Bipolar Disorder

Which Type of Bipolar Disorder do you have?

Petersmithuk

July 17, 2019

Which Type of Bipolar Disorder do you have?

Which type of bipolar do you have?

And how to live with it?

Bipolar Disorder Types Summary

Bipolar Type I (at least one bout of mania)

If you have just one bout of hyper-mania just called mania in your life then you classified as having bipolar type I, believe not you can have bipolar type I without ever having depression you just need to have the hypomania but most people with bipolar1 will also have bouts of depression. The extreme energetic, agitated and delusional behaviour of bipolar type I is very obvious to everyone around and will typically lead to a quick diagnosis.

Bipolar Type II (phases of depression and hypomania)

If you have phases depression but also at other times have phases of hypomania which are the opposite to depression during which you are very energetic, superconfident, very upbeat, very talkative but these phases are not so extreme that you could get sectioned or arrested or render you incapable of carrying on normal functioning then you would be classified as having bipolar Type II. The absence of the extreme mania often makes diagnosing bipolar Type II difficult people will go to the doctor when they are depressed but needed the doctor nor the patient may recognise the tell-tale signs of hypomania so people get diagnosed as having unipolar rather than bipolar depression and may be prescribed antidepressants which sometimes can have dire consequences.

Which type of bipolar disorder do you have?

Cyclothymia (phases of mild depression and hypomania)

In cyclothymia there are phases of mild depression as opposed to the severe depression of bipolar Type II and also periods of hypomania, cyclothymia may sound less serious and bipolar type I or two but it can be really very difficult to recognise and diagnose so may go untreated causing ongoing harm.

Mixed Effective State (what used to be called bipolar mixed states)

This is when you have both depression and mania together at the same time, it’s like being depressed but also having lots of energy, it’s a depressed and agitated state, I’ve had bipolar mixed states and from the inside it feels like having depression and anxiety at the same time however as I explained below bipolar mixed ages different from depression and anxiety at the same time, nevertheless it is a particularly unpleasant state to be in, it nearly killed me on several occasions.

Rapid Cycling and Ultra Rapid Cycling Bipolar

You can have rapid cycling with bipolar type I, bipolar Type II or cyclothymia. Rapid cycling is when you have four or more phases of mania/hypomania and depression in a year, some people have more and ultra-rapid cycling is having phases that can alternate every few days or even within a single day. The ever-changing and volatile nature of rapid and ultra-rapid cycling bipolar makes it extremely challenging but not impossible to treat.

Bipolar Disorder Not Otherwise Specified

This diagnosis has fallen out of fashion but I still think it’s useful, when someone has many traits of bipolar disorder but it doesn’t really fit into any of the other boxes, there are faces of mania that falls somewhere between hyper-mania and hypomania and the depression may be hard to quantify. Sometimes extreme mania can have such delusional qualities that it’s difficult to distinguish it from psychosis it may even have slight aspects that suggest schizophrenia, the point is real people don’t fit into clearly defined boxes.

N.B.: The description I’ve used do not strictly comply to conventional psychiatric classifications, my intention is to help guide you to a better understanding of yourself and your condition rather than help you determine the precise diagnosis, the point is in psychiatry precise diagnosis is often elusive.

My own diagnosis?

I started in my teens with bipolar Type II on about a three-year cycle, in my early 20s I had bipolar mixed states and short bursts of mania that although they were extreme would only last a day or two so didn’t quite meet the diagnostic criteria for bipolar type I, by my 30s and most of my life what have lived with would be classified as bipolar Type II with rapid cycling and occasional short bursts of borderline mania or hypomania on coffee. Today I live completely symptom-free on the maintenance regime of natural remedies.

Bipolar Type I

Bipolar type I is what most people think of when they think of bipolar syndrome. The hallmark of bipolar type I is the presence of one or more hyper-manic episodes, the condition will usually but does not have to also involve episodes of depression.

What is Hyper-Mania Like?

