Heaven and Hell | What's Bipolar Disorder?
双相情感障碍这个词似乎很神秘。但在过去两年始然公益的各种线下活动中，我们总能遇到一些参与者是双相情感障碍的患者，这些里头有不少都是我们周边的正常穿梭在人群中的人。但是，双相情感障碍究竟从医学上讲，是个什么东西呢？
The word “Bipolar Disorder” always seems to be a bit mysterious: you can only guess! However, for the past two years, we have been approached by many people living with bipolar disorder, who came to our CandleX offline events. Many of these people are just faces that you see every day at work, in your community group or at home even. What is exactly Bipolar Disorder from the medical stand point?
大家还记得吗？我们在2月22日-3月2日联手简单心理，进行了9天的双相情感障碍倡导篇章。也标记着我们始然公益（CandleX）“情绪实验室”项目（双相情感障碍社会倡导2016-2018）项目进入了第三个模块：社会教育宣传。
22nd Feb- 2nd March last month, our MoodlaB Project ( Bipolar Disorder Awareness Raising Project 2016-2018) has started on the third component: Psychosocial Education, with the spot light brought on by our partner: Mytherapist.
3月30日是国际双相情感障碍日（就是今天了！）
今天上汤：简单心理和始然公益联合倡导的双相情感障碍公众教育贴
作者｜丸子，本文首发于“简单心理”（ janelee1231），只提供高质量的心理服务
30th March is the World Bipolar Day. (IT IS TODAY)
Reading of today: Heaven and hell, in a single brain | all the things you need to know about bipolar disorder.
Author | Wanzi, published on “Mytherapist” (janelee1231) on26rd Feb 2017.
地狱天堂皆在脑中｜关于双相情感障碍你需要知道的一切
Heaven and hell, in a single brain | all the things you need to know about bipolar disorder.
“她会无缘无故地变成一个暴怒的怨妇，声音可以瞬间变得尖刻、刺耳，眼神尖锐到骇人；舞台上的她频频崩溃，忘词、唱错、攻击同台演员。但当她安静下来时，又楚楚可怜的像一个受伤的小孩。”
费雯·丽给予我们的印象可能是《乱世佳人》中那个活泼耀眼的斯嘉丽，但她患有双相情感障碍已不再是秘密。饱受双相障碍折磨的她，以健康为代价，换取了短暂而耀眼夺目的一生。
今天我们想聊聊关于双相情感障碍你需要知道的一切。
“She is sometimes a ranged shrew, with shrieks piercing my ears and frightful expressions in her eyes; standing on the stage, she forgets her lines, sings the wrong words, assaults other actors and falls into frustration from time to time. While she comes to a silence, her suffering martyrdom reveals her facet of a child.”
Vivien Leigh may leave us with an impression of the sprightly, shining Scarlet in Gone with the Wind. The fact that she suffered from bipolar disorder is not a secret. Swinging in this bi-polar state, she exchanged adazzling but brief life at the epense of her health.
什么是双相情感障碍？
双相情感障碍（bipolar disorder），也称为躁郁症，是一种躁狂与抑郁交替发作的严重类精神疾病。
躁狂发作是双相情感障碍的标志性特征。主要的表现有：
心境高涨：极High的同时也容易被激怒
思维奔逸：个体的思维比语言表达的频率更快，且能在不同话题之间快速转换。有时候因为想法塞满脑子以致于难以表达
活动性增多：变得极为健谈，语速快，且话语内容夸张
自尊膨胀，伴随冲动行为
睡眠需求减少：长时间高效率工作还不觉得累，不需要或只需很少的睡眠。
挪威剧《skam》中的男主角Even就是一位双相障碍患者。他在躁狂发作时处于高度亢奋状态，晚上从不睡觉，大半夜裸奔出去买吃的，突发奇想就闯入别人家游泳，说话时滔滔不绝且天马行空。
What is bipolar disorder?
Bipolar disorder, also called manic-depression, is a severe mental illness characterized by alternating periods of mania and depression.
