Bipolar Disorder Part 1

Jul 27, 2025 Features / Columnists, News

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By Dr. Telford Layne Jr. PsyD, MSc. Postgrad, BSc.
Clinical and Developmental Psychologist – Psychoanalyst
Unwrapping Gift -Clinic

Bipolar 1

Kaieteur News – In Guyana, mental health disorders, including bipolar disorder, contribute significantly to the overall disease burden, accounting for 25 per cent among individuals aged 10-40. Bipolar disorder, though less common than other mental health conditions, is a significant concern within the Guyanese population. In my clinical practice, 76 per cent of my patients with bipolar have experienced sexual trauma.

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes apparent shifts in a person’s mood, energy, activity levels, and concentration. People with bipolar disorder often experience periods of significantly “up,” elated, irritable, or energised behaviour (known as manic episodes) and very “down,” sad, indifferent, or hopeless periods (known as depressive episodes).

Bipolar disorder can affect children, with symptoms sometimes appearing as young as five years old, though it is more commonly diagnosed in adolescence. While the average age of onset is unclear, reported ages range from five to 19 years. Bipolar disorder affects men and women with similar overall prevalence, but the way it manifests can differ. Women may experience more depressive episodes, rapid cycling, and comorbid conditions like eating disorders, anxiety, depression, migraines or thyroid issues. Men may be more prone to substance abuse and exhibit more manic symptoms, along with a risk of suicide attempts, and suicide attempts among men may be more violent.

The cause of bipolar I disorder is believed to be a complex interplay of genetic (runs in families), suggesting a strong genetic component. Biological (differences in brain structure, imbalances in neurotransmitters, chemicals and function), psychological, and environmental factors (childhood trauma- sexual abuse, substance/drug abuse, stressful life events, physical illness and sleep disturbance).

Bipolar disorder is categorised into three primary types: Bipolar I, Bipolar II, and Cyclothymic disorder.

Bipolar I disorder is diagnosed when a person experiences a manic episode. During a manic episode, people with bipolar I disorder experience an extreme increase in energy and mood changes, including feeling extremely happy or uncomfortably irritable. Some people with bipolar I disorder also experience depressive or hypomanic episodes, and most people with bipolar I disorder also have periods of neutral mood.

Involves manic episodes that last for at least 7 days or require immediate hospitalization due to severe symptoms. Depressive Episodes: May also experience depressive episodes lasting at least two weeks. Mixed Episodes: Can include mixed episodes where symptoms of both mania and depression co-occur.

Symptoms of Bipolar I Disorder

Manic Episode

A manic episode is at least one week when a person is extremely high-spirited or irritable most of the day for most days, possesses more energy than usual, and experiences at least three of the following changes in behaviour:

• Decreased need for sleep (e.g., feeling energetic despite significantly less sleep than usual. Elevated or Irritable Mood, euphoric, extremely happy, or unusually irritable and agitated.
• Increased or racing thoughts and Speech: Difficulty concentrating, talking rapidly, and jumping from topic to topic
• Grandiosity: Having inflated self-esteem or a sense of self-importance
• Distractibility.
• Increased activity (e.g., restlessness, working on several projects simultaneously).
• Increased risky or impulsive behaviour (e.g., reckless driving, spending sprees, sexual/hypersexual, promiscuity).
• Psychotic Features: In severe cases, mania can involve delusions (false beliefs) or hallucinations (seeing or hearing things that are not there)

These behaviours must be severe enough to cause dysfunction in work, family, or social activities and responsibilities. Symptoms of a manic episode commonly require hospital care to ensure safety.

Hypomanic Episode

A hypomanic episode, or hypomania, is characterized by less severe manic symptoms that need to last only four days in a row rather than a week. Hypomanic symptoms do not lead to the significant problems in daily functioning that manic symptoms commonly cause.

Major Depressive Episode

A major depressive episode is at least two weeks in which a person experiences intense sadness or despair or a loss of interest in activities the person once enjoyed and at least four of the following symptoms:

• Low Mood: Feeling sad, hopeless, or empty, worthlessness or excessive guilt or self-blame
• Fatigue and Low Energy: Feeling tired and sluggish, even with adequate or decreased sleep.
• Loss of Interest, difficulty finding pleasure in once enjoyable activities
• Changes in Appetite: experiencing changes in eating habits.
• Restlessness (e.g., pacing) or slowed speech or movement.
• Difficulty concentrating. Having trouble focusing, making decisions, or remembering things.
• Frequent thoughts of death or suicide.

Bipolar I disorder can significantly impact or interfere with everyday activities, work or school responsibilities. Some people may also experience stigma related to their symptoms, which can keep them from seeking the help they need. However, relationships are affected the most, due to their characteristic mood swings and related behaviours. These mood changes can affect trust, communication, intimacy, and financial stability, leading to strain and potential relationship difficulties. People with bipolar disorder and other mental illnesses often have other mental disorders. Mental illness, like personality disorders, comes in clusters. There is a primary diagnosis and a secondary diagnosis.

These relationship challenges are:

Trust and Communication: Unpredictable mood swings can erode trust and make establishing open and honest communication challenging, which is crucial for a healthy relationship.

Emotional Volatility: Manic and depressive episodes can lead to impulsive or erratic behaviour, causing emotional distress and misunderstandings.

Intimacy Challenges: Fluctuations in libido and emotional availability can impact intimacy and create distance between partners.

Financial Strain: Bipolar disorder can affect employment and financial stability, leading to stress and potential conflict within the relationship.

Social Withdrawal: Depressive episodes can cause social withdrawal and isolation, impacting the partner’s sense of connection and support.

Coping with Stress: The partner of someone with bipolar disorder, may experience stress and feelings of uncertainty, potentially leading to caregiver burnout.

Hope

Navigating the Challenges of Bipolar 1

Education and Self-Management: Learning about bipolar disorder, recognizing early warning signs of episodes, and developing healthy coping strategies are essential for long-term management.

Lifestyle Factors: Maintaining a regular sleep schedule, eating a healthy diet, engaging in regular exercise, and managing stress are important for overall well-being and mood stability

Open Communication: Discussing the condition, its effects, and individual needs is crucial for fostering understanding and support.

Setting Boundaries: Establishing clear boundaries around specific behaviours or situations can help manage the impact of mood swings.

Seeking Professional Help: Individual and couples’ psychotherapy provides a safe space to address individual and relationship issues and develop coping strategies through Cognitive Behavioural Therapy (CBT), Family-Focused Therapy, Interpersonal and Social Rhythm Therapy (IPSRT). They may or may not recommend medication. Mood stabilizers, Antipsychotics and Antidepressants are last options or advanced options.

Empathy and Support: Empathy and understanding from family members, friends and partners can help navigate the challenges and build a stronger bond.

Self-Care: Prioritizing self-care is essential to managing the emotional toll of living with bipolar disorder. Daily sunlight in he mornings. Vegetables and a balanced diet. Adequate water intake. Sleep. Avoiding stressful work and environments. Use conflict resolution skills to resolve relationship problems. Build good self-esteem. Avoid alcohol and always practice self-awareness. Develop the tool to regulate your emotions.

When to Seek Professional Help:

If personal and interpersonal relationship problems are significantly impacting well-being or causing distress, and if there are concerns about safety or stability. Seeking professional help from a clinical psychologist is recommended.

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• Bipolar Disorder, Dr. Telford Layne Jr., mental health, Psychoanalyst, Psychologist

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