DBSA of Memphis

Subtitle

UNDERSTANDING YOUR MOOD -  An Introduction to Depression and Bipolar Disorder

What is a Mood Disorder?
Mood disorders are medical conditions that affect the brain. Their exact cause is not known, but we do know that an imbalance in brain chemicals plays a role. These conditions also have a genetic component, meaning they can run in families. They’re not your fault, and they’re nothing to be ashamed of. Having a mood disorder does not mean you can’t lead a fulfilling life. Everyone, at various times in life, experiences mood swings. It’s normal to feel sad on occasion— just as it’s normal to feel euphoric or on top of the world sometimes. The differences between these normal mood swings and a mood disorder are:

  • Intensity - Mood swings that come with a mood disorder are usually more severe than ordinary mood swings. 
  • Length - A bad mood is usually gone in a few days, but mania or depression can last weeks or months. Even if moods go quickly from high to low the person does not usually return to a stable mood for a long period of time.
  • Interference with life -  Mood disorders can cause serious problems, such as making a person unable to get out of bed, or causing a person to go for days without sleep or spend money he or she does not have. 

What is Depression?
Depression is a common and treatable health problem. Depression is both physical (involving chemical changes in the brain) and psychological (involving changes in thoughts, feelings, and behavior). It’s not a character flaw or a sign of personal weakness. Just like you can’t “wish away” diabetes, heart disease, or any other significant illness, you can’t make depression go away by trying to “snap out of it.” While depression sometimes runs in families, many people with the condition have no family history of depression. It can have many causes: genetic or inherited risk, early life traumas, stressful life events and other illnesses or injuries. Usually, it’s not just one factor, but several of them combined.

Common Symptoms of Depression:
  • Sad, empty, irritable, or tearful mood nearly every day 
  • No interest in or pleasure from activities once enjoyed 
  • Major changes in appetite or body weight 
  • Insomnia or sleeping too much 
  • Feelings of restlessness or agitation 
  • Fatigue, exhaustion, or lack of energy 
  • Feelings of worthlessness or excessive guilt 
  • Difficulty concentrating or making decisions 
  • Thoughts of death or suicide 

What is Bipolar Disorder?
Bipolar disorder is a treatable illness marked by extreme changes in mood, thought, energy and behavior. It is not a character flaw or a sign of personal weakness. Most people who live with bipolar disorder experience low or depressed periods as well as mania, or periods of extreme changes in their mood or emotions. Everyone can experience changes in mood, but mood episodes in bipolar disorder are severe enough to interfere with daily functioning. For some people, these high or low periods can last weeks or even months. For others, the changes are much faster - lasting just days or even hours. Some people even experience feelings of depression and mania at the same time.

Common Symptoms of Mania/Hypomania
  • Feeling overly energetic, high, or unusually irritable for at least one week 
  • Very high self-esteem; feeling all powerful 
  • Decreased need for sleep without feeling tired 
  • Talking more than usual or feeling pressure to keep talking 
  • Racing thoughts; many ideas coming all at once 
  • Distracted easily; thoughts or statements jumping topic-to-topic 
  • Increase in goal-directed activity
  • Restlessness 
  • Excessive pursuit of pleasure (e.g. financial or sexual) without thought of consequences 

Mixed States
When people experience symptoms of mania and depression at the same time, they’re said to be experiencing a mixed state. They can have all of the negative feelings that come with depression, but they also feel agitated and restless. Those who have had a mixed state often describe it as the very worst part of bipolar disorder.

Types of Bipolar Disorder
Patterns and severity of symptoms (or episodes of “highs” and “lows”) determine different types of bipolar disorder. The two most common types are bipolar I disorder and bipolar II disorder.

Bipolar I Disorder 
Bipolar I disorder is characterized by one or more manic episodes or mixed episodes. Typically a person will experience periods of depression as well. Bipolar I disorder is marked by extreme manic episodes. 

Bipolar II Disorder 
Bipolar II disorder is diagnosed after one or more major depressive episodes and at least one episode of hypomania, with possible periods of level mood between episodes. The highs in bipolar II, called hypomania, are not as high as those in bipolar I (mania). Bipolar II disorder is sometimes misdiagnosed as major depression if hypomanic episodes go unrecognized.

Just Diagnosed? You Are Not Alone.
If you’ve just been diagnosed with a mood disorder, you’re not alone. Mood disorders affect more than 21 million Americans. These disorders are treatable and one of the best things you can do to help yourself in your recovery is learn all you can about your condition.