Mania is a characteristic of bipolar disorder, but what it it? Mania often features:
A heightened stateof mind: an individual’s mind is extremely high but easily enraged.
Racing thoughts: an individual’s pace of thinking is much faster than the frequency of language expression; individuals may speak very quickly, often making quick changes between different topics. Sometimes individuals find it hard to express themselves because their brains are too full of ideas.
Increased activity: an individual becomes extremely talkative, fast-talking, and exaggerated in their words and content.
Elevated self-esteem with impulsive behavior.
Little need for sleep: the individual never gets tired even after prolonged activity and after working for a long time; they do not need to sleep, or only sleep a little.
The main character of Skam — the Norwegian TV series, suffers from bipolar disorder. When he is in a manic episode he never sleeps at night and runs around naked at midnight. He breaks into other people’s houses to swim,and speaks unceasingly in an unconstrained style.
( in our CandleX's column "My Story with Depression", you can also read about a manic story from our follower, describing what it's like to be on the manic side. Maria's Story on Mania)
抑郁发作是双相情感障碍的另一大特征。双相障碍中的抑郁发作期的症状往往与单相抑郁症的相似，经常临床上难以区分。他们在抑郁发作时，也会表现出心境低落、丧失兴趣和活动性减弱等抑郁表现。而只有情绪低落的时候，他们才会有求助的念头，而正是因为大部分患者都是在抑郁期就医，双相障碍很容易被误诊断为抑郁症。因此，当你察觉到身边的朋友或亲人有抑郁的症状时，也要留意Ta是否出现过（轻）躁狂的症状。
令双相情感障碍患者最痛苦的是，他们的抑郁和躁狂是交替发作的，可能你会看到他们在某段时间特别high，high到觉得自己是人间的主宰。有时他们又特别抑郁，难过到不想再继续活下去。
一位双相情感障碍患者曾对我们说：“有些人光是为了活着就要竭尽全力了，那就是我。”
Depression is the second characteristic of bipolar disorder. Depressive episodes of bipolar disorder tend to be very similar to single-phase depression (majord epressive disorder) and they are difficult to distinguish clinically. Low state of mind, loss of interest, and decreased activity appear when patients enter episodes of depression. People with bipolar disorder tend to only seek help when they feel depressed. It is exactly because they only go to the doctor when they feel depressed that many people suffering from bipolar disorder are wrongly diagnosed as having depression. If you notice symptoms of depression in your family or friends, you had better pay attention to whether or not they show signs of manic behavior as well.
The most painful truth for bipolar disorder patients is that they are alternately attacked by mania and depression. Sometimes you may see them living in an extremely high state of mind — so high that they feel like they are the master of the universe. In contrast, they sometimes get so depressed that they no longer want to carry on living.
One bipolar disorder sufferer said to us, “Someone bleeds all his energy to keep living — that person is me.”
一些对于双相的幻想
经历过痛苦的人，往往才会更理解别人的痛苦。没有经历过的人们常常对心理疾病有一些误解和迷思。尤其像「双相情感障碍」这种在字面上就给人的想象力以巨大发挥空间的词，对于它的误读往往是两极化的。
1.双相只是心情的正常起伏？
很多人会轻视双相情感障碍，认为它可能就是“一阵儿高兴一阵儿难过”的状态，甚至人们会胡乱地把「双相」的标签随意贴在别人和自己身上。
这对于那些真正饱受双相障碍痛苦的人们来说，是非常不公平的，就像以前我们轻视抑郁一样，认为抑郁患者只需要“积极点儿”就可以了。
双相障碍的患者总是游走于天堂与地狱之间，这种飙升和跌入感伴随着他们度过一个个挣扎的日夜。作为正常的人，我们会主动去玩跳楼机寻求刺激，但如果让你想象这一辈子都在跳楼机上过呢？这可能就是双相患者们的痛境。
Some misconceptions about bipolar disorder
Those who experience the pain will feel empathy towards those people suffering it. People without such experiences may easily have some misunderstandings and confusion about mental illness. This is especially true for bipolar disorder, which may give people a large space for imagination, and leads many misconceptions to arise.The following are some commonly help misconceptions:
1. Is bipolar disorder just the normal ups and doesn't of moods?
Many people may simply regard bipolar disorder as a state of “sometimes happy, sometimes sad”. Some people may put the label of “bipolar” on themselves and others at their will.