Common Symptoms of Hyper-Mania:

Unrealistic, grandiose beliefs about one’s abilities.
Feeling “high”, optimistic, euphoric alternatively feeling extremely irritable with outbursts of aggression.
Needing very little sleep yet still being extremely energetic.
Talking so rapidly that others can’t keep up.
Racing thoughts jumping quickly from one subject to another.
Impulsiveness.
Diminished ability to judge risk, acting recklessly without thinking about the consequences.
Heightened sexual desire.
Delusions and hallucinations in severe cases.
About 60% of people with bipolar will struggle drug and alcohol addiction at least at some point. See Treating Addiction with Natural Remedies

The hyper-manic state can be a dangerous and destructive condition, the person can feel overly self-confident to the point of behaving as if they are invincible, when manic one has diminished abilities to judge risks and make sensible decisions like a person under the influence of alcohol, however far from being slowed down like a drunk person the mind is speeded up.

In the hyper-manic state, the person often craves and engages in hedonistic behaviours (drugs, gambling, promiscuity etc).

The combination of perusing thrills, feeling over confident and a diminished ability to assess risks can lead a manic person into dangerous and harmful behaviour. The person may quit their job, start spending excessively, gamble their savings away or invest in an unrealistic new business etc.

The hyper-manic condition can also result in delusional thoughts and ideas when delusional thinking is present the situation is even worse.

Initially, the speeded up state may feel exciting but it can often become unpleasant, more agitated than euphoric.

The hyper-manic state doesn’t always end up in dangerous risk-taking however, it may manifest is simply extremely rapid almost nonsensical talking

The speeded up the erratic behaviour of the hyper-manic state is quite recognisable to psychiatrists and even non-medically trained people will most likely recognise that something is not right, this will ideally lead to the person receiving a correct diagnosis of bipolar type I much sooner than a person with bipolar type II with the milder hypo-manic state. Unfortunately, however, all types of bipolar often still take many years before they are correctly diagnosis and appropriate treatment started.

Another typical manifestation of hyper-mania is anger, irritability and aggression.

Bipolar Bad Moods

Part of learning to live well with bipolar syndrome learning to recognise when the manic aspect is active in your mind and knowing that your abilities to make sensible choices is not state of the art at this time, and choosing to wait until the manic phase has passed before doing anything important or expensive or risky. I’m not saying don’t have fun just have a preformed list (mental or written if needs are) of what’s Ok to do when you are manic and what’s not. Channel your cravings into

Have pre-set spending limits for manic phases if spending money is one of your manic things and indulge yourself within this budget, I wouldn’t, for example, allow myself to buy a new car when I’m manic, I’d end up making a really bad choice, going over budget and then the speed limit!

If your bipolar makes you crave the high of risky “adrenalin activities” this can lead to the pursuit of thrill-seeking activities such as gambling, excessive spending, drug taking, dangerous driving, promiscuous sex and even petty crime such as shoplifting. You could allow yourself to participate in any exiting adrenalin activity such as parachuting, bungee jumping etc. as long as it’s insurable! When I’m in a manic phase (I mainly only get hypo-manic) I seek and crave excitement so strongly it’s like needing a drug fix, when I don’t get my fix it can feel awful. The good news is that today you can quite easily participate in safely set up activities that that help you experience the thrill (dopamine high) of being terrified without any real risk of harming yourself and others.

If your dopamine levels are bouncing around due to bipolar disorder and you can obtain some release in this way make a point of deliberately timetable such things into your schedule whilst you are working on stabilising your dopamine levels with a tailor-made combination of treatments.

I believe a helpful technique to help people live with addictive personalities is not to try and stop the addictive nature but to redirect it into non-harmful behaviours, whilst at the same time improving dopamine balance in the brain and “remodelling” painful memories and feeling also involved in driving the addiction with cognitive hypnotherapy.

Living well with Bipolar Type I using natural remedies

The first therapeutic goal is establishing the ability to control the manic episodes, until you learn to take control of the manic episodes you can’t really or strongly use the antidepressant remedies because any antidepressant remedy whether natural or pharmaceutical has the potential to flip you straight up into mania and before too long when the mania ends you’re liable to crash back down into a depression. When I first start working with somebody with bipolar type I even if there are currently in a depression phrase I ask him to purchase and start taking the lease the background dose of the anti-mania remedies and implementing the anti-mania darkness therapy. Think of it like driving a car, increasing the neurotransmitters dopamine/norepinephrine with antidepressant remedies speeds you up, it’s like putting your foot on the gas pedal in a car which is exactly what you want when you depressed but a significant imbalance in the bipolar brain is the inability to keep dopamine levels under control and when you increase dopamine/norepinephrine levels instead of moving from low to normal they often overshoot and go straight up into elevated levels producing bipolar mania; in a car if you either don’t have a brake pedal you don’t have a use the brake pedal you shouldn’t be putting your foot on the gas pedal I mean to say when you learn to drive the first panel you learn how to use is the brake pedal.

