What is bipolar disorder?

In the elevator to the study hall when I was a student, a teacher told me about a student she had just graduated: she spent most of the year at home, and when school started in the spring, she was able to take the whole year's credits in less than 3 months, and by the way, she was able to write papers and play competitions. This was the case every year for four years in college.

At that time, my understanding of bipolar disorder still remained in the shallow impression of "bipolar disorder, also known as bipolar disorder, is characterized by a state of mind that shifts back and forth between mania and depression, and can be treated with lithium salts" in books. It seemed to be quite cost-effective - and there was even a little envy at the same time - until, one day, I read this paragraph: "Like many people suffering from bipolar disorder, I felt for the first time that the mental pain had reached unbearable, and the only solution was to end my life ...... In high school, there were several times when I thought about killing myself every day, and when, where, and in what way ...... During that period, it was as if I had fallen into sinking into a dark night - to me, everything seemed comical but had to be endured; like a blank slate that allowed people to put the best face on their lives. But as time passed and layer after layer of melancholy lessened, suicide became out of reach for me again." -Kay Jamieson, Life Passes Like It Does: Unraveling the Riddle of Suicide

In retrospect, the legendary former student, both teachers and later classmates, knew TA only for those 3 months of the year, and no one knew how TA spent the remaining 9 months. As if to confirm the credibility of this passage, the book has not yet had time to finish, the news appeared in the news of Hong Kong singer-songwriter Lu Kai Tong died of bipolar disorder self-inflicted death, at the age of 32. The author of the passage, Dr. Kay Jamison, is herself a bipolar disorder sufferer, and although she eventually carried the despair of her depressive phase, her beloved friend, who also suffers from bipolar disorder, left his wife and children behind and raised a gun to kill himself.

According to statistics, the current rate of suicide attempts by people with bipolar disorder is between 25% and 50%, and the rate of death by suicide is nearly 15%, compared to the worldwide suicide rate of only 0.011% as calculated by the World Health Organization, a difference of nearly a thousand times - so the "kill rate What's so special about bipolar disorder with such a high "kill rate"?

The key feature of bipolar disorder is extreme mood swings, from the peak of mania to the trough of major depression. It is called a mood disorder because it deeply affects a person's emotional experience and "feelings". It is called a "bipolar" disorder because the patient's state of mind fluctuates back and forth between the two poles, the peak and the trough, as opposed to the major depressive patient whose state of mind fluctuates only along a single pole (trough).

In the "peak" state of mania, the patient may experience a giddy or euphoric state of mind (extreme happiness or euphoria) or an impatient state of mind (extreme anger and sensitivity), a reduced need for sleep, and an obsessive confidence in his or her own abilities; at the same time, the racing mind makes the patient more talkative; compared to the usual The patient's energy and mobility are significantly higher, attention and perceptual senses are altered, and impulsive and reckless behavior may occur.

After the cessation of mania, the patient may gradually spiral into a depressive state or may suddenly fall into major depression without warning - some patients may move from a developing base of mild depression to major depression, while others may suddenly develop severe depression when they are feeling well in all aspects of their lives. symptoms. If major depression is an accidental fall into a deep pit, then bipolar depression can be a pole vault plus a Thomas spin straight into the pit - where the person may become extremely depressed or depressed, lose weight, lose appetite, feel tired but have trouble sleeping, feel guilty, contemplate suicide plans in meditation and so on.

The duration of a manic or depressive episode can vary from a few days to several months. Contrary to common belief, approximately 40% of patients do not experience depression and mania alternately, but rather experience both states of mind simultaneously. Patients who have had a mixed episode describe the experience as "tired but extremely euphoric. During a mixed manic episode, the patient feels extraordinarily pessimistic, hopeless, exhausted, and unable to concentrate fully, but at the same time still feels excitement, anxiety, impatience, a sense of urgency, lack of sleep, and a racing mind. In addition to seasonal bipolar disorder, the three subtypes of bipolar disorder commonly include type I bipolar disorder, type II bipolar disorder, and bipolar disorder accompanied by rapid cycling.

1. Type I bipolar disorder According to the American Diagnostic and Statistical Manual of Mental Disorders, 4th edition, patients with type I bipolar disorder will have at least one manic or mixed episode lasting a week or more and accompanied by a giddy state of mind and three other symptoms associated with mania (pompous thinking, rapid speech, racing thoughts, jumpy thoughts, impulsive behavior, etc.). Patients experience manic and depressive episodes in different sequences, usually as a change of state of mind from extreme depression to extreme mania. Some patients experience a manic phase followed by a depressive phase and then a period of return to a normal state of mind (an "emotionally normal" state of mind). Other patients go through a depressive phase followed by a manic phase and then a "emotionally normal" state of mind. Other patients experience a "rapid cycling" state of mind. In most cases, patients with Type I bipolar disorder experience five or more symptoms of major depression (depressed mood, change in appetite, lack of energy, fatigue, feelings of worthlessness, insomnia or excessive sleep, suicidal thoughts or actions, etc.) that last for at least two weeks at some point in their lives and during which they experience a decline in their daily functioning.

2. Patients with type II bipolar disorder alternate between major depressive episodes and hypomanic episodes, usually manifesting as a change in mood from extreme depression to hypomania. Hypomania is a mild form of mania, and although it may not last as long as full mania (the minimum criteria for this diagnosis is 4 days), the symptoms exhibited are the same. Generally speaking, although mild mania does not cause major problems in work, family or social life, so hospitalization is not required.

