TBI – Bipolar – Cyclothymic – Mental Health and Family

We are not always told the truth about the risks associated with some of the sporting activities that are so popular. On the back of the news stories out there about AFL/NRL and the serious subject of concussion. I would like to help people understand in particular mood disorder. Which can come about from a head injury. Results: Concussion, Playing Experience, and Long-Term Health – Harvard Football Players Health Study

When the AFL/NFL stories hit the headlines, I thought thank goodness we now have an opportunity to teach parents and children about the potential risks involved when playing high risk sport. Assessing risk is part of life for yourself however as a parent you are assessing the risk for your child.

(3) Traumatic Brain Injury Symptoms – YouTube

Now I am not saying all brain injuries are going to cause a mood disorder. However I am saying if you are struggling it may be worth further enquiry.

A full enquiry/examination is not just a 15 min consult with your GP. A full examination may involve consultation with a Neuropsychologist and a Neurologist.   You may find yourself asking your GP for a referral.

NOTE: There are people out there with mood disorders who have never played a sport.

I see many people with mood disorders in my office, most common Bipolar 2 and Cyclothymic for management though helpful lifestyle & belief therapies such as CBT.

It may surprise you to know Approximately 1 in 50 Australians (1.8%) will experience bipolar disorder during their lifetime. There are three types of bipolar disorder (Bipolar I Disorder, Bipolar II Disorder and Cyclothymic Disorder). All three types involve strong changes in mood, energy, activity levels. Risky behaviour is common when unmanaged. This may involve increased alcohol use, drug use, gambling, and risky sexual behaviour.

(3) Effect of Brain Injury on Personality – YouTube (Neuropsychologist talks about TBI)

NB: After a brain injury, the body’s tolerance to alcohol is greatly reduced, and many survivors find that they are no longer able to enjoy alcohol in the same way as they did before their injury.

Bipolar I and Bipolar II are two different subtypes of bipolar disorder, which is a mental health condition characterised by extreme shifts in mood, energy, and activity levels. Both disorders involve episodes of depression and mania or hypomania, but they differ in terms of the severity and duration of these episodes.

Bipolar I Disorder: To diagnose Bipolar I disorder, mental health professionals typically look for the presence of at least one manic episode. A manic episode is a distinct period of abnormally elevated, expansive, or irritable mood and increased energy or activity. The manic episode must last for at least one week or be severe enough to require immediate hospitalization. Depressive episodes may also occur but are not necessary for the diagnosis of Bipolar I.

Bipolar II Disorder: Bipolar II disorder is diagnosed when an individual experiences at least one major depressive episode and at least one hypomanic episode. Hypomania is a milder form of mania that doesn’t cause severe impairment in daily functioning or require hospitalization. Hypomanic episodes last for at least four consecutive days. In Bipolar II, the depressive episodes tend to be more frequent and longer-lasting compared to the hypomanic episodes.

Differences between Bipolar I and Bipolar II: The main difference between Bipolar I and Bipolar II lies in the severity and duration of the manic or hypomanic episodes. In Bipolar I, full-blown manic episodes are required for diagnosis, whereas in Bipolar II, hypomanic episodes are sufficient. Manic episodes in Bipolar I can be severe and may lead to significant impairment or even psychosis, while hypomanic episodes in Bipolar II are

There is also Cyclothymic disorder, also known as cyclothymia, is a relatively mild mood disorder that falls under the category of bipolar disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is characterised by recurrent fluctuations in mood that alternate between periods of hypomanic symptoms and depressive symptoms. However, the intensity and duration of these mood episodes are less severe compared to full-blown manic or major depressive episodes seen in Bipolar I or Bipolar II disorders.

Here are some key features of cyclothymic disorder:

  • Cyclical mood changes: Individuals with cyclothymic disorder experience numerous periods of hypomanic symptoms and depressive symptoms over at least a two-year period (one year in children and adolescents). These periods are characterized by distinct changes in mood, energy, and activity levels.
  •  Hypomanic symptoms: During hypomanic episodes, individuals may feel an elevated or expansive mood, have increased energy or activity, experience racing thoughts, engage in excessive talking, have inflated self-esteem or grandiosity, and display increased goal-directed behaviour. However, these symptoms are not as severe as in a full manic episode.
  • Depressive symptoms: During depressive episodes, individuals may experience sadness, loss of interest or pleasure in activities, changes in appetite or weight, sleep disturbances, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death or suicide. Again, the intensity and duration of depressive symptoms are less severe than in major depressive episodes.
  • Persistent pattern: The symptoms of cyclothymic disorder persist for a significant portion of the two-year (or one-year) period and do not meet the criteria for a major depressive, manic, or hypomanic episode.

It’s worth noting that cyclothymic disorder can still significantly impact an individual’s life and functioning, and it may progress to a more severe form of bipolar disorder over time in some cases.

