Bipolar Disorder: Signs, Symptoms, and Seeking Help - Psychiatry

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Bipolar disorder?


Recently, I have been experiencing extreme emotional fluctuations.
Normally, I feel very happy and believe that nothing can defeat me.
I have thoughts and behaviors that make me feel like a genius, and I often express to my family and friends how smart I am.
However, I also experience intense irritability; I can become enraged over minor issues, screaming, banging on tables, and kicking things.
When others make mistakes, I feel compelled to force them to apologize.

At times, I engage in self-harming behaviors without realizing it.
Recently, I have developed a tendency to argue and debate with others, and I increasingly enjoy expressing my opinions.
Yet, not long ago, I was in a state of extreme depression, feeling like an idiot and believing I couldn't do anything right, even considering giving up on my studies.
My academic performance has plummeted from being in the top five to struggling significantly.
My family struggles to understand my low moods, and I sometimes have difficulty distinguishing between dreams and reality.

I occasionally find myself crying secretly and avoiding communication with others.
There are moments when I suddenly feel that my friends and family, with whom I am talking, seem very unfamiliar, to the point where I cannot concentrate on what they are saying and instead find myself gazing into the distance.
This sense of unfamiliarity has led me to avoid and reject communication with them, resulting in the loss of three close friends (these situations occurred at different times during middle school, not all at once).
This stark contrast in my emotional state has been incredibly overwhelming for me.

Now, as a sophomore in high school, I am also facing the pressure of upcoming exams, and these behaviors are becoming more pronounced and increasingly out of control.
When I confide in my friends, they believe my behavior is normal and suggest that I am overthinking things, but I am deeply confused about whether this is truly normal.
Additionally, four close relatives in my family have a history of bipolar disorder: one committed suicide, two have been hospitalized, and one takes medication regularly.
Among them, my older sister is the one who has been hospitalized.
I feel that I need professional advice.
Thank you.

CC, 10~19 year old female. Ask Date: 2017/06/18

Dr. Li Zhengfeng reply Psychiatry


Hello: As mentioned in the letter, there are indeed significant emotional fluctuations; however, an online diagnosis is not possible.
It is recommended to consult a specialist.
I hope this is helpful to you.

Reply Date: 2017/06/18

More Info


Bipolar disorder, also known as manic-depressive illness, is a mental health condition characterized by significant mood swings that include emotional highs (mania or hypomania) and lows (depression). Understanding the signs and symptoms of bipolar disorder is crucial, especially in the context of your experiences and family history.

From your description, it appears that you are experiencing symptoms consistent with bipolar disorder. The manic phase may manifest as elevated mood, increased energy, irritability, and impulsive behavior, which can include aggressive outbursts and self-harm. The depressive phase, on the other hand, is characterized by feelings of worthlessness, hopelessness, and a lack of interest in activities that once brought joy. The fluctuations between these two states can be distressing and can significantly impact your daily life, relationships, and academic performance.

Given your family history of bipolar disorder, it is important to take your symptoms seriously. The fact that several close relatives have experienced severe manifestations of this condition, including hospitalization and suicide, suggests a genetic predisposition that may increase your risk. Mental health conditions often run in families, and having relatives with bipolar disorder can heighten the likelihood of developing similar issues.

Your experiences of feeling like a genius during manic episodes, followed by severe lows where you feel incompetent, are classic indicators of bipolar disorder. The intense emotional responses, such as rage over minor issues and the feeling of disconnect from friends and family, further highlight the need for professional evaluation. The inability to differentiate between dreams and reality, as well as the sudden emotional shifts, can be particularly troubling and warrant immediate attention.

Seeking help from a mental health professional is essential. A psychiatrist or psychologist can provide a comprehensive assessment, which may include interviews, questionnaires, and possibly a physical examination to rule out other medical conditions. Treatment for bipolar disorder typically involves a combination of medication and psychotherapy. Mood stabilizers, antipsychotics, and antidepressants are commonly prescribed to help manage the symptoms. Therapy, such as cognitive-behavioral therapy (CBT), can also be beneficial in developing coping strategies, improving emotional regulation, and addressing negative thought patterns.

In addition to professional help, there are several self-care strategies that can support your mental health. Establishing a routine, engaging in regular physical activity, maintaining a balanced diet, and ensuring adequate sleep can help stabilize mood. Mindfulness practices, such as meditation and yoga, may also provide relief from stress and anxiety.

It is crucial to communicate openly with your family about your feelings and experiences. They may not fully understand what you are going through, but sharing your struggles can foster support and understanding. If you feel comfortable, consider involving them in your journey to seek help, as their support can be invaluable.

In summary, your symptoms and family history suggest that you may be experiencing bipolar disorder. It is vital to seek professional help to receive an accurate diagnosis and appropriate treatment. Remember, you are not alone in this, and there are resources and support available to help you navigate these challenges. Taking the first step to reach out for help is a courageous and important decision for your mental health and well-being.

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