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Bipolar disorder (formerly called manic-depression) is a bio-chemical condition that results in an imbalance of the neurotransmitters in the brain. Genetic make-up is thought to play a role but so too are environmental pressures such as your family, work and social environment, stress, injury, illness and hormone imbalances.

Bipolar disorder is characterized by mood swings that can last for days, weeks or even months. These swings range from mild to severe. The “bi” in bipolar disorder refers to the dual nature of these mood swings – from feelings of great happiness and elation to sadness and despair. In its most severe expression, bipolar disorder can result in mania which is defined as strongly held beliefs that you are a famous person, have special physical abilities or knowledge, or that you are invincible. People can experience mania as a euphoric period. Unfortunately, mania is also accompanied by unwise behaviours tied to the false beliefs. These can include spending sprees, risky sexual activity, excessive drinking or drug use, and other reckless activities or decisions. Bouts of mania are followed by the depths of depression where people feel worthless and hopeless. This phase of bipolar disorder is excruciatingly painful. The mood swings of bipolar disorder deeply affect relationships, social and work functioning and can, in the extreme, bring people into contact with the law.

Living with bipolar illness is not easy but full recovery is possible. The first step is taking personal responsibility for your own health.

Some Statistics:

• One percent (1%) of Canadians aged 15 years and over reported symptoms that met the criteria for a bipolar disorder in the previous 12 months. About 1 in 50 adults aged 25-44 years or 45-64 years reported symptoms consistent with bipolar disorder at some point in their lifetime. The proportion of men and women who met the lifetime criteria for bipolar disorder decreased slightly with age. (2002 Mental Health and Wellbeing Survey, Statistics Canada)
• Nearly 9 out of 10 Canadians who reported symptoms that met the 12-month criteria for bipolar disorder (86. 9%) reported that the condition interfered with their lives. (2002 Mental Health and Wellbeing Survey, Statistics Canada)
• While most people with bi-polar disorder (or depression) will not commit suicide, the risk of suicide among those with bipolar disorder is higher than in the general population.

Source: Public Health Agency of Canada, Chronic Diseases, Mental Illness section. https://www.canada.ca/en/public-health/services/chronic-diseases/mental-illness/bipolar-disorder.html

Borderline personality disorder is a mental illness that affects the way to relate to other people and the way you relate to yourself. If you’re living with borderline personality disorder, you might feel like there’s something fundamentally wrong with who you are—you might feel ‘flawed’ or worthless, or you might not even have a good sense of who you are as a person. Your moods might be extreme and change all the time, and you might have a hard time controlling impulses or urges. You may have a hard time trusting others and you may be very scared of being abandoned or alone.³

BPD is made up of five groups of symptoms: unstable behaviour, unstable emotions, unstable relationships, unstable sense of identity and awareness problems.^4,5

Unstable behaviour means that you often act on impulses or urges, even when they hurt you or other people. Some examples of impulse control problems are:

• Thinking about or attempting suicide
• Hurting yourself on purpose, such as cutting or burning your skin (self-harm)
• Risky behaviours like spending a lot of money, binge eating or problematic substance use

Unstable emotions mean that your moods can be extreme and change very quickly. Some examples of unstable emotions are:

• Extreme depression, anxiety or irritability that might last for only a few hours or days, usually in response to a stressful event
• Intense anger or difficulty controlling anger
• Intense boredom

Unstable relationships mean that you have a hard time maintaining relationships with other people. Some example of relationship problems are:

• Doing anything you can to avoid being abandoned or alone
• Feeling like you don’t know yourself or having very unstable sense of who you are and how you feel about yourself
• Intense relationships where you often impulsively shift between seeing the other person as ‘all good’ or ‘all bad’

Unstable sense of identity means that you don’t have a good sense of who you are as a person. Some examples of an unstable sense of identity include:

• Feeling like you don’t know yourself
• Having a very unstable sense of who you are and how you feel about yourself
• Feeling “empty” much of the time

Awareness problems mean that, from time to time only and often in response to a stressful event, you experience sensations or feelings that aren’t based in reality. Some examples of awareness problems are:

• Psychosis (delusions or hallucinations)
• Feeling like you’re separated from your mind or body (dissociative symptoms)

There are many different combinations of symptoms, so BPD can look very different among people with the illness.⁶ To diagnose BPD, mental health clinicians look for patterns of behaviour that last for a long time and have caused distress or problems with relationships or other areas of life, such as work.

