Bipolar Disorder

What do the following people have in common: artist Michaelangelo, mathematician Isaac Newton, painter Vincent Van Gogh, politician Winston Churchill, novelist Virginia Woolf, president Abraham Lincoln and composer George Frederick Handel?

The answer is: they all suffered from extreme mood swings and breakdowns. If they could have benefited from today’s medical knowledge, they might have been diagnosed with bipolar disorder. Yet, in spite of emotional struggles, they were able to access their potential and live highly productive lives.

Sooner or later, clergy will encounter people who suffer from bipolar disorder. Here are some frequently asked questions (FAQs) and answers to help clergy provide effective ministry.

What is bipolar disorder?

It is a brain disorder which causes extreme shifts of mood, energy and activity levels. Psychologist Dean A. Haycock, Ph.D., says that a person with bipolar disorder experiences moods which “fluctuate widely and uncontrollably,” causing the individual to move from “depression to mania (periods of great excitement, euphoria, delusions and over-activity), from spirit-crushing and potentially life-threatening lows to dangerous highs.” Dr. Haycock adds that “these extreme fluctuations have a negative impact on a person’s energy level, thoughts, behavior and ability to function. Although not curable, bipolar disorder can be controlled with treatment.”

How many people have bipolar disorder?

This is difficult to determine precisely; however the National Institute of Mental Health (USA) estimates that approximately 5.7 million adults in the United States deal with this condition. That figure indicates that nearly 3 out of every 100 adults in the U.S. has some form of bipolar disorder. Of those, half are over 25 years of age when the disease is recognized.

Translated worldwide, those figures suggest more than 250 million people may have bipolar disorder. And, in addition to individuals who suffer from the illness, bipolar disorder impacts the lives of people around them.

What are the symptoms?

Symptoms are divided according to the two phases, manic and depressive. According to the Mayo Clinic, signs and symptoms of bipolar disorder can include:


• Euphoria
• Inflated self-esteem
• Poor judgment
• Rapid speech
• Racing thoughts
• Aggressive behavior
• Agitation or irritation
• Increased physical activity
• Risky behavior
• Spending sprees or unwise financial choices
• Increased drive to perform or achieve goals
• Increased sex drive
• Decreased need for sleep
• Easily distracted
• Careless or dangerous use of drugs or alcohol
• Frequent absences from work or school
• Delusions or a break from reality
• Poor performance at work or school


• Sadness
• Hopelessness
• Suicidal thoughts or behavior
• Anxiety
• Guilt
• Sleep problems
• Low appetite or increased appetite
• Fatigue
• Loss of interest in activities once considered enjoyable
• Problems concentrating
• Irritability
• Chronic pain without a known cause
• Frequent absences from work or school
• Poor performance at work or school.

Are there different types of bipolar disorder?

There is a spectrum of severity in bipolar disorder which can be divided into four patterns:

Bipolar I Disorder — This is considered the most severe condition with a high percentage of patients needing to be hospitalized in addition to a medication regime. Bipolar I patients may exhibit delusional psychosis, the inability to distinguish reality from fantasy. This may be accompanied by poor judgment, impulsive behavior and a complete lack of awareness that they have a mental illness.

Bipolar II Disorder — This is defined by a pattern of mild depressive to mild manic episodes shifting back and forth. People around a person with bipolar II disorder view him as extremely moody and given to mood swings.

Bipolar Disorder Not Otherwise Specified (BP-NOS) — This diagnosis is made when a person has symptoms but does not meet diagnostic criteria for either bipolar I or bipolar II. However, the person’s emotions and behavior are clearly beyond normal range.

Cyclothymic Disorder or Cyclothymia — This is the mildest form of bipolar disorder. Many people with this disorder never seek diagnosis or treatment. They are generally functional but subject to moderate swings from depression to mania. Their symptoms do not meet diagnostic requirement for any other type of bipolar disorder.

What causes bipolar disorder?

The cause of bipolar disorder is not yet known but one view holds that there may be a genetic vulnerability because the condition runs within families. If one parent has bipolar but the other parent does not, there is a 7.8 percent risk of an offspring developing the condition. Another theory suggests that the disorder comes as a result of an underlying defect in brain chemistry. This may be triggered by environmental or lifestyle factors such as high stress or drug or alcohol abuse. Today, researchers are working hard to predict and prevent this illness.

How is bipolar disorder diagnosed?

This begins when an individual or their close family members suspect that professional assistance is needed. Candida Fink, M.D., a psychiatrist specializing in bipolar disorder, says that the process for obtaining an accurate diagnosis entails the following two steps:

First, an appointment with a family physician. “Other health issues, such as thyroid malfunction, menopause, or nutritional deficiencies can cause symptoms similar to those of bipolar disorder. Medications and other substances can also generate similar symptoms,” Dr. Fink notes. A visit with a family physician can help rule out other possible causes of symptoms.