How are Mood Disorders Treated? 
The most important thing to know is that wellness is possible. The most common treatments for managing mood disorders often include several different tools: medication, talk therapy, personal wellness strategies, and support from a peer-run group like DBSA. 

People who go to DBSA groups say that the groups:
• give them the opportunity to reach out to others who have had similar experiences
• provide a safe and welcoming place for mutual acceptance, understanding and self-discovery
• motivate them to follow their treatment plans
• help them to understand that mood disorders do not define who they are 
• help them rediscover their strengths and sense of humor 

Suicide Prevention and Mood Disorders:  Understanding Suicidal Thinking


Don’t give in to suicidal thoughts—you can overcome them.

If depression or bipolar disorder affects you or someone you care about, you know that symptoms may include feelings of hopelessness and thoughts of suicide. If such thoughts occur, it’s important to remember that they can be overcome with the right kind of care, treatment, and support. 


If You Are Feeling Suicidal: 

  • The belief that there is no hope is not the truth. When you feel this way, it’s your illness talking— your mind is lying to you. Remind yourself that suicidal thoughts are not reality. 
  • If you are thinking of suicide, it’s important to recognize these thoughts for what they are: expressions of a treatable medical condition. They are not true and they are not your fault. Don’t let fear, shame, or embarrassment stand in the way of communicating with your physician, therapist, family or friends; tell someone right away. 
  • Tell a trusted family member, friend, or other support person—someone you can talk with honestly. Try not to be alone when you feel this way. This may mean sitting quietly with a family member or friend, going to a support group, or going to a hospital or crisis center. 
  • Get help. Tell your health care professional. Suicidal thinking can be treated. When suicidal thoughts occur, they are your signal that, more than ever, you need help from a professional.  Know that you can get through this. Promise yourself you will hold on for another day, hour, minute - whatever you can manage. 


Suicide Prevention:

 

It’s very helpful to have a plan of action ready before thoughts of suicide occur. 


• Learn to recognize your earliest warning signs of a suicidal episode. There are often subtle warning signs your body will give you when an episode is developing. As you learn to manage your condition, you’ll become sensitive to these signs.They are signals to treat yourself with the utmost care, instead of becoming ashamed or angry. 

• Stay in contact with your doctor. Always have your doctor’s phone number with you—an office number as well as an after-hours number—and a back-up number, such as an emergency room or Suicide and Crisis Lifeline (988). 

• Stay in contact with trusted friends. Develop a list with phone numbers of dependable family members and friends who can give you support during a crisis. Keep the list with you. 

• Recognize symptoms for what they are. With your doctor, therapist (counselor), or trusted friends, identify the symptoms you are likely to experience when your condition is at its worst. Always remember: feelings are not facts. Suicidal feelings are not your fault; they are a symptom of your illness. They may not seem temporary, but they are. As you learn to manage your condition, you will be able to spot your warning signs sooner and get help earlier. 

• Write down your thoughts. Spend a little time each day writing down what things and people you appreciate and value in your life and your hopes for the future. Read what you’ve written when you need to remind yourself why your life is important.

• Connect with other people socially. When you are feeling suicidal, don’t be alone. Visit family and friends who are caring and understanding, even if it’s difficult. Attend support group meetings where you can meet others who understand what it’s like to live with a mood disorder. 

• Avoid drugs and alcohol. Many suicides result from sudden, uncontrolled impulses. Since drugs and alcohol can make you more impulsive, it’s important to avoid them. Drugs and alcohol can also make your treatment less effective. 

• Know when it’s best to go to the hospital. There may be times when your condition becomes so severe that hospitalization is the best way to protect your health and safety. Discuss this possibility and your options with your doctor and family before the need arises. 

• Understand your health coverage. Know whether your insurance, HMO, Medicaid, or Medicare plan provides psychiatric hospitalization coverage and how much. Keep copies of policy numbers and important health care information in an easy-to-find place. If you don’t have insurance coverage, find out what other options you have, such as community or state-run facilities. 

• Keep yourself safe. Make sure you do not have access to weapons or anything you could use to hurt yourself. Have someone hold on to your car keys when you are feeling suicidal. Get rid of all medications you are no longer taking. 

• Give yourself time to get better. When you are first treated, or when you have recently had a severe depressive or manic episode, give yourself time to heal. Allow yourself to take life a little more slowly and don’t get discouraged if you aren’t up to your previous activity and lifestyle levels right away. With continued treatment, you can feel better.


