5 Early warning signs of Bipolar Disorder
December 15, 2023. In Penn Station for the last leg home. Meg will be picking me up so I don’t have to drive.
Marriage and Family Therapists will encounter real-full on mental illness from to time to time. While it’s true that about 3% of humans will have the misfortune of developing bipolar disorder at some point during their lives, our community of practice must be up to speed on the emerging symptoms of dangerous conditions.
There are 5 early warning signs of bipolar disorder that every Marriage and Family therapist should be aware of…
Recent research advises us to be on the lookout for:
Problems with sleep hygiene.
Thoughts or incidents of self-harm.
Swings in mood, and emotional lability.
Depression, and
Substance abuse.
When all seen together, along with frequent visits to, and missed doctor’s appointment, this can suggest a bipolar disorder diagnosis.
FESTIVAL: AN ACRONYM FOR A Depressive episode:
F eeling – sad, anxious, or guilty.
E nergy – having very low energy, and feeling tired or fatigued.
S leeping – under or over-sleeping, notice any persistent change to normal sleep patterns.
T hinking – very poor concentration, memory problems, fluidity of thought is bogged down.
I nterest – emotional inertia, a loss of interest in hobbies, family or social life
V alue – persistent low self esteem.
A ches – physical aches and pains that elude any logical explanation.
L ife – loss of interest in living, thinking about the end of life, suicidal ideas.
FESTIVAL: SAME ACRONYM for A Hyper, elevated episode:
F eeling – elated, enthusiastic, excited, angry, irritable or depressed.
E nergy – increased energy, over-talkative or over-active. Fidgetty, can’t stay still.
S leeping – reduced need for sleep, marked difficulty in getting to sleep.
T hinking – racing thoughts, ‘pressure in the head’, indecision, jumping from one topic to another, poor concentration
I nterest – poor impulse control, increased interest in pleasurable experiences, new adventures, sexual acting out, excessive use of alcohol, and other recreational drugs. Powerful focus sometimes on religion, music or artistic endeavors.
V alue – high self-esteem, a feeling so delicious, they feel as if they can achieve absolutely anything.
A ches – the physical aches from the depressive episode and pains disappear
L ife – delusional assessments of their personal power, reckless, risk-taking behavior or, if angry or overwhelmingly dysregulated, can have suicidal thoughts
Bipolar disorder is particularly difficult to diagnose, taking six years on average, during which time some humans can’t bear how their brains have betrayed them and commit suicide…
Spotting the early symptoms and following up with medical treatment options can improve the course of the condition, explained epidemiologist Dr. Catharine Morgan, the study’s lead author:
“Bipolar disorders are serious mental illnesses characterized by instability in mood.
They can impact on the lives of patients and their families to a seriously detrimental degree.
Early treatment, however, can be crucial in averting years of hardship and elevated risk for patients; our study provides crucial information that could help GPs to consider a diagnosis of bipolar much earlier to enable timely effective treatment and referral on for specialist assessment.”
The 5 early warning signs you need to be aware of…
This 2023 study included data from nearly 50,000 humans both with, and without bipolar disorder in Great Britain.
Ms Anya Francis, another co-author of this research added this comment:
“This work was inspired by sharing my personal experience of missed opportunities to spot the early warning signs of bipolar and receive a timely diagnosis.
The early warning signs included such as sleep disturbances, anxiety, irritability, and high energy levels).”
The results showed that up to 10 years before they were diagnosed, most humans with bipolar disorder:
Experienced frequent sleep disturbances.
Engaged in ongoing substance misuse.
Experienced mood swings, and emotional lability.
Were prescribed as many as 3 different psychotropic medication classes.
They also tended to have more frequent doctor’s appointments, and they were also more likely to be a no show.
Please note the presence of these symptoms, or in your assessment and family of origin history taking, please explore and signs of these symptoms. Sometimes folks with bipolar will show up with marital complaints, ample symptoms odf concern but lacking a formal diagnosis.
Professor Carolyn Chew-Graham, the study co-author, explained how serious delayed diagnosis can become:
“There is evidence that a delay in diagnosis of bipolar can be up to nine years, with a third of people who are eventually diagnosed with bipolar will have attempted to take their own lives because of the distress that they feel and the delay in getting appropriate care.”
Final thoughts…
I’ve had several situations over the past decade where these symptoms, lacking a formal diagnosis, compelled me to advocate for a psychiatric evaluation, which confirmed a diagnosis of Bipolar Disorder.
Don’t be afraid to challenge your client. Stand alone-talk therapy, absent a medical assessment is not a thing with Bipolar disorder. This is a dangerous affliction which requires curiosity, respect, and sometimes clinical leadership.
Be well, stay kid, and Godspeed.
RESEARCH:
Catharine Morgan, Darren Ashcroft, Carolyn A Chew-Graham, Matthew Sperrin, Roger T Webb, Anya Francis, Jan Scott and Alison R Yung. Identifying prior signals of bipolar disorder using primary care electronic health records British Journal of General Practice 11 October 2023; BJGP.2022.0286. DOI: https://doi.org/10.3399/BJGP.2022.0286