Source: Canadian Mental Health Association, British Columbia Division. “Borderline Personality Disorder.” https://cmha.bc.ca/documents/borderline-personality-disorder-2/.

Personality disorders involve patterns of behaviour, mood, social interaction, and impulsiveness that cause distress to one experiencing them, as well as to other people in their lives.

Many of these behaviours may cause severe disturbance in the individual’s personal and work life. In general, individuals with personality disorders have difficulty with close, intimate or attachment relationships. They experience chronic interpersonal problems, have difficulties in establishing a coherent sense of self or identity, and may be seen to be impulsive, irritable, fearful, demanding, hostile, manipulative, even violent.

Problem alcohol or drug use, mood disorders, certain anxiety or eating disorders, suicidal thoughts or attempts, and sexual problems often accompany personality disorders.

Symptoms The symptoms of personality disorders are varied and depend on the type of disorder the individual is experiencing. Since many of the symptoms are common across various personality disorders, an individual may exhibit signs of more than one personality disorder.

There are three personality disorders that describe people with social avoidance or low sociability issues. These are:

• Paranoid Personality Disorder, which is a tendency to mistrust others and to suspect that their motives are hurtful
• Schizoid Personality Disorder, which a tendency to not be able to relate to other people and to have a restricted range of emotional expression
• Schizotypal Personality Disorder, which is a tendency to feel very uncomfortable in close relationships, and to have odd or distorted thoughts or perceptions

There are another four types of personality disordersat that describe those who appear to be highly emotional and dramatic in social situations, and react to feelings with impulsive or spur-of-the-moment behaviour. These include:

• Antisocial Personality Disorder, which is seen when one persistently ignores and violates the rights of others
• Borderline Personality Disorder, which is a tendency to have unstable relationships, intense mood changes, rapidly shifting self-image, high levels of anxiety, including chronic worrying and intense panic, and noticeably impulsive behaviour
• Histrionic Personality Disorder, which is a tendency to be highly emotional in social situations
• Narcissistic Personality Disorder, with its pattern of feeling overly important, needing admiration from others and having a lack of empathy

Additionally, there are three other personality disorders that describe people who seem very cautious and fearful:

• Avoidant Personality Disorder, which includes extreme shyness, feeling inadequate or ‘not good enough’, and being very sensitive to criticism
• Dependent Personality Disorder, which involves a tendency of needing to be led in making decisions, clinging to others and having an extreme need to be taken care of
• Obsessive-Compulsive Personality Disorder, which is a pattern of constantly needing things to be orderly and of wanting to be in control

It is important to remember that all of us may experience some of the characteristics of personality disorders from time to time in our lives in varying degrees. But an actual personality disorder is defined by the extremes of several traits and by the rather inflexible way these traits are expressed, as well as their influence on our activities and relationships of day-to-day life.

Symptoms of personality disorders are usually first displayed in childhood or adolescence and usually go on for a long time. However, this depends to some extent, on the type of personality disorder and the situation or events surrounding the individual. Borderline personality disorder, for example, usually peaks in adolescence and early adulthood, and may become less prominent by mid-adulthood in some individuals, or not. On the other hand, narcissistic personality disorder may not be identified until middle age.

Personality disorders also have a major effect on the people who are close to the individual experiencing them. The individual’s fixed ideas and patterns of behaviour make it difficult for them to adjust to various situations. As a result, other people adjust to them. This creates a major strain on all relationships among family and close friends, and in the workplace. At the same time, when other people do not adjust, the individual with the personality disorder can become angry, frustrated, depressed or withdrawn. This establishes a vicious cycle of interaction, causing the individuals to persist with their stressful behaviour until their needs are met.