This is very unfair for those who are actually suffering from bipolar disorder — just as some wrongly believe that patients with depression will get better merely by “being more positive”. It minimizes what it is actually like to live with bipolar.
Sufferers of bipolar disorderare always swinging between heaven and hell in their lives. The feelings of surging and falling follow them, along with the struggle through day and night. As people who have not experienced bipolar, we may seek excitement by playing Mega Drop. But what if you imagine that you spend your entire life on the MegaDrop? This would probably be somewhat like the reality of a somebody who is living with bipolar disorder.
2. 双相偏爱天才（我也想得）？
有人认为，双相情感障碍是一种“天才病”，是人类为了换取智慧和创造力所付出的代价。许多轶事和传记记录也一直呈现着这样一种趋势，好像患有双相障碍、精神分裂症等精神障碍的人似乎都是天才，都有独特的世界观（比如《天才在左。疯子在右》）。
美国精神病研究者Kay Redfield Jamison在《躁郁症与艺术家气质》一书中，列出了一系列可能患有双相障碍的名人名单，其中作家、艺术家和作曲家占绝大多数，丰富想象力和创造力是他们疾病黑暗中留存的一丝光明（silver lining）。
双相障碍是很严重的精神疾病，它所带来的痛苦足以将人击倒，这些媒体宣传的“天才躁郁患者”是一种幸存者偏差，南派三叔自爆患有躁郁症，也加深了这种幸存者偏差的印象。虽然能够创作出无与伦比的艺术听起来极具吸引力，但是双相绝不值得追寻。
2. If bipolar disorder favors geniuses, can I getsome too?
Some people think that bipolar disorder is a kind of “genius disease”, that it is the price people pay in exchange for intelligence and creativity. Many anecdotes and biographies show a tendency for people suffering from bipolar disorder or schizophrenia to show signs of genius and of being in possession of an “incomparable vision of theworld.” Some believe that an abundant imagination and creativity are the silverlining that keeps sufferers alive through the darkness of the disease.
In the book Bipolar Disorder and Temperaments of Artists by American psychologist Kay Redfield Jamison, a list of celebrities who may suffer from bipolar disorder is given. Writers, artists, and composers make up the majority of this list.
In reality, bipolar disorder is a severe mental illness; the pain brought by it is strong enough to beat a person down. The “genius patients of bipolar disorder” reported by the media is a survivor biased, romanticized view of the realities of the disorder. Though the ability to create incomparable arts sounds really captivating, bipolar is definitely not worth looking for.
3. 是否存在一个切换情绪的开关？
很多人认为双相障碍患者在躁狂和抑郁之间的切换是一种很神奇的事情。有些躁郁症患者也隐约能察觉到自己找到了一个“开关”，可以自己选择随时开启躁狂的状态。
确切来说，并不存在一个真正的“切换开关”，只是当患者在进行某些活动时，脑内激素的分泌水平影响了神经活动，从而触发了躁狂的状态，这其实是一个转换的过程（switching process）。
正常情况下，患者并不能预期自己下一秒的状态是怎样的。情绪的波动也不是他们所能够完全“控制”的。
3. Is there a "switch" that can alter the mood?
Many people think it incredible that bipolar disorder patients can switch between mania and depression. Some believe that the patients themselves can dimly perceive a “switch” in their brains, which they can choose to use in order to turn on themanic state.
In fact, the “switch” does not exist. Only in some conditions when the patients are participating incertain activities, does a hormone secreted in their brains affect neural activities and accordingly trigger the mania. It is actually a switching process.
Normally, patients are not able to anticipate the onset of this change. Mood swings cannot be absolutely controlled.