3. Rapid-cycling bipolar disorder The third subtype of rapid-cycling occurs either with type I bipolar disorder or with type II bipolar disorder. In rapid cycling, the patient's state of mind rapidly changes back and forth between manic or hypomanic or mixed disorder and depression, and is accompanied by four or more episodes of the disorder in a year. Some patients have "ultra-radian cycling," which means that their state of mind shifts from one pole to the other within 24 hours. Bipolar disorder and borderline personality disorder Borderline personality disorder shares many similarities with bipolar disorder, particularly with the rapid cycling type of bipolar disorder, in that they are both characterized by emotional instability, but they also have distinguishable differences. Changes in mood in borderline personality disorder tend to be very brief, often going from feeling good to being extremely distressed within minutes-often in response to being rejected or even simply belittled by close others. In contrast, mood changes in bipolar disorder often last for days or even weeks, and there is a high probability that the change will occur suddenly and for no apparent reason. Although people with borderline personality disorder do become depressed at some point in their lives and often meet all of the diagnostic criteria for major depression, they rarely experience manic moods, and the mood shift is more likely to be from such a shift from upset to feeling good, rather than from a bad mood to a high mood, as is the case in people with bipolar disorder. Between 10% and 40% of people with bipolar disorder also meet the diagnostic criteria for borderline personality disorder. Borderline personality disorder is marked by the display of unstable features of mindfulness, relationships, and feelings about self or identity. Individuals with borderline personality disorder experience chronic feelings of emptiness and boredom, have difficulty being alone, and make frequent suicidal gestures or threats of this type. Bipolar disorder and suicidal thoughts Suicidal thoughts and self-destructive impulses are part of bipolar disorder, which is related to neurophysiological factors in the patient (reduced levels of pentothal) rather than being caused by moral defects or character weaknesses. In fact, many people who do not suffer from bipolar disorder will think about suicide at some point in their lives, even if the thought is fleeting. However, in people with bipolar disorder, such thoughts tend to be frequent and intense, and are more likely to turn into a definite plan of action (e.g., taking medication at a specific moment to commit suicide). People with bipolar disorder or other depressive disorders often feel desperate, as if nothing will ever get better. They have a strong desire for relief from that increasingly intense, seemingly never-ending mental anguish. When the patient's depressive symptoms worsen further and he or she feels fear and apprehension, although the TA may desperately want to live, those unbearable pain and gray expectations of the future will push the TA step by step to the end. Nevertheless, even very strong suicidal thoughts can be managed and controlled through medical treatment.

There is evidence that long-term lithium treatment can reduce the rate of suicide attempts and completed suicides in people with bipolar disorder. Antidepressants, anticonvulsants, and tranquilizers can all reduce those agitated and aggressive states of mind that lead to suicidal action. Despair, distress, and emptiness are all temporary rather than permanent states, although they do not seem to be so at the time. Several strategies for suicide prevention 1. Eliminate suicidal tools If suicidal thoughts have occurred, but not so much as to seek death wholeheartedly, a useful measure that can be taken immediately is to keep those items that might be used for suicide out of one's reach. Such items include sleeping pills, pesticides, rope, sharp knives or other weapons. Give them to a trusted friend, or to your own psychotherapist. To avoid overdosing yourself on medications for mental illness, keep only a few days' worth of doses in your home and have a friend or relative keep the rest of those pills. Although this practical strategy may seem to be a cut above the rest, it will greatly reduce the chances of actual suicide.2. Seek social supportContact with other people can act as an antidepressant and will give a person a temporary reprieve and respite from painful emotions. When suicidal ideation occurs, contact with others and gaining their support is undoubtedly crucial to prevent sinking deeper and deeper into the quagmire of suicide. Unfortunately, when individuals are at their most depressed and suicidal, they are also more likely to refuse help from others. Thoughts such as "I'm hopeless" and "No one will understand, they can't help me at all" will churn through the mind of the person, creating a sense of hopelessness. Therefore, even if you feel that it is futile to seek help at first, keep doing it and you will definitely get some response to this attempt, which will help alleviate the pain. Stills 3. Find a reason to live When suicidal thoughts and feelings arise, patients are sometimes overwhelmed by them. This is because suicide is somewhat of a cognitive process.

When people feel desperate, they begin to evaluate the pros and cons of suicide as a means of solving their problems. When they believe that nothing they do will get them anywhere good, they begin to think that suicide seems like a better option. Conversely, they will largely avoid putting suicide into action when they believe they can effectively cope with the problems in their lives or when they feel that others need to depend on them to live. In short, when people can find legitimate reasons to live, they can avoid suicide. Here are some reasons to consider: I'm afraid of pain and blood I still have many unfulfilled dreams I don't want my family to suffer because of my suicide No matter how bad it feels, it will all pass as long as I don't die ...... Treatment of bipolar disorder and PrognosisBipolar disorder can be treated with mind-stabilizing medications such as lithium, sodium bivalate, carbamazepine, and lamotrigine. Also, antidepressant medications or agents can be taken to control the patient's anxiety symptoms or problems with thinking. This type of medication requires patients to see a psychiatrist regularly and have their blood levels checked to ensure that the side effects of the medication do not cause too much distress to the patient's normal social life. Patients may also receive additional psychological support by participating in individual and family psychotherapy or attending support groups. Psychotherapy may help patients gain a more comprehensive understanding of their disease, learn to prevent relapses, monitor their mood and wake cycles, and function better at home and in the workplace.

If the patient has problems with substance abuse or alcoholism, it may also be helpful to participate in a support program such as Alcoholics Anonymous. Although patients may still experience high and low mood episodes in the future, with medication, psychotherapy, and support from others, episodes of mood disorders will become less frequent and less severe. With the help and support of others, the patient is actually able to take on considerable social responsibility and achieve many family and career goals.