Neil Stegall

Neil Stegall, LCSW - Serving individuals, couples and families.
1001 S. Capital of Texas Hwy, Bldg L, Suite 100, Austin, TX 78746
(512) 773-6810

About Bipolar Spectrum Disorders

Bipolar Spectrum Disorders occur across a continuum from the more dramatic variations involving mania, hypomania and deep depression, to spontaneous but milder fluctuations in mood, thinking, and behavior characteristic of cyclothymia.

These disorders usually become evident by early adulthood and can diminish or disrupt daily functioning. These mood disorders can interfere with learning and adaptation across the life span. As a result, relationships, education, and professional achievement can be impacted significantly. In some of its forms, bipolar disorders can be crippling.

There are several challenges characteristic to the treatment of bipolar disorders. Commonly, individuals only seek professional help when they are in the despair of depression and things are failing. As a result, there is a tendency to abandon treatment when feeling better- the “feeling better” not infrequently being the result of mood cycling before any form of treatment has had a chance to be effective. This can result in a difficult, uneven and even failed course of treatment. Also, the tendency to seek help in the midst of depression often leads less experienced clinicians to an incorrect diagnosis and course of treatment, since the depressed phase of the cycle is treated without regard to the cycling nature of the disorder.

Self-medication- substance abuse- is also very common among those with bipolar disorders. This usually stems from an attempt to manage mood states and functioning with street drugs and alcohol as well as misusing prescribed medications and over-the-counter drugs and herbal preparations. While the substance abuse is quite intentional, it nevertheless often happens outside the person’s conscious awareness of the larger picture- it is a momentary or sometimes habitual response to continuing problems that arise from an underlying mood disorder. Substance abuse complicates diagnostic evaluation and the course of treatment. In the latter instance, the individual has already arrived at a habitual, preferred method of managing the mood disorder, which has had a further impact on brain functioning. As a result, substance abuse can be a continuing concern in some cases.

Tragically, bipolar spectrum disorders- especially if more severe- can result in suicide. The emotional pain and impulsive style frequently seen in bipolar disorder can lead to self-destructive attempts to end the torment. The result is profound guilt and distress for those close to the person.

Thankfully, bipolar disorders are more readily recognized today and sound psychiatric treatment is more available than any time ever before. Effective medical treatment can make an immense difference in the person’s experience of life. If medication is indicated, a mood stabilizer is prescribed to level out the cycling; an antidepressant may subsequently be added. There are other medications that may be used for targeted symptoms.

Psychotherapy also has a role in treatment. A psychotherapist familiar with the biological nature of bipolar disorder can help create daily routines of life that decrease stress and help with the regulation of sleep and activity. The therapist can also help with the challenges of what it means to take medication on a continuing basis. The therapist assumes the role of a coach in this case. Moreover, a skilled psychotherapist can help untangle the knots of damaged relationships and cope with some of the costly results of living with an untreated disorder.

Overall, the psychotherapist can be a resource in reclaiming a vital life from the distress and confusion of bipolar disorder.

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