What Happens After a Bipolar Diagnosis?

Bipolar disorder is a mental health condition that affects about 2.3 percent of the United States population (DSM V-TR, 2022, pp. 146, 155). It is the most heritable mental illness as it is inherited from the family. Up to sixty percent comes from genetics. Even though an individual might be susceptible to bipolar disorder from family history, it does not necessarily mean that an individual will develop bipolar disorder later in life.

Various factors influence the development of bipolar disorder: Did the person have adverse childhood experiences? Does the person use legal and illicit substances? Did the person experience trauma from accidents, natural disasters, or a sexual assault? Did the individual experience major stressors, such as the death of a loved one? Did the person undergo a major medical procedure, like childbirth?

Positive responses to a bipolar diagnosis

For some people, a bipolar diagnosis comes as a relief, because they could not understand why they felt euphoric for up to six weeks, had inflated self-esteem, felt pressured to speak, were agitated constantly, had racing thoughts, required three or fewer hours of sleep a night, and engaged in high-risk activities with potentially painful consequences (i.e. one-night stands, giving money to Nigerian princes, and running up their credit cards).

In addition to these manic episodes, they also experience depressive symptoms (lack of energy, sad mood, diminished interest in activities, weight loss or gain, sleeping too much or too little, feeling worthless and/or hopeless, unable to think or concentrate, and suicidal ideation). These individuals experience a sense of embarrassment and shame from their behaviors during a manic episode. They will hopefully be motivated to manage their bipolar disease well.

Carrie Fisher is best known for her role as Princess Leia in the Star Wars movies. She was diagnosed with bipolar disorder. Like many individuals living with bipolar disorder, Fisher struggled with alcohol and substance use disorder. Once she abstained from alcohol and illicit substances, she became a well-known advocate for mental health. Along with her advocacy for mental health, she also wrote screenplays and continued to act in movies.

Toward the end of her life, a cruise ship company hired her to present plays on one of their ships. As she was reading, a passenger suggested that she needed to go to an AA meeting. Fisher thought about it and immediately knew that she was having a manic episode (feel euphoric, racing thoughts, pressured speech, etc.).

At this point, she canceled all future performances on the cruise ship and isolated herself in her room until the ship reached port after contacting the ship’s doctor who monitored her health and contacted UCLA Psychiatric Unit.

Upon reaching port, Fisher voluntarily went with UCLA hospital staff to the UCLA Psychiatric Unit. Her psychiatrist discovered that her medications were not as effective, made changes the appropriate changes, observed her and released her from the hospital after three days.

Negative responses to a bipolar diagnosis

To other people, a bipolar diagnosis feels like a life of drudgery, because they must take medications, their mood will be more controlled, or their creativity will be squashed. They experience great ambivalence about taking medications and engaging in therapy to help manage their moods. Those with bipolar disorder tend to be talented, artistic, and creative. They often become artists, painters, actors, or are otherwise involved in creative arts.

A modern example of an ambivalent individual with bipolar disorder is the artist formerly known as Kanye West. West is a Grammy-winning, popular rap artist who has sold millions of records. It was apparent by his numerous public outbursts that he was experiencing manic episodes (inflated self-esteem, non-stop energy, increased goal-directed activities, pressured speech while talking, etc.).

Before their divorce, Kim Kardashian, his then-wife, had begged West to get help (New York Post, February 15, 2022). His frequent mood swings between manic and depressive episodes likely contributed to his divorce. Around the time of his divorce, West stated that he struggled with bipolar disorder.

It is beyond dispute that West is a talented musician based on his record sales. Many individuals like West crave the creativity that comes with mania and refuse to let go of it (Manchester 1824, 29 November 2018). However, he has paid a high price for his ambivalence toward medication and therapy to manage his bipolar condition.

In addition to his divorce described above. West’s popularity has waxed and waned over time as more individuals have been exposed to his bizarre behaviors, i.e. running for president, jumping on stage with Taylor Swift, etc. Individuals like West will experience the revolving doors of psychiatric hospitals as they ride the rollercoaster of mood swings.

