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This is Bipolar: Episode 4
In this episode of PSYCHEDUP, we explore bipolar disorder, a condition defined by two extreme mood poles. Our guest Pauline pulls back the curtain on what living with bipolar disorder is really like, revealing the challenges she faces, the ultimate highs, the depressive lows and how bipolar impacted her relationships.
Then, Dr. Diane McIntosh and Dr. Randy Mackoff share their expertise in treating bipolar disorder, providing valuable guidance for people who have or know someone who has this disorder.
PODCAST GUEST
Dr. Randy Mackoff, PhD
Dr. Randy Mackoff is a registered psychologist in British Columbia. He has a private clinical practice where he provides psychological treatment for a wide range of issues, including but not limited to depression, anxiety, PTSD, coping with psychosis, and marital therapy. He is a retired Professor in the Criminology Department at Douglas College and a past Chairperson of the Criminology Department. He is a Clinical Associate in the Clinical Psychology Department at Simon Fraser University, providing clinical supervision to graduate students. He currently consults with law enforcement agencies in Crisis Negotiations, Undercover Operations, Witness Protection, Psychological Support for witnesses, Source Suitability, Major Crimes, Recruiting, and Human Resources. He is a designated Vancouver Police Department Psychologist and represents them at the Major Cities Chiefs Association Psychology meetings. He is the Co-Chair of the Psychology Committee for the Canadian Association of Chiefs of Police (CACP).
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Episode Highlights
3:21
Pauline discusses her experience with bipolar disorder
11:21
Dr. McIntosh breaks down the type of medications used to treat bipolar disorder
19:17
Dr. McIntosh discusses the longer term consequence of untreated bipolar disorder
Key quotes from This is Bipolar
"The result is that bipolar disorder is misdiagnosed more than 90% of the time. It takes, on average, 10 years and four different clinicians before the right diagnosis is made.”
“You can’t talk someone out of a mania… If someone is manic, they need treatment, and often they need hospitalization, because they could have psychotic symptoms.” 10:28
“The pull of mania is so hard to resist. It’s so difficult to decide to stop feeling that good, especially when so much of your time is spent depressed” 18:15
More About Bipolar
Bipolar disorder is a collection of mood disorders characterized by emotional highs and lows. They include episodes of depression as well as periods of elevated mood.
A manic episode is a severe high, often leading to impaired judgment, risky behavior, and, in some cases, psychosis, where false beliefs may emerge. Hospitalization may be required if the individual is at risk to themselves or others.
A hypomanic episode, or “little mania,” is a milder form of mania, sharing symptoms such as increased energy, confidence, and impulsivity.
The key difference between mania and hypomania lies in their severity and impact on daily functioning.
Depression:
Low mood, Loss of interest or pleasure in once-enjoyable activities, Weight loss or gain, Insomnia or excessive sleep, Apathy or agitation, Fatigue or loss of energy, Feelings of worthlessness, Difficulty concentrating or making decisions, Suicidal thoughts (always to be taken seriously).
Mania:
Excessively high or elevated mood, Extreme irritability or anger, Unrealistic optimism,
Impulsive decision-making, Increased spending or changes in sexual habits, Racing thoughts, Excessive energy or restlessness, Talking quickly or incoherently, Little need for sleep, Extremely short attention span, Hallucinations.
Bipolar disorder can be overlooked when seen through the lens of addiction:
During depressive or manic episodes, individuals may turn to substances that either amplify or medicate their feelings. This common co-occurrence of bipolar disorder and substance use often leads to misdiagnosis, with the underlying bipolar condition being missed.
Many only seek treatment when depressed:
During manic episodes, individuals with bipolar disorder often feel invincible and are less likely to seek help. They typically seek treatment only during depressive episodes, leading to frequent misdiagnosis and delays in receiving the correct diagnosis.
Bipolar disorder treatment typically involves:
- Mood stabilizers (often the first choice, but require regular monitoring)
- Antipsychotics (effective for managing manic episodes, but may have side effects).
Goals of treatment:
- Manage symptoms and reduce distress
- Improve work and social functioning
- Reduce the risk of relapse.
Additional components:
- Psychotherapy
- Healthy lifestyle.
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Founded by Dr. Diane McIntosh, RAPIDS Health provides timely, effective clinical decision support for mental health diagnosis and treatment. Whether you’re a clinician or someone seeking help, we offer evidence-based, personalized treatment guidance tailored to each individual’s needs.