If You Are Worried that Someone Is Considering Suicide 


  • You cannot make someone suicidal by asking straightforward, caring questions.
  • If you are prepared and informed, you will be better able to assist friends and family who are dealing with suicidal thoughts. 
  • It’s extremely important for people with mood disorders to receive early, quality treatment from health care professionals. If you believe someone close to you has depression, help that person find and stick with effective treatment. Be supportive, reassuring, and willing to talk about suicidal feelings and thoughts. 
  • While not every mention of suicidal thoughts means that a person is in immediate danger, take any mention of death or suicide seriously. If someone you know talks about suicide, asking direct questions about whether they have a plan for how, when, and where they intend to end their life may help you discover the level of crisis and how you can best help. 
  • It’s natural to fear that a question about suicide may anger or offend someone you care for - or even that it may put the idea of suicide into a person’s mind. However, you cannot make someone suicidal by asking straightforward, caring questions. A person considering suicide may welcome the chance to talk about these thoughts and feelings. 
  • Many people dealing with suicidal thoughts fear judgement, misunderstanding, and over-reaction. Focus on listening to the person instead of offering advice or countering their thoughts or feelings. It may be very tempting to jump to conclusions or try to cheer the person up by offering all the reasons they have to live, but allowing them to talk about why they’re feeling so down and why they’re considering suicide will show them that you are someone they can truly talk to. 


Warning Signs that Someone May Be Considering Suicide 

• Unbearable feelings - Depression causes some people to have powerful, extreme feelings of hopelessness, despair and self-doubt.The more intense these feelings become, and the more often they are described as unbearable, the more likely it is that the idea of suicide may enter the person’s mind. 

• Taking care of affairs - Making final plans, preparing wills or life insurance, or arranging for the family’s welfare is another warning sign. The person may give away valued possessions or make reference to what others will do “after I’m gone.” 

• Rehearsing suicide - Seriously discussing one or more specific suicide methods, purchasing weapons, and collecting large quantities of medication are all signs that an individual is rehearsing suicide. Even if the person’s suicidal thoughts seem to come and go, it’s important to step in early and help. 

• Substance use - Addiction to alcohol and/or drugs is a treatable condition that must be addressed along with the mood disorder in order for treatment to be successful. Substance use may cause impulsive behavior and make a person more likely to act on suicidal thoughts.

• Isolation - If a person seems determined to cut off friendships and social connections, there’s a chance that the person might be experiencing serious depression and/or preparing for suicide. 

• Sudden sense of calm - A person with a mood disorder may be most likely to attempt suicide just when he or she seems to have passed an episode’s lowest point and be on the way to recovery. If a person who was recently feeling hopeless suddenly seems very calm and settled, it may be a sign that he or she has decided on a plan.



If Someone Is Considering Suicide 

Remind the person there is help and hope. 

• Take the person seriously. Stay calm and let the person know you are willing to listen.

  • Express concern. Ask direct questions. Try to find out if the person has a specific plan for suicide and what it is. Be sure to ask in a neutral way without judgement.  

• Involve other people. Don’t try to handle the crisis alone or put yourself in danger. 

• Be understanding, not judgmental. It’s important to remember if you have not experienced suicidal thoughts, it’s nearly impossible to truly understand how the person is feeling. While the idea of suicide may be unfathomable to you, remember at this time the person likely feels that it would be better than continuing to live. Remind the person that while thoughts of suicide may feel never-ending and unbearable in this moment, they can be overcome and that you and others are here to help. 

• Never promise confidentiality. You may need to speak to the person’s family or doctor in order to protect the person. Secrecy can endanger your loved one’s life. 

  • Contact the person’s family, psychiatrist, therapist or others who are trained to help. 

• Don’t leave the person alone, if possible. Stay with them until you are sure he or she is in the care of others.

  • Get help from The Suicide and Crisis Lifeline (988) or call 911 if necessary.


Difficult Situations 

It takes courage to help a person who is considering suicide. If the person is also abusing drugs or alcohol or is verbally or physically abusive, helping may seem impossible. You may have decided that you cannot tolerate this behavior and want to keep your distance. However, even if you keep your distance or live far away, you can still help by informing the person’s doctor, or another friend or family member who lives nearby, of the person’s suicidal thoughts. People experiencing severe depression - no matter how unreasonable or angry they become - need help.