You can’t make full use of antidepressant treatments until you know how to keep the lid on the mania, I learnt when treating my own bipolar disorder that the better I got at counteracting the mania the more I was able to make full use of the antidepressant remedies, eventually I was able to really aggressively treat depressions whenever I needed to knowing that I could safely prevent my dopamine/norepinephrine levels going too high and flipping me up into mania.

The other priority is to learn how to recognise the early warning signs of mania so that you can start nipping it in the bud before it even gets a hold of you; sometimes mania can come on rapidly without warning but one usually gets some warning signs for at least a several days beforehand and the opportunity to take early action to prevent a severe relapses. Once you can manage the mania you can start to treat the depression. Gradually over time, one can learn how to use combinations of natural therapies live well with bipolar syndrome.

Bipolar Type II.

In bipolar type II one does not experience full-blown hyper-manic episodes, the condition is characterised by episodes of a milder form of mania called hypomania and severe depression. Bipolar type I and bipolar type II typically manifest as very different conditions: bipolar type I is dominated by crazy hyper-mania with or without alternating depression and bipolar type II is typically dominated by severe often long-term depressions occasionally alternating with periods of productive, super energetic hypo-mania. These are just generalised characterisations and should be taken with a pinch of salt.

What is Hypo-Mania Like?

In the hypomanic state a person’s self-confidence creativity and energy are higher than normal, their work output can become significantly increased, they produce more paintings, writing, plan and start lots of new ideas and projects. Psychiatrists and psychologists always point out that the hypomanic person is unlikely to complete and follow through all the new ideas and projects they start, although this is true it’s not the only way to look at this and is in opinion is a negative point of view. Despite not all the projects they start being completed the hypo-manic state is a highly productive time such that many people with bipolar type II become high achievers in professions like medicine, law and possibly business although the high risk-taking tendencies in bipolar and good money-management don’t go together, so in business they are more likely to be a boom and bust rather than a sustained growth entrepreneur; they may be great in a creative capacity during the start-up phase of a new venture but ill-equipped for consistent maintenance. An artist with hypo-mania may start a dozen paintings all at the same time and by the end of the hypomanic phase, they’ve completed or nearly completed four paintings with another eight half-done. Why focus only on the half-done paintings rather than the enormous amount of work they’ve person has achieved. Given that people with bipolar Type II have to live with hypo-mania let’s focus on the positive productive benefits it can give us rather than the negative.

It’s Only Mental Illness When It Harms You

I appreciate what psychiatry is trying to do in defining the characteristics of mental illnesses so that we can understand them, but an unfortunate consequence of this when you live with mental illness is that one can start to worry or feel that perfectly normal and harmless behaviours and thoughts are signs of illness. For example, a healthy person never diagnosed with any mental illness could be a daydreamer and enjoy lots of fantasies, or be a bit obsessed with stamps or football statistics, or have some eccentric hobby and no one’s worried that they have mental health. If on the other hand, a person has had a diagnosis of mental illness even if they have successful recovery or learned to manage the condition they may feel worried and inhibit normal behaviour that may NOT pose any problem to them at all and other people can get away with.

I suggest it’s important to understand the warning signs that you may be experiencing relapses in your condition, however, focus on only learning those characteristics of your condition that potentially harmful then accepting and allowing everything else without feelings of guilt, judgement or shame.

Another example to illustrate the point I’m making is what’s the difference between having obsessive-compulsiveness and having obsessive-compulsive disorder (OCD)? In simplistic but practical terms the difference is the presence or absence of harm to the person’s life, there’s nothing wrong with being obsessive and compulsive however eccentric it may make you appear; in the right context these qualities can be gifts and assets but when they are so intense that they cause feelings of anxiety, take over and harm your ability to live a full and healthy life in some way that’s a mental health disorder.