患了双相障碍之后的路
双相情感障碍是一种难以完全疗愈的精神疾病，经药物治疗康复的患者，在停药后的一年内复发率也较高。
除了生理上服药来减缓痛苦之外，心理治疗在康复期起到了重要的辅助作用。如果患者在用药维持情绪稳定的情况下，同时接受心理咨询或治疗，那么复发的可能性会大大减少。正念技术、认知行为疗法等都被证明是治疗双相情感障碍的有效措施。
The road after bipolar disorder
Bipolar disorder cannot be completely cured. Patients treated with medication have quite a high recurrencerate one year after treatment. In addition to the physical treatment with medication, psychological therapy plays an important supporting role during the rehabilitation period. In the case of emotional stability, the corresponding psychological counseling and treatment can greatly decrease the rate of recurrence. Mindfulness techniques and cognitive behavior therapy have provento be effective measures for the treatment of bipolar disorder.
For the family and friends of patients, the symptom of swinging between mania and depression is a heart-breaking and grievous problem. This situation seems “unreasonable” to them and it may consume all of their care and patience.
双相患者会一直处于躁狂与抑郁交替进行的状态，对于家人、伴侣和朋友来说，这是一件令人心碎又头疼的事情，他们起伏的状态、“不可理喻”，会消耗掉周围人的关心和耐心。
但对于病人来说，所处的家庭环境和社会环境宽容是缓解病情的重要因素。来自亲人的社会支持以及包容、陪伴会提供一个良好的愈后环境，是预测患者之后情绪稳定性的有效指标。用《skam》洒一把优质狗粮~愿每个受伤的灵魂都可相互依偎，不再孤独。
Above all else, for the patients themselves, the tolerance from both their families and the society in which they live is a crucial factor in alleviating the illness. Support, comprehension, and companionship from family and friends will provide the patients with a better environment for their recovery. They are also useful indicators for predicting the patient’s emotional stability.
(do NOT stop reading. Moreafter the references)
References:
AmericanPsychiatric Association (2013). DSM-5.
Andreasen, N.C. (1987). Creativity and mental illness. American journal of Psychiatry,144(10), 1288-1292.
Ball, J. R.,Mitchell, P. B., Corry, J. C., Skillecorn, A., Smith, M., & Malhi, G. S.(2006). A randomized controlled trial of cognitive therapy for bipolardisorder: focus on long-term change. The Journal of clinical psychiatry, 67(2),277-286.
Gale, C. R.,Batty, G. D., McIntosh, A. M., Porteous, D. J., Deary, I. J., & Rasmussen,F. (2013). Is bipolar disorder more common in highly intelligent people? Acohort study of a million men. Molecular psychiatry, 18(2), 190-194.
Salvadore, G.,Quiroz, J. A., Machado-Vieira, R., Henter, I. D., Manji, H. K., & ZarateJr, C. A. (2010). The neurobiology of the switch process in bipolar disorder: areview. The Journal of clinical psychiatry, 71(11), 1488-1501.
Zammit, S.,Allebeck, P., David, A. S., Dalman, C., Hemmingsson, T., Lundberg, I., &Lewis, G. (2004). A longitudinal study of premorbid IQ score and risk ofdeveloping schizophrenia, bipolar disorder, severe depression, and othernonaffective psychoses. Archives of general psychiatry, 61(4), 354-360.
What’s more?
With the intention to unite the isolated voices, our MoodlabPhotoshoot( Sep 2016-2017) is still ongoing. We invite you to join us as a model, a story teller and an advocate (click here)
By Photographer: Pere Ibenaz
Dance for Charity | CandleX’s 2 Year Anniversary Party
It is tomorrow, 1stApril!
Here’s something you don’t know about CandleX! Behind all the depression talks, workshops, and events, we are a team of people with good sense of humor, diverse talents, and fun driven energy. So instead of a traditional celebration with speeches, medals, and sitting tables, we are going to make it FUN!
Tomark this two-year anniversary, we are throwing a PARTY at night, and DanceWorkshops during the afternoon. You are invited to join us. Meet the CandleX’screw! It will be a night of fun and celebration.
Formore info: click here( you can purchase the tickets at the door as well)