Assessment and services for bipolar disorder:
(Please note: Information provided here is for education purposes and not intended for diagnosis of a mental health condition)
Why consult with a mental health professional?
Do you suspect you have a bipolar disorder and want some assessment to determine if this might be true?
Have you been diagnosed with bipolar disorder and want help learning how you can better manage this condition?
Have you received a bipolar disorder diagnosis but aren’t confident it’s correct and want further assessment and exploration to feel certain whether this diagnosis truly fits?
These are some of the reasons I consult with clients who want to learn more about bipolar disorders – how they’re recognized, what it means to have them, and how they can be treated and managed.
A few words about what bipolar disorder may look and feel like
Many misconceptions exist about what bipolar disorder is and what it means to live with a bipolar disorder. One thing I feel is important to understand is that bipolar disorder exists on a continuum. It may look and feel very different in different people. One person may have a bipolar disorder with mild symptoms that are hard to spot, while someone else may have more profound symptoms which cause much more distress and disruption in functioning. Bipolar disorder is not always easy to diagnose. There’s nothing like a blood test or genetic test for bipolar disorder that can determine if you have it. If only it was that simple!
Many of us have seen sensationalized and often inaccurate portrayals of people with bipolar disorder in movies and on television. This hasn’t helped the public’s understanding of what this condition looks like and its implications. People living with bipolar illness often know the pain of depression and the way it undercuts one’s motivation and makes it deeply difficult to enjoy life. Bipolar depression can bring with it a level of irritability or restlessness that makes being around others very difficult and interferes with one’s ability to focus. Other aspects of bipolar depression may include exhaustion, sleeping excessively, and feeling emotionally and physically weighed down.
Individuals with a bipolar disorder can go a long time misdiagnosed as what is called unipolar depression (more typical clinical depression) where more subtle indicators of bipolar are missed or a patient/client doesn’t think their symptoms that aren’t directly related to depression are noteworthy or problematic so don’t report them. Typically, people with a bipolar condition are asking their physician or a therapist for relief from depression and that is what gets focused on.
People often know bipolar may have something to do with “mania” or “manic episodes” but may not be aware what is actually meant by these terms. Symptoms might include
things like unusually high energy, talking more rapidly than normal, needing much less sleep than usual, and jumping from one thought to another quickly. Other possible changes include notable lapses in judgment and increased impulsivity, increase in risky behaviors, a marked increase in sexual desire or behavior, and sudden grandiosity – an unrealistic over-estimation of one’s skills, abilities, or importance. A key factor here is that we’re looking at obvious changes from a person’s typical or normal way of being and feeling that last for a matter of days not hours. It is more than an individual being changeable, moody, or angry off and on within a day. These episodes may be marked by sustained elevated moods – feeling especially good, self-confident, and happy. Alternately a person may not feel extremely good but may feel edgy and irritable.
It’s important to note that not all bipolar conditions show up with well-defined or obvious manic or hypomanic indicators. For some, the prominent feature of the illness is recurring episodes of depression interspersed with periods of normal functioning and occasional appearance of mild or subtle indicators that suggest there is more going on than a depressive condition.
It’s not uncommon for people’s pattern of drug and alcohol use to vary along with shifts in their bipolar condition, where they may be “self-medicating” to try to manage depression or using substances to magnify feelings of acceleration or euphoria when they have excessive energy.
The personal and relationship costs of untreated bipolar
Individuals suffering with bipolar disorder can feel out of control, speeded up, distractible, uneasy, weighed down and slowed down, irritable, euphoric, and exhausted. Bipolar disorders can involve a great deal of personal pain and great personal cost, causing disruption in job performance or job loss, time lost to severe depression, difficulty maintaining personal relationships, conflict with family members, financial ruin due to impulsive decisions, legal problems due to impulsive behaviors and poor judgement, development of addictions, embarrassment and shame over actions taken while in a mood episode, and even self-harm and suicidal thoughts or acts, among other possible painful and highly difficult consequences.
What to expect from me when assessing for and treating bipolar conditions
When working towards a proper diagnosis I take a thorough history, have clients track elements of their functioning such as sleep, energy, and mood, and also factors like substance use and sources of stress. I believe when possible it’s important to gather information from someone close to my client who knows them well and has observed them over an extended period of time. This last piece can be very valuable in helping identify patterns and would mean that if you were working with me, I might ask who you would be willing to invite into a session to help in gathering this information. Sometimes others around us notice things about our behavior which we ourselves aren’t so aware of.
If you were my client, we’d also be having a conversation about your willingness to consider involving a prescriber of psychiatric medication to get their recommendations if you have not already done so. Medication can be very beneficial for long-term stabilization of a bipolar illness and I might want to help you find a suitable provider to consult about prescribing.
I enjoy teaching clients who have been identified as having a bipolar disorder how to better manage lifestyle choices which may include monitoring sleep, diet, and use of drugs or alcohol, how to manage personal relationships to their advantage to help in identifying changes to their bipolar condition, and how to improve their ability to spot the onset of what we call a “mood episode” (a deviation from normal or ideal functioning) so they can react before it gets worse.
I want to emphasize that this is not a guide to diagnosing a bipolar disorder. This information is meant to inform you about factors that are taken into consideration when attempting to identify bipolar disorders, as well as elements that may be included when a therapist helps you address difficulties thought to be related to a bipolar condition or certain depressive disorders.
If you are reading this and have questions about bipolar disorder or want to discuss assessment or treatment of a bipolar condition, please consider scheduling a free initial consultation with me. Call 505-431-5058 or email me at ravenwatercounseling@outlook.com.