"I have been told I have bipolar disorder and I just can't accept it."

What is bipolar disorder?

Symptoms of bipolar disorder, also called manic-depressive disorder, include both symptoms of depression, and symptoms of mania or hypomania. Symptoms of mania include:

• Pleasant emotions like euphoria, elation, and enthusiasm, and occasionally unpleasant emotions like anger and irritability;
• Behaviors like impulsively spending a lot of money, initiating multiple sexual liaisons, driving recklessly, making risky business investments; talking excessively, staying up all night working or playing;
• Cognitions (thoughts) like, "I can do anything I want," "I'm going to make a huge fortune," "Everyone loves me," and cognitive problems like racing thoughts or distractibility;
• Physical symptoms like reduced need for sleep, increased libido, high energy levels.

The term hypomania is used to refer to mild symptoms of mania. Often individuals with bipolar disorder experience multiple episodes of depression and only one or an occasional manic or hypomanic episode. Sometimes individuals with bipolar disorder experience depressed and manic symptoms simultaneously (for example, feeling simultaneously depressed and revved up).

Bipolar disorder can ruin relationships and destroy careers; nearly 20% of patients with bipolar disorder commit suicide. Effective treatment is essential, because people who manage their illness well can have productive, happy lives.

Cognitive-behavioral Model of Bipolar Disorder
Symptoms of Bipolar Disorder are influenced by a genetic vulnerability that likely involves physical changes in the brain and an imbalance of neurotransmitters. When biological vulnerabilities are activated by life stressors, individuals experience symptoms of Bipolar Disorder. Psychological factors contributing to Bipolar Disorder can include the tendency to set and strive to achieve excessively ambitious personal goals. Symptoms, in the cognitive-behavioral model, are made up of emotions (e.g., depression or elation), thoughts (e.g., "I'm worthless," or "I'm amazingly talented") and behaviors (e.g., passivity or excessive activity).

Cognitive-behavior therapy for bipolar disorder

Cognitive-behavioral interventions typically include helping the person with bipolar disorder to:

• identify and change the thinking (cognitions) and behaviors that accompany depressed and elated emotions, with the notion that if the cognitions and behaviors change, the emotions will also change;
• establish a regular routine of daily activities, especially a regular sleep-wake cycle, as this regularity can help stabilize mood and behavior;
• identify early signs of depression or mania so that early action can be taken to head off large mood swings;
• identify reasonable goals and reasonable levels of activity to accomplish them;
• rely on family members to help provide feedback and moderated activity and thinking;
• understand the need for medication and overcome obstacles to taking it regularly.