Source: Canadian Mental Health Association. (n.d.). Personality disorders. https://cmha.bc.ca/documents/personality-disorders-2/

Depression, also known as clinical or major depression, is a mood disorder that will affect one in eight Canadians at some point in their lives. It changes the way people feel, leaving them with mental and physical symptoms for long periods of time. It can look quite different from person to person. Depression can be triggered by a life event such as the loss of a job, the end of a relationship or the loss of a loved one, or other life stresses like a major deadline, moving to a new city or having a baby. Sometimes it seems not to be triggered by anything at all. One of the most important things to remember about depression is that people who have it can’t just “snap out of it” or make it go away. It’s a real illness, and the leading cause of suicide.

Depression can affect anybody; young or old, rich or poor, man or woman. While depression can affect anyone, at anytime, it does seem to strike most often when a person is going through changes. Changes can be negative life changes such as the loss of a loved one or a job, regular life changes such as starting university or a big move, or physical changes such as hormonal changes or the onset of an illness. Because depression can be linked to change, certain groups of people are at risk more often than others:

• Youth: More than a quarter of a million Canadian youth—6.5% of people between 15 and 24—experience major depression each year. Depression can be hard to recognize in youth because parents and caregivers often mistake a teen’s mood swings and irritability for normal adolescence, rather than depression. Studies have shown that gay, lesbian, bisexual or transgendered youth have higher rates of major depression.
• Older adults: Around 7% of seniors have some symptoms of depression. This can be brought on by the loss of a spouse, a shrinking circle of friends or the onset of an illness. It’s also much more common among seniors living in care homes or who have dementia. Depression in people 65 and over appears to be less common than in younger groups, but researchers aren’t sure if this is a real difference or an issue with the research questions. It’s likely that depression is at least somewhat under-recognized in seniors. Some symptoms like changes in sleep or activity levels may be mistaken as signs of aging instead of depression.
• Women: Depression is diagnosed twice as much in women as it is in men. Some reasons for this difference include life-cycle changes, hormonal changes, higher rates of childhood abuse or relationship violence, and social pressures. Women are usually more comfortable seeking help for their problems than men which likely means that depression in men may be highly under-reported. Men generally feel emotionally numb or angry when they are depressed whereas women usually feel more emotional.
• People with chronic illness: About one third of people with a prolonged physical illness like diabetes, heart disease or a mental illness other than depression, experience depression. This can be because a long term illness can lower your quality of life, leading to depression.
• People with substance use problems: There is a direct link between depression and problem substance use. Many people who are experiencing depression turn to drugs or alcohol for comfort. Overuse of substances can actually add to depression in some people. This is because some substances like alcohol, heroin and prescription sleeping pills lower brain activity, making you feel more depressed. Even drugs that stimulate your brain like cocaine and speed can make you more depressed after other effects wear off. Other factors, like family history, trauma or other life circumstances may make a person vulnerable to both alcohol/drug problems and depression.
• People from different cultures: Depending on your cultural background, you may have certain beliefs about depression that can affect the way you deal with it. For example, people from some cultures notice more of the physical symptoms of depression and only think of the emotional ones when a professional asks them. Attitudes from our cultures can also affect who we may ask for help. For example, in one BC study Chinese youth were twice as reluctant to talk to their parents about depression as their non-Chinese counter parts. Aboriginal people, on and off-reserve, may also have higher rates of depression, from 12–16% in a year, or about double the Canadian average.

Source: Canadian Mental Health Association. (n.d.). Depression. 23, https://cmha.ca/mental-health/understanding-mental-illness/depression

Anxiety disorders are mental health conditions. The different types of anxiety disorders include:

Phobias A phobia is an intense fear around a specific thing like an object, animal, or situation. Most of us are scared of something, but these feelings don’t disrupt our lives. With phobias, people change the way they live in order to avoid the feared object or situation.

Panic disorder involves repeated and unexpected panic attacks. A panic attack is a feeling of sudden and intense fear that lasts for a short period of time. It causes a lot of physical feelings like a racing heart, shortness of breath, or nausea. Panic attacks can be a normal reaction to a stressful situation, or a part of other anxiety disorders. With panic disorder, panic attacks seem to happen for no reason. People who experience panic disorder fear more panic attacks and may worry that something bad will happen as a result of the panic attack. Some people change their routine to avoid triggering more panic attacks.

