TYVETTE SYMONE

What is Bipolar Disorder?

Bipolar disorder is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe.  The difference between an occasional mood shift and bipolar disorder has to do with the frequency, duration, and intensity of the mood shift.

What Causes Bipolar Disorder?

Bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the U.S. population age 18 and older every year according to the National Institute of Mental Health.

Scientists don’t yet know the exact cause of bipolar disorder, but experts believe bipolar disorder is partly caused by an underlying problem with specific brain circuits and the functioning of brain chemicals called neurotransmitters.

They also believe there’s a strong genetic (inherited) component. Bipolar disorder is considered one of the most heritable psychiatric conditions — more than two-thirds of people with bipolar disorder have at least one close biological relative with the condition. However, just because you have a biological relative with bipolar disorder, doesn’t necessarily mean you’ll also develop it.

Environmental factors such as severe stress, sleep disruption, major life changes, childhood trauma, and misuse of drugs and alcohol may trigger mood episodes in vulnerable people.

Types of Bipolar Disorder

People are diagnosed with three basic types of bipolar disorder that involve clear changes in mood, energy, and activity levels. These moods range from manic episodes to depressive episodes.

Bipolar I disorder is defined by manic episodes that last at least 7 days (most of the day, nearly every day) or when manic symptoms are so severe that hospital care is needed. Usually, separate depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of mood disturbance with mixed features are also possible. The experience of four or more episodes of mania or depression within a year is termed “rapid cycling.”

Bipolar II disorder is defined by a pattern of depressive and hypomanic episodes, but the episodes are less severe than the manic episodes in bipolar I disorder.

Cyclothymic disorder (also called cyclothymia) is defined by recurrent hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.

Mania is a phase of bipolar disorder in which one displays an over-the-top level of activity, energy, mood or behavior. This elevation must be a change from their usual self and be noticeable by others. During periods of mania, they may make decisions that can result in long-term consequences. 

The symptoms of a manic episode can include:

• Feeling very up, high, or elated
• Feeling jumpy or wired, more active than usual
• Having a very short temper or seeming extremely irritable
• Having racing thoughts and talking very fast
• Needing less sleep
• Feeling like you are unusually important, talented, or powerful
• Doing risky things that show poor judgment, such as eating and drinking too much, spending or giving away a lot of money, or having reckless sex

Depression is a mood disorder that includes a sad, despairing mood that lasts longer than 2 weeks. It causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home. 

The symptoms of a depressive episode can include:

• Feeling very sad, hopeless, or worthless
• Feeling lonely or isolating yourself from others
• Talking very slowly, feeling like you have nothing to say, or forgetting a lot
• Having little energy
• Sleeping too much
• Eating too much or too little
• Lack of interest in usual activities and being unable to do even simple things
• Thinking about death or suicide

People that have bipolar disorder with mixed features experience symptoms of both manic and depressive episodes. This means one can have a depressive episode with mixed features, where the main symptoms are depressive but manic symptoms are also present. For example, a person may feel depressed and also experience racing thoughts or rapid speech.

One can also experience a manic episode with mixed features, where the main symptoms are those of a manic episode but depressive symptoms are also present. For example, you may be doing several high-energy activities, but you also feel depressed. 

Symptoms can include feeling a mixture of elevated and low moods, doing pleasurable activities but still having depressive symptoms, experiencing low mood with rapid speech, elevated mood with suicidal ideation, severely disturbed sleep, or having a severe disruption of appetite. Any combination of manic and depression symptoms is possible.

People with bipolar disorder, depression, and other mood disorders often have episodes when they feel extremely sad, hopeless, anxious, or confused. When these emotions get too intense, the person may struggle with how to cope with overwhelming emotions, and for some people, efforts at coping with distress may take the form of acts of self-injury.

Self-injury, often including cutting, self-mutilation, or self-harm, is an injurious attempt to cope with overpowering negative emotions, such as extreme anger, anxiety, and frustration. It is usually repetitive, not a one-time act. Often, people who deliberately injure themselves are survivors of traumatic events during childhood or early developmental periods in life. Self-injuring behaviors that occur because of difficulty coping with stress are not a necessary symptom needed to define bipolar disorder, but may happen when someone's emotional coping strategies are not well-developed.

Suicidal ideations, often called suicidal thoughts or ideas, is a broad term used to describe a range of contemplations, wishes, and preoccupations with death and suicide. Suicidal ideation can involve a person thinking and romanticizing thoughts around ending their own life. 

Common warning signs that someone is having suicidal thoughts, according to the National Institute of Mental Health, include:

• Talking about wanting to die
• Saying they feel guilty or like a burden to others
• Feeling trapped, hopeless, empty, or that there’s no reason to live
• Feeling agitated, anxious, or filled with rage
• Feeling extreme sadness or physical pain
• Withdrawing from family and friends
• Saying goodbye to loved ones or drafting a will with seemingly no logical reason
• Having intense mood swings
• Increasing their drug or alcohol use
• Engaging in dangerous behaviors like unsafe driving
• Sleeping more or less than usual
• Researching ways to die or making a plan

Suicide is preventable. Support from healthcare professionals and loved ones can keep a person from becoming isolated. Treatment may involve a combination of safety planning, therapy, and medications. If a loved one is experiencing suicidal ideation, taking them seriously and getting immediate help is vital.

