As a Psychiatrist, I have read many writings on Bipolar Disorder. The writings by mental health professionals have tended to provide information and insights from a clinician/researcher point of view. While these documents gave the reader information, it was often difficult for patients and non-medical individuals to understand and incorporate the information into their daily lives. On the other hand, writings by individuals with mental illnesses, family members or friends, tend to be autobiographical. They are interesting, but only chronicled one person’s journey. This book was written as a collaborative between an individual with a mental illness and his primary support person. This book is written using the language, which anyone can understand and individualize. At this time, it is paramount for consumers, friends, and family and support groups to be active participants in the treatment of Bipolar Disorder. The ability to be a positive, contributing member of the mental health team starts with knowledge. The ability to communicate effectively with professionals and nonprofessionals is essential for maximum medical/emotional benefit. This book provides an excellent source of information to anyone who has or is associated with individuals having Bipolar Disorder. I highly recommend this book as part of the resources available to educate and empower those trying to control and maintain stability with Bipolar Disorder.

- Ollie R. Mack, J.D., M.D.

A quick and easy reference to help understand Bipolar Disorder James Witschner and Marcia Rose 

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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RAPID CYCLING When you hear the term that a person is cycling, it means that they are leaving one mood and cycling around to another. Cycles appear in some to be continuous with few times of being stable. In others the obvious times of cycling can be observed. From a diagnostic view, any person experiencing 4 or more episodes in a year is considered rapid cycles. The duration of wellness gets shorter as the illness progresses. Diagnoses and good treatment are necessary to bring balance and productivity. Though it is not clear why some individuals with bipolar disorder are rapid cycles, most are not. It is clear that it shows up in women more than men, about 75 percent.

RATING SYSTEM (Numerical evaluation) 1. Extreme depression, actively suicidal, totally withdrawn, delusional and unable to eat or take medications. Medical emergency. 2. 2. Severe depression, must be reminded to do most daily routines, loss or gain of weight, very withdrawn, extremely agitated, rarely sleeps or sleeps too much, Volunteer’s suicidal thoughts. Medical treatment is needed. 3. Moderate depression, loss of energy, disinterested in others, sleep and appetite disturbed, normal functions become an effort, wants to stay in bed, does not want to go to work, life is not worthwhile, little sexual interest. Needs outpatient treatment. 4. Mildly depressed mood, a noticeable lack of energy, motivation decreased, not feeling optimism or pleasure, feels slowed 4. Down, decreased interest in sex. No treatment needed. 4.5-5.5 Mood within normal range. Even as this would be considered “normal”, the individual can feel strange, wondering why they are no longer unhappy or depressed. Perhaps even bored in missing the euphoric feelings of mania. 6. Mildly elevated, many ideas for projects, creative, funny, feels wonderful, increased sex drives, and increased activity. Treatment not needed. 7. Moderate elation, overactive, over talkative, sleeps only 4 to 6 hours. Could go on spending sprees, travel is an option, becomes unsure of self and could 7. Switch from happy to irritable easily. Outpatient treatment advised in some cases 8. High extreme elation, flight of ideas, agitated, indecisive, hostile, sleeping very little and rapid speech. Should be admitted or observed very closely. 9. Extreme elation, out of control, hardly sleeps and completely uncooperative. Hospitalization usually necessary. 10. Wildly manic and psychotic can’t stop talking, incoherent, elated, belligerent, not sleeping at all, possibly delusional, paranoid or hallucinating. Medical emergency.

RELATIONSHIPS It is often true those with bipolar disorder are charming, creative and charismatic. People are drawn to the happy, bouncy personalities. In hypo manic times they can form many relationships. Multiple marriages are not uncommon. Hypomania is, as we know, a temporary state, eventually true mania will set in with the eventual depression. The behavior can become unpredictable and outrageous. Spending sprees of thousands of dollars, public displays of indignant anger, arguments and brawls where the police become involved. Sexual indiscretions are common and can impact a relationship beyond repair. Sometimes the most forgiving partner or friend cannot cope with all the intricacies that are involved in a relationship. There is hope in all of this. People that are involved in the individuals with bipolar disorder life can learn the tools required to understand that this is an illness that can be managed. With medication and proper medical attention a individual can live with and have meaningful relationships with friends, family and loved ones.

RESTORIL (temazepam) This medication is a sedative and is used primarily as a sleeping pill. It can become addictive.

RISPERDAL (risperidone) This medication is mostly used in the treatment of schizophrenia but is also used in bipolar affective disorder when a person is in a manic state. Minor side effects are constipation, decreased sexual ability, difficulty sleeping, drowsiness, headache, and sensitivity to the sun, menstrual irregularity, nausea/vomiting, stomach pain and tiredness. Side effects of a more serious nature and less common are weight gain, aching muscles and joints, changes in vision, confusion, palpitations, fainting spells, restlessness, loss of balance, and stiffness or spasms.