Agoraphobia Agoraphobia is fear of being in a situation where a person can’t escape or find help if they experience a panic attack or other feelings of anxiety. A person with agoraphobia may avoid public places or even avoid leaving their homes.

Social anxiety disorder Social anxiety disorder involves intense fear of being embarrassed or evaluated negatively by others. As a result, people avoid social situations. This is more than shyness. It can have a big impact on work or school performance and relationships.

Generalized anxiety disorder Generalized anxiety disorder is excessive worry around a number of everyday problems for more than six months. This anxiety is often far greater than expected—for example, intense anxiety over a minor concern. Many people experience physical symptoms too, including muscle tension and sleep problems.

Obsessive-compulsive disorder (OCD) Obsessive-compulsive disorder is made up of unwanted thoughts, images, or urges that cause anxiety (obsessions) or repeated actions meant to reduce that anxiety (compulsions). Obsessions or compulsions usually take a lot of time and cause a lot of distress.

Post-traumatic stress disorder (PTSD) Post-traumatic stress disorder can occur after a very scary or traumatic event, such as abuse, an accident, or a natural disaster. Symptoms of PTSD include reliving the event through nightmares or flashbacks, avoiding reminders of the traumatic event, and feeling unsafe in the world, even when a person isn’t in danger.

Source: Canadian Mental Health Association. (2021, April 14). Anxiety Disorders. CMHA. https://cmha.ca/brochure/anxiety-disorders/

Schizophrenia is a mental health condition that affects the way you understand and interact with the world around you.

At the beginning of an episode, people may feel that things around them seem different or strange. They may start to experience problems concentrating, thinking or communicating clearly, or taking part in their usual activities. At the height of the episode, people may experience breaks from reality called psychosis. These could be hallucinations (sensations, like voices, that aren’t real) and delusions (strong beliefs that aren’t true, like the belief that they have superpowers). Some people feel ‘flat’ or numb. They may also experience changes in mood, motivation, and the ability to complete tasks. After an episode, signs can continue for some time. People may feel restless, withdraw from others, or have a hard time concentrating.

The exact course and impact of schizophrenia is unique for each person. Some people only experience one episode in their lifetime while others experience many episodes. Some people experience periods of wellness between episodes while others may experience episodes that last a long time. Some people experience a psychotic episode without warning while others experience many early warning signs. No matter how someone experiences schizophrenia, researchers agree that early treatment can help reduce the impact of episodes in the future.

Who does it affect? Schizophrenia can affect anyone. It usually starts to affect people in the teen years, though females often start to experience the illness a little later than males. No one knows exactly what causes schizophrenia or why it can affect people so differently. Genes, the way a person’s brain develops, and life events may all play a part.

What can I do about it? While there is no cure for schizophrenia, people can and do recover. Recovery may mean learning to reduce the impact of problems, work around challenges, or maintain wellness. Most people use some combination of the following treatments and supports.

Some people need to spend time in hospital if they experience a severe episode of psychosis. This is a time to figure out the best treatment for you and begin your journey to health. Before you leave the hospital, care providers should help you map out the service providers (like doctors, counsellors, and social workers) who will be involved in your care and support your recovery.

Source: Schizophrenia. (n.d.). Canadian Mental Health Association. https://cmha.ca/brochure/schizophrenia/

Developmental disorders: One of several disorders that interrupt normal development in childhood. They may affect a single area of development (specific developmental disorders) or several (pervasive developmental disorders). With early intervention, most specific developmental disorders can be accommodated and overcome. Early intervention is absolutely essential for pervasive developmental disorders, many of which will respond to an aggressive approach that may combine speech therapy, occupational therapy, physical therapy, behavior modification techniques, play therapy, and in some cases medication.

Examples of developmental disabilities include autism, behavior disorders, brain injury, cerebral palsy, Down syndrome, fetal alcohol syndrome, intellectual disability, and spina bifida. 

Source: MedicineNet. (n.d.). Developmental Disorder. https://www.medicinenet.com/developmental_disorder/definition.htm