Hallucinations are sensory experiences that appear real but are created by your mind. They can affect all five of your senses. For example, you might hear a voice that no one else can hear or see an image that isn’t real. Hallucinations can feel confusing, even terrifying — especially when you don’t know what causes them.

Three types of hallucinations that appear most commonly with bipolar disorder are auditory, or hearing things no one else can hear, somatic, or feeling something you can’t see or hear, and visual, or seeing something no one else can see. 

Hallucinations are a symptom of psychosis, and they may be more likely to happen during the manic phases of bipolar disorder.

A delusion of grandeur is a false belief in one’s power or importance. It can cause confusion between what is real and what is not. It contradicts reality or what is commonly considered true. The strength of a delusion is based on how much the person believes it.

A person may believe that they are someone other than who they are, such as a supernatural figure or a celebrity. They may also believe that they have special abilities, possessions, powers, or have power and authority. For example, they may think they're the president of a country.

In the case of Tyvette’s experience, ‘Symone Seraphim’ is a delusion of grandeur that was developed during her psychosis. Seraphim are supernatural beings who were created to serve and worship. The word ‘seraph’ comes from the Hebrew verb ‘sarap’, which means to literally burn with fire—or more specifically, destruction by means of fire. The name may also hint at the seraphim’s role as purification agents. These angels have the appearance of burning flames.

These six-winged angelic creatures are said to continually attend God at the throne. Each set of the seraphim’s wings serves a different purpose; one set covers the face, denoting reverence and awe and acts as protection from the radiance of God’s glory—another set of wings is used for flying, to aid in their swift servitude—and the third set is used to cover the seraphim’s feet so that they can humbly conceal their unworthiness, while in God’s holy presence.

Tyvette mentally adopted a warped and misconstrued version of these qualities in her perceived reality and began to wear the wings that she uses in her artwork publicly to express this internal experience externally.

Psychosis (also called a 'psychotic experience' or 'psychotic episode') is when one perceives or interprets reality in a very different way from people around them. They might be said to 'lose touch' with reality.

Bipolar psychosis happens when a person experiences an episode of severe mania or depression along with psychotic symptoms and hallucinations. With psychosis, the person’s thinking becomes disconnected from reality, and they may have issues recognizing what is real and what is not. People who have psychotic episodes are often unaware that their delusions or hallucinations are not real, which may lead them to feel frightened or distressed.

The symptoms tend to match a person’s mood. During a manic phase, they may have grandiose thoughts, such as believing they have special powers or are famous. This type of psychosis can lead to potentially harmful behavior.

If bipolar psychosis occurs during a low period or a depressive episode, the individual may believe that someone is trying to harm them or that they have done something wrong. These beliefs can trigger extreme anger, sadness, or fear.

Many people believe psychosis is a sudden, severe break from reality, but psychosis usually develops slowly. A person may show signs before a psychotic episode that can include suspiciousness, difficulty organizing thoughts, withdrawal from social interactions, unusual or intense feelings or ideas, a decline in personal hygiene, insomnia, trouble communicating, and a sudden drop in work performance.

Recovery is a process that goes beyond reducing symptoms and involves gaining control over one's life, setting and achieving goals, developing skills and fulfilling dreams. It has been defined as "a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills, and/or roles" and "a way of living a satisfying, hopeful, and contributing life even within the limitations caused by illness."

Recovery includes the concept of treating the symptoms of bipolar disorder along with environmental stressors in order to increase the person's ability to function in everyday life and achieve the goals they are setting out to achieve. The recovery process will vary from person to person in terms of duration and degree of functional improvement.

The best chances for recovery are when everyone works together as a team. What we do know works to improve recovery is working as a team; professionals working closely with the person and their family and support networks, finding the right medication at the right dose, and managing, decreasing or eliminating major stressors and developing a lifestyle that supports mental wellness.

Family and friends may be unsure of how to act at first. There may also be hurt feelings or apologies that need to be made because of things that may have happened while in mania or depression. Family members may feel the need to apologize to you for their responses. Recognize that everyone has been affected in their own way and needs time to heal.

Hearing that you have bipolar disorder is a life-changing moment, one that many people find  hard to accept. Stigma surrounding mental health conditions still exists in the media, online, and via word of mouth. Many people with mental health conditions don’t seek help because they’re concerned about being treated differently — whether that’s at work or in their social lives.

But it’s not just stigma from others that creates challenges in accepting bipolar disorder.

If you’ve recently been diagnosed with bipolar disorder, you may carry that stigma yourself. You could have internalized a certain prejudice against mental health conditions that makes it harder for you to come to terms with your diagnosis.

Finding the right support system is crucial in navigating bipolar disorder. Living well with bipolar disorder is absolutely possible with the right tools and approach. Whether it’s accepting your diagnosis, telling people about your condition, or finding the right healing practice that’s the biggest challenge for you, there’s always ways to address these challenges and move forward.

A mental health crisis plan is a safety net. It’s the difference between an unknown, out-of-control situation and knowing that someone with bipolar disorder has done what they can to prevent worse outcomes and get to safety.

People with bipolar disorder can’t always control or prevent a crisis entirely — mental health emergencies can occur even when they’re following a treatment plan and doing their best. But they can still be prepared. With the right tools, people can seek help sooner and take care of themselves now for moments when they may not be able to. 

Remember, if you are experiencing these symptoms after your diagnosis, you’re not alone. You deserve support.