I’m not suggesting that the way psychiatry categorises behaviour and ways of thinking isn’t useful, without it, we couldn’t identify mental illness. For example hypo-manic activity is often simply presumed to be a healthy upbeat, outgoing personality, however when put in context with bouts of depression it enables us to see that the persons health problem is bipolar type II with periods of dopamine deficiency (depression) and dopamine excess (hyper-mania), as opposed to a person who has an upbeat, outgoing, energetic personality but is prone to depression perhaps from serotonin deficiency. Actually bipolar type II is often misdiagnosed as endogenous depression, I know from personal experience because it happened to me for years.

Let’s not forget that point to a medical diagnosis is to be useful and help you not hinder you, it’s just a starting point to lead us to practical solutions. So once you’ve gotten your diagnosis make it work for you and not against you. Take on board only those aspects of the diagnosis that help you get the right treatment and keep you well, that help you and the people around you to understand your behaviour and to help you make career and social choices that suit your nature. Only focus on the parts of a mental health diagnosis that help you to lead a better life and ignore the parts that distress and limit you.

For example 10 days ago I intended to write this page but instead simultaneously started three writing projects and produced 9000 words in the first four days, as I then tried to the projects I got other ideas and pursued them producing another 5000 words and lots of extracurricular reading over the following week. It was only when my sleep cycles began to become delayed and rather than feeling happy with the amount of writing I was doing I felt unhappy because I couldn’t get it all down quickly enough and anxious as to how long this is all going to take me that I decided the hypo-manic creative condition I was in was beginning to get out of control, move towards hyper-mania and needed to be treated. Within a day of making this decision and taking taurine, glycine, theanine, tryptophan and melatonin to induce deep sleep I was no longer hypo-manic and felt inclined to work on one thing at a time, tidying up and finishing off the 14,000 words plus research I’d just produced. I’ve heard psychiatrists say that the deluded manic patient starts lots of unrealistic projects that they never finish, I disagree this episode was definitely a manifestation and indication of the bipolar illness I have but it was productive in fact highly productive and I will eventually use and finish the material I produced. We need to be sensible how we use medical diagnoses, diagnosing and recognising bipolar behaviour is useful if it helps you to understand your condition and get the right treatment, but it’s not useful when it lead you to think that all your behaviour is part of a sickness that needs to be cured and stopped. I suggest that successfully learning to live with and manage bipolar syndrome only focusing on aspects of the condition that are uncomfortable or harmful, anything that is not uncomfortable or harmful doesn’t need to be considered unhealthy and medicated away, but most it just informs you what phase you condition is in and helps you to keep an eye on it.

Living well with Bipolar Type II using natural remedies

The primary therapeutic goal is usually to boost the deficient neurotransmitters causing depression. The depression in bipolar type II may be primarily due to a deficiency of dopamine and boosting serotonin may not alleviate the depression. Increasing serotonin levels, however, may improve one’s sleep which is also important to managing bipolar syndrome. Unfortunately increasing deficient dopamine levels to treat depression poses a risk of inducing mania, agitation and insomnia so it is important to learn how to manage hyper and hypo-mania before one starts boosting dopamine levels. The good news is in practice there are techniques one can use to set up this safety net within weeks and then start on combatting the depression. SEE TX

We’ve known how to boost deficient serotonin and dopamine with natural remedies for years, I’ve been doing it since 1986, and this is great for treating endogenous depression. It has not been so easy until recent years to find effective non-drug solutions to treat mania i.e. to down regulate excessive dopamine activity in the brain. Today, however, I have several effective and viable solutions which can be used occasionally and individually for gentle maintenance or combined altogether for an intensive knockout punch to terminate a hyper-manic attack.

I have tried and tested all of these remedies and approaches on myself before introducing them into practice where they have proved to be practical helpers; to do this I give myself an excessive dose of bright light therapy or SAM-e both of which will reliably induced a hyper-manic state in the within a day and then try the new anti-mania therapy to see how effectively it terminates the hyper-manic state. I’m fully aware that my personal experiences do not constitute scientific research, but neither my patience or I have the time to wait for conventional medical research and development into nondrug treatment for the bipolar syndrome. I wish conventional medicine would invest in the R&D needed to develop our understanding of how to down regulate excessive dopamine and control the hyper-manic state using amino acid therapy and total darkness therapy, but I frankly doubt that they ever will because the costs of research are so high and the potential profits from these nondrug and non-patentable approaches is so low. Conventional anti-mania pharmaceuticals are better than nothing but they can make you feel awful, the natural therapies don’t make you feel awful and they offer you tremendous flexibility to vary your dosage and combination of Meds to manage your individual condition on a day-to-day basis.