In others, a bipolar diagnosis unleashes strong emotions, because they feel that they cannot live normal lives without being hospitalized and that other people may have to intervene on their behalf. Bipolar disorder can limit one’s life choices (the inability to join or stay in the military, qualify for some government jobs that require secrecy, etc.), or their moods fluctuate constantly.

It appears to them that their lives are always interrupted. It seems unfair that someone may have to limit their freedom by making decisions for them. They feel disappointed that their career choices may be limited. It frustrates them to endure the mood swings of bipolar disorder.

In addition to Carrie Fisher above, many celebrities have been hospitalized due to bipolar disorder interrupting their careers (Page Six Team, March 11, 2021). Amanda Bynes is a childhood actor who was diagnosed with bipolar disorder requiring her parents to intervene on her behalf to get medication treatment.

Former Major General Gregg Martin was forced to resign from the United States Army because his manic behaviors were interfering with his ability to do his job. Mel Gibson admitted that his struggle with bipolar disorder has caused some “really good highs, but some very low lows” (Russell, L., August 28, 2022).

Getting real help for bipolar disorder

In summary, it might be a relief to receive a diagnosis to explain why your moods fluctuate. However, bipolar disorder is not cured by reading a self-help book from the Oprah Winfrey Book Club or watching an episode of Dr. Phil. Diagnosis and treatment of bipolar disorder should be left to qualified mental health professionals.

Medications, like lithium, must be monitored closely for side effects by a qualified medical professional. Working with a mental health professional can decrease the chances of a severe manic or depressive episode.

Early detection of bipolar disorder can reduce the impact and the overall prognosis of bipolar disorder. Unfortunately, bipolar disorder is sometimes hard to detect, because individuals do not see their doctors during manic episodes. During these manic episodes, individuals think that the symptoms are normal because manic episodes can be subtle.

Hopefully, the several examples provided above will encourage individuals with bipolar disorder and their families. It is possible to have a successful bipolar disorder treatment. While bipolar disorder may place limits on one’s creativity and occupational choices, it is entirely possible to live a fulfilling life. As illustrated above and in the popular media, celebrities have used their status to highlight the challenges presented by bipolar disorder.

Negative effects of bipolar disorder

Even celebrities, like Kanye West, who have been ambivalent toward mental health treatment, can still function in society. However, without proper treatment and medication, the mood swings will return. As a result, individuals will experience even higher “highs” and lower “lows.” Suicide, hospitalizations, and developing psychiatric features are common for individuals with untreated or improperly treated bipolar disorder.

Despite staying in a psychiatric ward or an emergency room, individuals with bipolar disorder will sometimes use alcohol and illicit substances. The result is that individuals with bipolar disorder also develop a substance use disorder. Individuals with bipolar disorder and substance use can become trapped in a vicious circle of substance abuse that triggers the manic and depressive episodes, and they may try to use substances to manage the mood swings.

Treatment options

When others intervene the behalf of an individual with bipolar disorder, the individual is often sent to the emergency room or placed in psychiatric wards. Going to an emergency room for an acute manic episode or spending a long time in a psychiatric ward are unpleasant experiences for these individuals.

Emergency room doctors prescribe enough medications to incapacitate the individual completely for 24-48 hours to interrupt a manic episode. A psychiatric ward may keep an individual for up to 180 days in the state of Washington to ensure proper treatment.

Because this writer has gone to the emergency room and psychiatric facility countless times, he has seen both chemical and mental health treatments for bipolar disorder. It would be preferable to assist individuals with bipolar disorder with the minimum required amount of medication.

It is not the long-term goal of all mental health professionals to keep individuals with bipolar disorder doped up or warehoused in mental health facilities. We would prefer that individuals with bipolar disorder find ways to manage their moods with the minimum amount of required medication.

Reducing the amount of required medication and Cognitive Behavioral Therapy can help these individuals to correct overly positive or negative thinking. Staying active through exercise can help with the depressive symptoms. These types of therapies are available from clinicians at Spokane Christian Counseling.

We can help

We understand that mood swings are something that cannot easily be controlled. Since bipolar has a large genetic source, we understand that individuals cannot control their genetic makeup. Spokane Christian Counseling is a safe place for individuals experiencing bipolar disorder. Please let us know how we may assist you.