His laughter and tears 😥: Things you didn't know about bipolar disorder

So one day, while I was sitting in the cafeteria at the hospital, a friend of mine from school, Rohan, saw me and came over to talk to me. It had been a long time since we had met! He was a computer engineer now, and I was a doctor. Anyway, after we had been talking for a while, I realized that there was something seriously wrong with Rohan's face.

While we were talking, Rohan told me, “ I’ve been wanting to talk to someone about this… this is about Aditi.” Aditi is his girlfriend. We’ve been in love for two years now. We’ve even thought about getting married and staying that way. But recently, Rohan has been feeling very scared and suspicious about Aditi.

“ He’s either very happy, smiling, and planning a million new projects. Otherwise, he’s just sitting there, not talking ,” Rohan said with great concern. “I thought this was just a coincidence , you know, when a girl’s hormones change with her periods , her mood also changes.” Who should I show this to, a VOG or an endocrinologist?

I felt that Rohan's problem was deeper than just the problems of a normal romantic relationship. "Rohan," I began slowly, "from what you're saying, Aditi may be going beyond just hormonal changes. From what you've said, it seems like she may have a condition called bipolar disorder ."

Bipolar Disorder: Let's understand it simply 🤔

Rohan seemed a little surprised by my story. He looked at me with a mixture of curiosity and hope. Perhaps it was a relief to have a name for his problem. I explained to him that bipolar disorder is a mental health condition . It causes a person’s moods to change dramatically. These “highs” and “lows” are much more intense than normal mood swings. This means that the feelings experienced during this period are much stronger and more intense than the feelings of happiness and sadness that we usually feel in our daily lives. These feelings affect a person’s thoughts, behavior, and even their ability to function. In the United States alone, about 5 million people suffer from this condition. This means that it is more common than we think.

“This is a lifelong condition, but with treatments and the necessary support, most people with this condition can control it and live a normal life,” I reassured him.

The “good” and “bad” of bipolar disorder: What Rohan Aditi saw 👁️‍🗨️

Rohan was curious to know more, so I showed him Aditi's changes, matching them with the symptoms of bipolar disorder.

The “good” side or hypomania: Aditi's beautiful days ✨

Rohan spoke of Aditi's "good days" with great fondness and affection. "Sometimes she's so lovely," he said. "She can stay up all night planning new projects, laughing, and suddenly suggesting trips. It's like she has a lot of energy inside her."

I explained to him that these times are called hypomania . This is a common feature of bipolar II disorder . When someone is in hypomania, they feel unusually energetic, active, and creative. During hypomanic episodes, they can feel very optimistic and euphoric . This can lead to impulsive decisions, spending too much money, and staying up all night thinking about things. Hypomania is not as severe as mania (which is seen in bipolar I disorder) , but the difference is clear to those closest to them. “On his good days, he has a lot of energy, but if he can control it, it’s more likely to be hypomania than mania,” I explained.

In manic episodes, that is, in bipolar I disorder, these good days can be even more intense. During such times, things like driving fast, spending money without thinking, and seeing and hearing things that are not there ( hallucinations ) can occur. But Aditi's good days, as Rohan described, tend to be more hypomanic than mania.

The “bad” side or depressive episodes: How Aditi feels lonely 😔

Rohan agreed. The joy on his face slowly faded as he talked about Aditi’s bad days after her good days. “After those super happy days, she’s like… lost. She’s at a loss, avoiding everyone, not interested in anything. It’s like a part of her life has been lost,”Rohan said with great sadness.

These “down” days, I explained, are another common symptom of bipolar disorder . During depressive episodes, a person may feel tired, empty, and hopeless. Sometimes this can last for weeks. During these times, things that used to bring them joy and pleasure are no longer enjoyable. Even doing ordinary tasks becomes boring. For Rohan, it was very difficult to bear the sudden drop in sadness from being so full of happiness.