Update January 2013

An interesting new approach has been trialled on a small scale at Oxford University. Patients who are hospitalised for mania were given a drink containing all the normal amino acids found in an amino acid formula but with the tyrosine removed. The amino acid tyrosine is the precursor or building block for the neurotransmitter dopamine. This preliminary trial showed dramatic results with improvements beginning within hours and all the patients being sufficiently well to be discharged within a week. Using this technique it may be possible to have a non-dopamine containing amino acid drink in your fridge that you could use to down regulate excess dopamine as and when you feel your manic symptoms getting worse.

I have not yet tried this formula but hope to do so and would like to do further research; an alternative approach to achieve similar results is to take branched-chain amino acids which is just a combination of three amino acids the effect of this formula is to deplete DLPA, tyrosine and dopamine levels in the brain see Bipolar Neurotransmitters and How to Treat Bipolar Mania with Natural Therapies.

Rapid-cycling Bipolar

A popular misconception about bipolar syndrome is that all bipolar people are always either manic or depressed. Some people with bipolar syndrome change between the different phases of bipolar (mania and depression) only occasionally with symptom-free periods in between.

Alternatively, some bipolar people do get what is called rapid cycling when they have four or more cycles of mania and depression within a year. It’s also possible to have extremely rapid cycling, perhaps several times in a week or even within a single day. Establishing a treatment regime with rapid or ultra-rapid cycling can be very challenging. The problem is that antidepressant medications (both pharmaceutical and natural) can lift a person out of depression then flip them straight up into mania, whilst medicines that treat the mania may move a person straight down into a depression. The new technique of total darkness therapy may turn out to be an amazing solution to this problem.

Total Darkness Therapy

A little-known treatment technique appears to be a breakthrough to treat and manage rapid cycling bipolar. It is not fully understood but research shows that in bipolar syndrome there is a disturbance in the same part of the brain that regulates sleep-wake cycles and this part of the brain is influenced by external light and darkness. [see Moving Sleep Cycles] Exposure to bright light has proven antidepressant effects and like all antidepressants can potentially induce mania in people with the bipolar syndrome. In some way that we don’t yet understand it appears that total darkness has a therapeutic effect on mania and may be especially useful in cases of rapid cycling.

Before I discovered how to use total darkness therapy to manage rapid cycling I would use natural antidepressant remedies and anti-mania remedies at the same time to gradually wrestle the condition into a state of balance. I still use this type of combined therapy but adding total darkness therapy has made managing the condition much easier. Total darkness therapy may turn out to be superior at managing rapid cycling bipolar to drug therapy and without any toxic side effects. The initial stages of total darkness therapy are somewhat demanding because of the length of time one has to spend in total darkness however once the condition has been stabilised the treatment time can be reduced to 8 or 9 hours of normal sleep in 100% darkness which requires no effort at all. See total darkness therapy [UNDER CONSTRUCTION] and www.psycheducation.org

Bipolar Syndrome with the Mixed States

It is possible for a person to be in a manic state of high energy, speeded up thinking etc. and experience feelings of depression: self-loathing, despair, isolation, painful unhappiness at the same time. Mixed states in bipolar syndrome are not uncommon and for this reason, I personally still prefer the old-fashioned name for the bipolar syndrome which was manic depression. In my view, the name bipolar implies the condition consist of being in one poll all the other whereas manic depression implies that one can be manic and depressed at the same time.

