Bipolar Indivviduals And Their Social Relationship

Bipolar disorder is a psychiatric disorder in which a manic and depressive mood periods are observed. It is characterized by extreme mood fluctuations that can affect a person’s thoughts, behavior, and daily functioning. It leads to significant changes in feelings of a person varying from intense unhappiness, to extreme energetic intemperance besides to different emotional situations such as despair, hopelessness, suicide, worthlessness, pessimism at the same time. These emotional extremes can interfere with personal relationships, job performance, and overall quality of life. Bipolar disorder is mood disorder that shows mood swings alternate between periods of hypomania, mania, depression or mixed episodes. These episodes can last for days, weeks, or even longer if not properly managed. (Grande, Berk, Birmaher, & Vieta, 2016).

Manic symptoms include: feeling happy, joyful and fast talking, decrease in concentration and distraction, increase in sexual desire, sleep problems and increase in alcohol and substance use. These behaviors may initially appear as increased productivity or sociability, but they can quickly escalate into reckless or dangerous actions. (Grande, Berk, Birmaher, & Vieta, 2016).

Depressive symptoms include: feeling sad and unhappy, tense situation, lack of energy, to be hopeless, loss of appetite, feeling of worthlessness and having suicidal thoughts. These symptoms can be so severe that they impair the ability to perform basic daily tasks or maintain personal hygiene. This disorder can be seen in women, men, children, everyone. It does not discriminate by age, gender, or socioeconomic status, and its onset can occur as early as childhood or adolescence. (Grande, Berk, Birmaher, & Vieta, 2016).

In general, people with bipolar disorder may live alone, have less education, and be more likely to be unemployed compared to others. These social and economic difficulties often stem from the challenges of maintaining consistent functioning during mood episodes. (Mengi, & Aygür, 2018). People with bipolar disorder often have difficulties in their social relationships. They may struggle with trust, emotional regulation, and maintaining long-term connections. Studies show that they tend to have insecure attachments and less social support. (Greenberg, Rosenblum, McInnis, & Muzik, 2014). Factors such as stressful life, family conflicts, social relationships, stressful education and work life, exposure to violence, and disruptions in the sleep-wake cycle trigger bipolar disorder. Early identification and management of these triggers can be crucial in preventing the escalation of symptoms. (McIntyre, Berk, Brietzke, Goldstein, 2020).

LITERATURE REVIEW

Bipolar Disorder

Individuals with bipolar disorder become more open to the social environment, especially during hypomanic periods, while uncontrolled behaviors during manic periods can cause deterioration of social relationships. While empathic relationships, especially in the immediate environment, can positively affect the course of the disease, loss of social support can trigger mood attacks. (Owen, Gooding, Dempsey, & Jones, 2017).

It has been determined that the mood swings of an individual diagnosed with bipolar disorder make the educational process difficult, create conflicts in communication with his/her family, and his/her interaction with his/her circle of friends decreases over time. This finding shows that mood swings directly affect the individual's social life (Mengi & Aygür, 2018).

Bipolar disorder is a recurrent mental illness that occurs at a rate of 1% to 2% worldwide and begins at a young age. Diagnosis usually begins with depression, which makes it difficult to make a correct diagnosis. (Grande, Berk, Birmaher, & Vieta, 2016).

Genetic predisposition is evident in the development of bipolar disorder (heritance rate of up to 70%), but environmental factors such as childhood traumas can affect the onset and severity of the disease. Therefore, both biological and environmental factors should be evaluated together. (McIntyre, Berk, Brietzke, Goldstein, 2020).

Mood Disorder

Mood is the response that people give to the other party. Mood disorders are one of the most common mental disorders. It is a mental state in which people express themselves as happy, sad or angry for a certain period of time. Mood disorders are a disease that can recur over the years, cause deterioration in people’s quality of life and characterized by deterioration in cognitive, social and occupational functions. The cause of these disorders is due to many conditions. People can be negatively affected by genetic factors, stress, social relationship and neurobiological effects. (Johnson ve Kring, 2019).