“These bad days can be just as hard as those good days,” I explained. “It’s not something he can just ‘make up his mind to.’”

Bipolar Disorder, Women and Hormones: Rohan's Original Idea 🧐

Rohan was surprised when he was told that his initial thoughts about hormonal changes were not entirely wrong. Hormones do not cause bipolar disorder. However, hormonal changes such as during periods , pregnancy, and menopause can affect the mood of people with this disease. In fact, women with bipolar disorder are more likely to experience rapid mood swings ( rapid cycling ). And their mood swings can be exacerbated by their hormonal changes.

“So, seeing a VOG or an endocrinologist is not a direct solution to her mood swings. But it can increase the way hormonal changes affect her,” I explained. “Seeing a mental health specialist, like a psychiatrist or a psychologist, is the best thing to do.”

Treatment for Aditi and others with bipolar disorder 💊

Rohan next asked about a way to get help for Aditi. “Can she get better?” he asked with great hope, but also fear.

I reassured her that there are very effective treatments for bipolar disorder. And, while it is a lifelong illness, people with it can control their symptoms and live a good life. The key, I explained, is to find the right treatments.

Medications: People with bipolar disorder are often prescribed mood stabilizers, antipsychotics , and sometimes antidepressants .) has had good results. Everyone responds differently to each medication. So it takes some time to find the right medication .

Therapy: Cognitive Behavioral Therapy ( CBT ) is very effective for people with bipolar disorder. It helps them control the thoughts and behaviors that cause mood swings. Another treatment is Interpersonal and Social Rhythm Therapy (IPSRT ). This helps them to manage their daily activities. By doing things on time, such as sleeping, eating, and exercising, you can reduce mood swings.

Lifestyle changes: Simple things like getting enough sleep, exercising, and eating a balanced diet can make a big difference. These are things you can do in addition to medication.

Considering Supplements

Some people find relief from things like omega-3 fatty acids. But it's important to talk to a doctor before taking these, as they may not work well with some medications.

Causes and risk factors: Why does bipolar disorder develop? 🧬

Rohan asked why some people develop bipolar disorder. I explained to him that it is a combination of genetic, biological, and environmental factors. If someone in your family has the condition, you are more likely to develop it. It is caused by changes in brain chemicals and nerves. Major life events, such as trauma, can also trigger symptoms in someone with the condition.

Helping Aditi: Rohan's role ❤️

Rohan's biggest question was how he could help Aditi. I told him there were a few things he could do:

• Help her stay on schedule: Help Aditi go to bed, eat, and exercise at the same time every day. This will help keep her mood consistent.
• Be strong for him: The support he gets from family, friends, and support groups will be a great strength for him. You should always be by his side.
• Keep a record of his mood: By keeping a mood journal, that is, a book where he writes down how his mood changes from day to day, he can find out what changes in his mood and what factors affect it. Then he can talk about it with his therapist. Help him with that.
• Be patient: A person with bipolar disorder's moods change frequently, so it's important to understand that and be patient.
• Listen to him: Listen carefully when he wants to talk about his problems and how he feels.
• Help with his treatment plan: Find out if he's taking his medication properly and going to therapy.
• Think about yourself too: It's not easy to help someone like this. It's important to think about yourself too and stay in a good mood.

A journey we all take together: Finally 🤝

As Rohan prepared to leave the cafeteria, he felt much more at ease than before. He now knew that Aditi's mood swings weren't just a hormonal imbalance, but a treatable illness. With love, patience, and the advice of a good doctor, he could help Aditi through this journey right from her side.

Bipolar disorder is not easy. But with the right support and medication, people with this illness can live good, normal lives. And, as Rohan learned, the biggest help you can give someone you love when they have this illness is to be understanding and loving.

I felt very happy that Rohan worked so hard for his girlfriend Aditi. We should all be like Rohan. Life is very short. So it is important to help others as much as possible, be loving, and be happy.

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