Bipolar Disorder
Bipolar Disorder contains both manic and depressive episodes. There are different types of Bipolar Disorder, with Type 1 showing both mania and depressive episodes over a lifetime. Bipolar Disorder Type 2 includes a manic episode and then depressive episodes over a lifetime. Cyclothymia is a lower-level episode with less manic symptoms that present, along with depression. There is an unspecified level, where more observations are needed to determine symptoms.
A Manic Episode
Bipolar disorder is a mental illness that causes dramatic shifts in mood, with highs, or mania, and low moods and low energy or depression. The mania symptoms include a heightened mood that may appear happier, more intelligent, spiritual, and talkative. The mood continues to increase causing problems with concentration, racing thoughts, making poor decisions, overspending, irritability, arguing, fighting, and sometimes getting arrested for reckless behaviors. People can get into abuse substances, and alcohol, and go to parties. Suicidal thoughts occur when mania gets too chaotic.
What are Sadness, Depression, and Grief
Emotion | Sadness | Depression | Grief |
Duration | Shorter period | Ongoing, longer period | It starts intense, and comes in waves, then lessens over time. |
Self-Esteem problems? | Healthy self-image | It affects behaviors and the development of Self-blame, low self-image | Healthy self-image |
Attitude, Mindset changes? | Hopeful | Hopeless is continual, shame, guilt, worthlessness, helplessness | Anger, Denial, guilt, bargaining, depression, acceptance, and moving forward. |
Able to function? | Ok with some counseling | Difficulties, impairments at home, work, school | Slowed activity, reduced energy |
Relationship problems? | Able to keep relationships | Withdrawal and isolation from others, not accepting help | Focus inward and on the deceased, or the loss |
Thoughts | A certain incident | Self-critical thoughts Negative thoughts | Focused on the deceased or the loss |
Treatment | Support | Medications, psychotherapy, support groups, a Team Approach | Grief and loss support group, psychotherapy |
Grief, Loss, and Depression
Grief and loss can come when people lose support that previously was there. Group therapy members mentioned examples.
I can’t talk to my sibling about my mental illness. They say that it doesn’t exist, but I know it does. They told me that the medications that the psychiatrist prescribed were dangerous for me and would damage my body.
I told them that my mother had schizophrenia and they say she was just having troubles like everyone else. I know she hallucinated because I have them too. I have voices now; I understand how difficult it was for her. If I didn’t get help from my psychiatrist and the medications, I would be as bad as she was.
My parents could not take care of us kids, so my grandma had to do it. I didn’t have a mother really when I was growing up. My dad wasn’t in the picture.
Grief and loss issues can challenge a person’s spiritual views and create new ideas. Grief and loss issues do not go away if they are ignored. They wait at our front door each day until we are ready to re-examine our beliefs and what we value at the moment. Grief and loss demand that we acknowledge what was lost. This may be best done with a therapist.
People with mental illness face societal and cultural stigmas where they have been told God is punishing them for having a disease. Sometimes believe that they are cursed by God or that God has abandoned them. Their level of pain and suffering returns each day, and their depression, anxiety, and psychosis symptoms remind them of negative thoughts regularly.
Suffering, grief, and loss are not encouraged in the US culture. People are supposed to grieve for two weeks then go back to their usual activities and be happy. If you are not happy, you are encouraged to indulge in dessert, food, drink, or activity to allow yourself to feel more pleasure (Hofstede 1980, 2016). Without the experience of suffering, we would not gain wisdom.
Grief and loss issues are different from depression. Grief and loss can challenge our values and transform us. It affects our spirituality and tests our faith. Grief and loss issues cause us to question our purpose in life. Grief and loss issues question our life purpose and present issues that may need to be forgiven. This process affects spirituality and faith.
Depression Feelings, PTSD and Psychosis
The group discussed problems with PTSD and psychosis symptoms and how they interfere with concentration. The group explained how flashbacks and nightmares can make the voices and visual hallucinations more intense. One participant talked about being under stress from an argument with another resident in the building and how the voices were criticizing. the participant talked about how they were extremely anxious and depressed and sometimes the voices insulted and told them they didn’t deserve to live. The discussion raised issues of suicidal thoughts, intent, and plans. The group discussed the participant’s value to the group and how they didn’t want anything to happen to this person.
The group talked about using music to help. One participant wore earbuds to hear talking or music helped drown out the voices. The group included participants who had different ethnicities and sexual orientations.
The group emphasized that it was important to notice and tell a therapist about the PTSD and psychosis symptoms. The group asked about different symptoms since they interacted with many feelings, thoughts, actions, and sensations.
Symptoms to observe and notice:
PTSD _____________________________________________________________
Psychosis _____________________________________________________________
Physical Sensations _____________________________________________________________
Thoughts _____________________________________________________________
Feelings _____________________________________________________________
Actions _____________________________________________________________
Images _____________________________________________________________
The participants did a check-in hour, and some told others what they noticed and observed with their moods and feelings during the day and throughout the week. The group discussed how moods or symptoms could change when they miss a dose of medication, are under stress, have poor sleep, experience substance use, or have arguments.
Investigate Losses that I have experienced…
(Highlight or circle them and show this to your therapist)
___ Childhood abuse
___ Bullying
___ Loss of innocence from childhood or early adulthood
___ Unable to experience pleasure due to trauma
___ Relationship loss, break-ups, friends moving away, loss of contact,
___ Loss of a job
___ Loss of ability to attend college classes
___ Loss of contact with colleagues, retirement from a job
___ Assaults, robberies, domestic abuse
___ War, combat, veteran activities involving violence
___ MIA Missing In Action, do not know where someone is
___ Death of a loved one, suicide, homicide,
___ Death of a pet
___ Loss of physical health functioning
___ Loss of independence, dementia
___ Loss of functioning due to recurring serious mental illness
___ Loss of functioning due to physical health change, car accident
___ other _____________________________________________________________
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