Second, when other issues are ruled out, the family physician will advise undergoing a psychiatric evaluation. Performed by a psychiatrist, this includes an in-depth review of one’s medical history, family history and symptoms. The psychiatrist will then offer a treatment plan.

How is bipolar disorder treated?

While there is currently no cure for bipolar disorder, there are a variety of effective treatments. “Your psychiatrist’s treatment plan almost always includes prescribed medications designed to treat your current state (manic, depressed, mixed) and to prevent further cycles,” says Dr. Fink. “Psychiatrists often prescribe multiple medications to treat all symptoms and to improve the drugs’ overall effectiveness,” Dr. Fink adds. A bipolar cocktail can include anti-manic medication along with antidepressants. The prescription medication is not designed to cure bipolar disorder but “to treat the physical side of the disorder in your brain so the rest of your being can function without the interference of mania or depression,” Dr. Fink notes.

Can a bipolar person who is feeling well go off medications?

This is highly inadvisable. However, the temptation to quit taking medication is great for two reasons: first, because symptoms have eased and, second, because the side effects are unpleasant. Specialists in bipolar disorder advise against “tweaking” or modifying one’s prescriptions and strongly suggest that patients first consult with their psychiatrist who may make a minor adjustment.

Along with medication, is it advisable to see a psychotherapist?

Ongoing counseling is a powerful companion to medication for helping bipolar people manage their lives. In his book, The Bipolar Disorder Answer Book: Professional Answers To More Than 275 Top Questions, psychiatrist Charles Atkins, M.D., explains the advantages of seeing a psychotherapist: “If someone is recovering from depression, psychotherapy can speed up recovery. If someone is experiencing early signs of a mood swing or relapse, these can be explored in the therapy session and interventions put in place to prevent it from developing further.

If someone is struggling with taking prescribed medication, this can become a focus of therapy.” Furthermore, therapy can be effective in understanding and managing the “emotional aftermath of a mood episode, especially a manic or mixed one, in which impulsive behaviors may have damaged relationships, reputation, employment, finance, or gotten the person into legal trouble.”

Can faith save me from bipolar disorder?

Prayer, faith, trust in God are all spiritual tools which can help deal with and manage bipolar disorder. However, they must be accompanied by “works” as cited in James — “Faith by itself, if it does not have works, is dead” (Jas 2:17). In the case of a bipolar diagnosis, the “works” are those of a medical doctor. That means following the doctor’s treatment plan along with exercising spiritual tools of prayer and faith.

Is a bipolar person more likely to try suicide than a non-bipolar person?

Unfortunately, the answer is yes. According to Dr. Atkins, “between 10 and 20 percent of people with bipolar disorder will end their lives by suicide (some reports put this figure much higher, at 40 or 50 percent).” He adds that nearly one percent of people with bipolar disorder end their lives by suicide each year “or 30 to 60 times the rate of suicide in the general population.” Therefore, it is critical for family members and friends to act promptly if when there is any suicidal express from a bipolar person. “Thinking of suicide is a medical emergency that needs immediate attention,” says Dr. Atkins.

Should a person with bipolar disorder disclose that at workplace?

“I do not advise patients to tell others in the workplace about their illness,” says psychiatrist Wes Burgess, M.D., Ph.D., author of The Bipolar Handbook: Real-Life Questions With Up-To-Date Answers. He explains his answer: “For one thing, many of the feelings in bipolar disorder have to be experienced to be understood. Moreover, bipolar disorder is a complicated disease, and most people know little about it. This could create tension between you and your coworkers due to misconceptions and stigma regarding the illness.” However, if there has been an incident in the workplace caused by the bipolar condition, there may be times when some disclosure is appropriate. Confiding in a supervisor could help reframe what occurred at work in a less negative manner.

Is there hope for a person with bipolar disorder?

“Absolutely,” says Dr. Burgess. “With successful treatment, people with bipolar disorder are healthy and can achieve the kind of life they want and deserve. For the first time in history, we have a broad choice of effective treatments for bipolar disorder,” he adds. For patients and their families, it is important to maintain a positive attitude, refusing to permit bipolar disorder to keep a person from developing personally or professionally.

Today many prominent people have come out publicly about being bipolar, including actor and martial arts expert Jean-Claude Van Damme, actress Catherine Zeta-Jones, television journalist Jane Pauley, and actresses Linda Hamilton and Carrie Fisher. Being diagnosed with bipolar disorder does not mean the end of a productive, fulfilling life.

REV. PARACHIN writes from Tulsa, Okla.