The combination of lots of energy drive for new ideas with despair and painful depression puts the sufferer at a potentially high risk of suicide. Deciding how to treat a bipolar mixed state is a difficult judgement call, generally speaking when you treat mania it will initially cause depression and vice versa. With rapid cycling I have no hesitation in choosing to bring down the mania first then as quickly as possible dealing with the ensuing depression; however in mixed states the presence of mania may make it difficult to judge how intense the depression is and the person could potentially already be seriously depressed and suicidal, as you bring down the mania the depression is likely to intensify and they may still have enough residual energy to act rashly. Alternatively giving antidepressants to a person in a manic state could fuel the mania and is contraindicated. Combine therapy is the only real option, however, simultaneously combined anti-mania and antidepressant medication are unpredictable and difficult to gauge. At least initially such treatments may result in rapid cycling with either the antidepressants intensifying the mania or the mood stabilisers intensifying the depression. Eventually, balance can be achieved but until it is the safest recommendation is that the person with mixed states is hospitalised and put on suicide watch. Bipolar syndrome kills somewhere between 1 in 10 and 1 of 7 people with the condition, so we must take these risks seriously.

Cyclothymic Disorder

Sometimes described as “bipolar light”, there are periods of hypomania with brief periods of depression not as severe as major depression. The condition is still nevertheless disruptive to a person’s life, particularly because it may never receive the proper diagnosis.

Misconceptions about Bipolar Syndrome

It is the presence of mania that distinguishes bipolar syndrome from endogenous depression but it’s mistaken to think that mania is always the dominant feature of the condition as is often portrayed. For some individuals the condition may be dominated by long and severe depressions and the mania may be only an infrequent occurrence.

It’s also a mistake to think that people with bipolar are always flipping from one pole to other, either depressed or manic. Some people do switch frequently this is called rapid cycling, but as just mentioned sometimes the condition consists of long periods even years of depression and other people only have manic episodes. So although mania is the distinguishing diagnostic feature its role in the day to day life of someone with bipolar may or may not be very significant.

If a person has just one manic episode in their life they are classified as having bipolar (or bipolar type I) according to psychiatric medicine, so strictly speaking that is how I am classified myself because once in the early 80’s I was hyper-manic for about three days and I’ve been slightly hyper-manic for a few hours at a time occasionally since then. However the classic description of bipolar type I would not at all describe how this condition manifests in my case, when I tell people who supposedly know what bipolar is (medics, psychologists etc.) that I have bipolar syndrome I notice their understanding of the condition is often limited to only the hyper-mania aspect of the condition. However on an on-going year to year basis what I live with is best described by the symptom picture of bipolar type II that does not include hyper-mania.

Take What’s Helpful from a Diagnosis of Bipolar Syndrome and Reject What Is Not

What Is Normal and What is Mental Illness

I’ve asked a lot of people who don’t have bipolar syndrome do you sometimes engage in grandiose fantasies in your mind? Winning the lottery, being married to a celebrity, being elected president of the world or being the next Bill Gates and most people say they do, but if you have a diagnosis of bipolar syndrome you are told that these types of thoughts are part of mental illness which can make you feel bad and worry about having normal thoughts, some of your fantasies may even be good ideas that one day with enough focused hard work you may achieve. it can be difficult for someone that has a mania to determine the difference between normal healthy fantasy and signs of mania, I suggest it’s not helpful to feel afraid of indulging in normal fantasies and feel good pleasures because psychiatry includes them to be a sign of mania. Ask yourself is the time you spend engaging in these thoughts and behaviours a waste of time even if they feel good OR do they lead you to productive activities and goal seeking; does the way your mind work lead you to pursue potentially harmful behaviour OR healthy safe fun. e.g. spending lots of time focusing on your health may appear to be obsessive to others and if obsessing about it does genuinely cause you stress and that’s not ideal however what’s the alternative being unhealthy, being highly focused on the goal would be similar. You don’t have to try to be normal (I know what’s normal? But you know what I mean) what you have to do is figure out ways of eliminating harmful aspects of bipolar syndrome and living maybe even enjoying the rest of it, play the cards you’ve been dealt live the life that feels normal for you

I remember regularly throughout my 20s being negatively told that I was too intense or serious, my response to this criticism was I tried to change, to conform and become someone I wasn’t. I didn’t know at that time that I have the bipolar syndrome and that the being somewhat manically intense is part of who I am and that trying to change this kind of fundamentals isn’t a viable option so a much better idea than trying to change is to channel myself into something useful. Today if someone said that I was too intense or serious I’d say with a big smile, yes I am, I like it! (OK that’s not entirely true the last time someone said to me they felt I was always too intense I replied I always felt they should wake up and smell the coffee), this worked completely I was left without feeling there was something wrong with me and he looked down and into himself.