Happiness can be experienced naturally in a normal mood. However, excessive joy and enthusiasm is defined as euphoric mood and is a symptom of mania or hypomania.

Sadness is a part of daily life, intense and prolonged sadness is called depressed mood and is the main symptom of depression. (Morrison, 2019,).

Anger is often seen in a dysphoric mood. This situation can occur in both depressive and mixed bipolar episodes. (Karamustafalıoğlu, 2022,).

It is a characteristic feature, especially for bipolar disorder, that individuals experience transitions between these emotions very quickly and to extremes. In depression, sadness, hopelessness, worthlessness and guilt are usually at the forefront. (Uher, 2008,).

Depression

Depression in bipolar disorder lasts longer and is more frequent compared to manic episodes. Individuals with bipolar II disorder (BD-II) and patients experiencing mixed episodes are particularly prone to depression. Research has shown that bipolar patients spend a significant portion of their lives in depressive episodes (Judd, 2003). This negatively affects the course of the illness and the individual's functionality. In addition, while current treatment approaches are more effective on mania, the treatment of depression is more difficult and limited (de Almeida & Phillips, 2013). Depression negatively affects both the course of the illness and quality of life. Therefore, depression should be carefully considered as one of the most important components of bipolar disorder in terms of both diagnosis and treatment.

Family Relationships

The relationships of individuals with bipolar disorder with their families are quite complex and emotionally charged, both in terms of the individual's illness process and family functionality. Due to the nature of the illness, individuals' moods can show sudden changes; this can create instability and conflict in their communication with family members. During manic periods, excessive energy, intolerance and impulsive behaviors; and during depressive periods, withdrawal, hopelessness and social withdrawal can strain family relationships. Families may have to cope with intense stress, fatigue, guilt and feelings of helplessness while trying to support the individual during illness periods (Konuk Şener & Karaca, 2022). This situation can also cause secondary problems such as depression, anxiety and burnout in family members. In addition, functional impairments such as communication disorders, role confusion and lack of empathy are more frequently observed in families of individuals with bipolar disorder. However, it has been observed that these difficulties can be overcome and the individual's recovery process can be supported in families that receive social support, can establish open communication and learn to cope with the illness in cooperation.

Social Support

In bipolar disorder, social support stands out as a psychosocial factor that significantly affects the course of the disease. According to Studart 2015) review based on a comprehensive literature review, it was determined that individuals diagnosed with bipolar disorder generally have low levels of social support. In this study, where social support is considered in two dimensions, structural social support refers to the number of social relationships of the individual, while functional social support includes the emotional, material and spiritual support that the individual receives when needed. The findings show that individuals who receive high levels of social support recover more quickly from mood attacks and experience fewer relapses during depressive periods. It is also stated that social support reduces the severity of depressive symptoms and increases compliance with treatment, but its relationship with manic periods has not yet been sufficiently clarified. In this context, it is emphasized that social support plays a decisive role not only in the success of treatment, but also in the quality of life and functionality of the individual.

Psychological Effects Of Social Support

In bipolar disorder, social support is an important factor that directly affects not only the person's relationships with their environment but also their mental health. According to the literature review by Studart, 2015), individuals with high social support experience less depressive symptoms and recover more quickly from mood attacks. In particular, functional support (i.e. the emotional and practical help an individual receives during difficult times) strengthens self-esteem by making the person feel valued and reduces the risk of recurrence of depressive episodes. However, individuals with a lack of support may have poor coping skills; this may mean greater feelings of loneliness and resistance to treatment. Therefore, social support plays both a protective and healing role.

The aim of this research is to explore how bipolar disorder affects individuals' ability to maintain and build social relationships, with a particular focus on the psychosocial challenges they face in educational, familial, and interpersonal contexts. By examining the lived experiences of a diagnosed individual through a qualitative case study approach, the study seeks to reveal the emotional, behavioral, and structural dynamics that shape their social interactions and support systems. Additionally, it aims to identify the role of social support in mitigating the negative effects of mood fluctuations and enhancing the individual’s social functionality and overall well-being.