Bipolar Disorder: Understanding the Highs and Lows

Bipolar Disorder

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

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

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.

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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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