If you suspect that you or someone you know may have cyclothymic disorder, it’s important to seek professional evaluation and diagnosis from a qualified mental health professional. They can conduct a thorough assessment and provide appropriate treatment options, which may include therapy and medication. Less severe and often associated with increased productivity or creativity.

(3) What is bipolar spectrum? Will it become bipolar 1 or bipolar 2? – YouTube

It’s important to note that bipolar disorders are complex, and each individual’s experience can vary. A proper diagnosis is typically made by a mental health professional based on a thorough evaluation of symptoms, medical history, and sometimes additional assessments or psychological tests.

If you or someone you know is experiencing symptoms of bipolar disorder or any mental health concerns, it is crucial to seek professional help for an accurate diagnosis and appropriate treatment.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides the diagnostic criteria and guidelines used by mental health professionals for various mental disorders, including Bipolar II disorder. According to the DSM-5, the diagnostic criteria for Bipolar II disorder include the following:

  •  Presence or history of one or more major depressive episodes.
  • Presence or history of at least one hypomanic episode.
  • The occurrence of the major depressive and hypomanic episodes must not be better explained by other factors, such as substance use or a medical condition.
  •  The symptoms of depression or the change in functioning during the depressive and hypomanic episodes are significant and cause distress or impairment in social, occupational, or other important areas of functioning.

Additionally, the DSM-5 specifies the following criteria for a hypomanic episode:

a. A distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least four consecutive days. b. During the period of mood disturbance, three or more of the following symptoms (four or more if the mood is irritable):

  • Inflated self-esteem or grandiosity
  • Decreased need for sleep
  • Increased talkativeness or pressure to keep talking
  • Flight of ideas or racing thoughts
  • Distractibility
  • Increased goal-directed activity or psychomotor agitation
  • Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., excessive buying sprees, sexual indiscretions)

It’s important to note that these are just a summary of the criteria, and a qualified healthcare professional should make the final diagnosis based on a comprehensive evaluation. The DSM-5 provides further details and additional specifiers that can help clinicians in making a more accurate diagnosis of Bipolar II disorder.

There is some evidence to suggest that a concussion or traumatic brain injury (TBI) may increase the risk of developing psychiatric conditions, including mood disorders like Bipolar II disorder. However, the relationship between concussions/TBIs and bipolar disorder is complex and not fully understood.

Research studies have shown an association between TBIs and subsequent mood disturbances, including depressive symptoms, anxiety disorders, and in some cases, bipolar spectrum disorders. Some individuals may experience changes in mood, behaviour, or cognition following a concussion, which could be a result of brain injury-related effects on neurochemical and neurobiological processes.

It’s important to note that not everyone who experiences a concussion will develop Bipolar II disorder or any other psychiatric condition. Other factors such as genetic predisposition, family history, and other environmental factors may also contribute to the development of bipolar disorder. (See ACE’s) Adverse Childhood experiences (3) Adverse Childhood Experiences (ACEs): Impact on brain, body and behaviour – YouTube

If you or someone you know has experienced a concussion and is exhibiting significant changes in mood or other mental health symptoms, it is advisable to seek professional medical and psychiatric evaluation. A healthcare professional can assess the individual’s symptoms, medical history, and any potential underlying factors to determine the most appropriate diagnosis and treatment approach.

How to Make a Bipolar Relationship Work

It takes effort to keep any relationship strong, but it can be especially challenging when your partner has bipolar disorder.

Go to Couples Counselling

Couples counselling is essential for working through upset over a bipolar partner’s actions. It’s common for someone with bipolar disorder to hurt and offend their partner. When someone is first diagnosed, there are often relationship issues that need to be addressed. Couples counselling can help you:

  • Understand that there’s an illness involved in the hurtful behaviour.
  • Forgive the behaviour that happened during an altered mood state.
  • Set boundaries with a partner about maintaining treatment.

Get Involved with Treatment

Ask if you can be involved with your partner’s treatment, which may include occasionally going to the psychiatrist together. Being a part of your partner’s treatment has multiple benefits, including:

  • Gaining a better understanding of the illness.
  • Providing additional insight for the psychiatrist.
  • Learning to spot signs of impending episodes.
  • Alerting the psychiatrist about mood changes.

Even if your partner hasn’t signed off on you exchanging information with their psychiatrist, you can still report worrisome signs (the doctor just won’t be able to tell you anything). This gives the doctor a chance to make quick medication changes that may help your partner avoid being hospitalised.

Practice Self-Care

Self-care gets a lot of buzz these days, but nowhere is it more important than when you’re caring for someone with a serious illness such as bipolar disorder. It’s essential to dedicate time to your own physical and mental health, whether that’s going to a support group, talking to a therapist or attending a yoga class.

Being in a healthy relationship with someone with bipolar disorder requires not only careful management of their illness, but also setting aside time to take good care of yourself.

I hope this has helped to shed some light on a subject we rarely see in the media, yet 1 in 50 Australians experience at least once in their lifetime.