplements like melatonin and St. John’s Wort, they also discuss the benefits, the risks, and the research surrounding various supplements.;
Seasonal Affective Disorder (Community Chat Series)
Feeling like you’ve got the winter blues? If you’re noticing symptoms of depression with the change of seasons, it may be a sign that you’re suffering from Seasonal Affective Disorder, or SAD. In this special Community Chat episode of Mind Your Mind, therapists Christy Wilkie and Lucas Mitzel discuss the common symptoms of Seasonal Affective Disorder, how it can affect other mental health disorders, and some useful tips, tricks, and resources for managing symptoms of SAD.;
Trying New Things With Confidence
Join Christy and Lucas, therapists at Dakota Family Services, as they share practical tips for building confidence when trying new things. From managing self-doubt to building resilience, this episode will empower you to approach new experiences with a positive mindset.;
Relationships are Hard
In this episode, Christy and Lucas explore why relationships can be so hard. Join them as they discuss the characteristics of both healthy and toxic relationships, talk about the difference between normal conflict and abuse, and help you discover your love languages so you and your partner can best express your love to each other.;
Is Everybody Anxious?
In this episode, Christy and Lucas explore anxiety. Join them as they discuss the signs and symptoms of an anxiety disorder, what you can do to decrease your anxiety, and how to best help loved ones struggling with anxiety.;
Is Everyone Feeling Sad
In this episode, Christy and Lucas explore depression. Join them as they discuss the signs and symptoms of Major Depressive Disorder, what you can do to help yourself feel better, and what you can do to help your loved ones. They will talk about coping strategies, therapy interventions, and ways to help you identify when your child might need extra help.;
Change is Hard
Change is inevitable. Join Christy and Lucas as they explore big and small changes and how they impact you. Learn why change can be so hard, even good change, and discover ways to manage it effectively.;
We Need to Talk About Suicide
In this episode of "Is It Just Me," Christy and Lucas discuss the very important topic of suicide. Listen to learn about risk factors, warning signs, and what you can do to help a loved one who is struggling. Remember, you are not alone. If you need immediate assistance, call 911. If you need to talk to someone, call the Suicide and Crisis Lifeline at 988.;
Do We Need to Get Outside?
Join Lucas and Christy as they explore the power of spending time outdoors on mental and emotional well-being. Discover practical tips, personal anecdotes, and expert insights on the benefits of getting outside and reconnecting with nature.;
Exploring ADHD
In this episode of "Is It Just Me?" Lucas and Christy discuss ADHD, shedding light on its prevalence and impact on daily life. Learn practical strategies for managing symptoms and understand why your friend or loved one with ADHD does the things they do.;
Internet Safety and Mental Health
In this episode of "Is It Just Me?", join our hosts Christy and Lucas as they delve into the complex relationship between the internet and mental health. With the digital age bringing information and social connections to our fingertips, it also presents unique challenges and opportunities for our safety and psychological well-being.;
Boosting Self-Esteem: From Marathons to Daily Triumphs
In this episode of "Is It Just Me?", Christy and Lucas discuss how common it is for people to see themselves differently from others. Using their own personal triumphs and challenges as examples, they outline the things that shape our self-esteem. Additionally, they share simple daily practices to help listeners recognize and celebrate their own personal victories. This episode is filled with tips and engaging stories aimed at encouraging listeners to undertake challenges that foster self-growth and personal confidence.;
Therapy Unveiled: What to Know Before You Go
In this episode of "Is It Just Me," Lucas and Christy talk about what it's like to begin therapy. Feeling apprehensive about starting therapy is normal, but surmountable. Together, Lucas and Christy unravel common myths about therapy and emphasize the role of therapy in disrupting negative life patterns and routines that are no longer serving you.;
Coping with the Back-to-School Blues
In the latest episode of “Is It Just Me?” Christy and Lucas tackle the transition from leisurely summer days to structured school schedules with warmth and wisdom. This episode is a must-listen for parents seeking guidance and strategies to help navigate the shift with confidence. Learn how to handle changes in routine, the importance of communication, and strategies to help the entire family adjust to and embrace the new normal. Listening to this episode can be your first step toward making back-to-school a season of growth and positive change for all.;
The Art of Overcoming Trauma
In this month’s episode of the "Is It Just Me?" podcast, Lucas Mitzel and Christy Wilkie, Dakota Family Services, dive into the complexities of trauma and its therapy. The episode sheds light on Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and the importance of creating a trauma narrative as a cornerstone of healing. The thoughtful discussions aim to educate listeners on the intricacies of trauma, the innovative methods used in therapy, and the role of caregivers in the recovery process. Through expert insights and compassionate storytelling, Lucas and Christy provide practical advice and real-world examples for individuals who have experienced trauma.;
Navigating Life Through Mindfulness
In this episode of “Is It Just Me?”, Lucas and Christy delve into the world of mindfulness and relaxation techniques. From body scans to mindfulness exercises, they provide a soothing experience to help you unwind and distress. Discover practical tips and advice on incorporating mindfulness into your daily routine and learn how to prioritize mental well-being in today's fast-paced world.;
Mindfulness: Body Scan
In this special additional episode of “Is It Just Me” join therapist Lucas Mitzel as he gives listeners a transformative journey within their own body and mind. In this episode, Lucas guides listeners through a soothing body scan to promote calm, mindfulness, and inner peace. This episode offers a unique mixdown of gentle narration, and relaxation techniques, leaving you feeling refreshed, rejuvenated, and more connected to yourself.;
Beyond the Labels: Dismantling Myths About Mental Health
In this podcast episode of “Is It Just Me?” Lucas Mitzel and Christy Wilkie delve deep into the prevalent stigma and myths surrounding mental health. Through personal stories and insightful discussions, they aim to challenge misconceptions, break down barriers, and promote greater understanding and empathy towards people dealing with mental health challenges.;