Health Education

Everything You Need to Know About Bipolar Disorder

What is Bipolar disorder?

Manic depression, or bipolar disorder, is a mental illness marked by extreme mood shifts leading to changes in behaviour, thoughts and even activities.

The person experiences crests and troughs of mania, characterised by an overly-happy feeling paired with very high energy, and depression, a period in which they feel hopeless, sad, sluggish/constantly fatigued. As the person suffers from two distinct poles of mood, i.e. mania and depression, this disorder is labelled ‘bipolar’.

While they may achieve a ‘normal’ period, this constant wave-like pattern of highs and lows impact their lives adversely.

Most people with bipolar disorder struggle more with the depressive period, during which they feel sad or depressed.

Hypomania refers to a milder form of Mania in which the symptoms do not usually interfere with the person’s everyday life tasks. Unlike in case of Mania, hypomania doesn’t usually require hospitalisation and the symptoms are manageable with a little help.

Symptoms
While bipolar disorder can be diagnosed in any age group, it is generally found in teens and those in their early twenties. The symptoms may also vary over time and from person to person. The series of highs and lows in bipolar disorder do not follow a pattern but the common symptoms are:

Symptoms of Mania

  • Restlessness
  • Rapid speech and poor concentration
  • Unjustified grandiose
  • Increased energy
  • Insomnia high
  • Sex drive
  • Unrealistic, grand plans
  • Drug and alcohol abuse
  • Excessive happiness
  • Unexplained excitement
  • Impulsiveness

Symptoms During Depressive Period

During the depressive period a person with bipolar disorder might have the following symptoms:

  • sadness
  • sluggishness
  • insomnia
  • appetite changes
  • trouble concentrating
  • loss of energy
  • attempted suicide
  • irritability
  • trouble making decisions
  • confusion
  • feeling of hopelessness and worthlessness

Causes
Even though bipolar disorder is a common issue; the causes are still not clear. However, some possible causes are:

Heredity
If you have a history of bipolar disorder in your family you are more likely to develop the condition. While it may not be backed by research, statistics have pointed out that the risk increases by 5 to 6 times if a close family member happens to have the disorder.

Environmental factors

At times external stimuli may be attributable to the development of bipolar disorder, such as

  • traumatic experiences
  • extreme stress
  • physical illness
  • extreme anxiety

Brain structure

Abnormality in the structure or functions of the brain can increase the chance of developing bipolar disorder.

Types of bipolar disorder

To get a bipolar disorder diagnosis, one of the 3 bipolar disorder types must be identified. Here are three types of bipolar disorders:

Bipolar I
To be diagnosed with Bipolar type 1, the following are the prerequisites:

  • at least one manic episode lasting a minimum of 1 week
  • a major depressive episode before or after this Manic episode

The key takeaway is the fact that this type of bipolar disorder can be diagnosed only if a manic episode has been experienced.

Bipolar II
To be diagnosed with this type, the prerequisites are:

One major depressive symptoms lasting at least two weeks is experienced by the person and is followed by a hypomanic episode.

Cyclothymia
Cyclothymic disorder refers to a persistent series of hypomania and depression. The person must have suffered from both hypomania symptoms and depressive symptoms for at least two years. While the symptoms may be less severe, to be diagnosed with cyclothymia, they must last for a longer period.

All three types of bipolar disorders are distinct and are given a separate diagnosis.

Diagnosis of Bipolar disorder

Only one test cannot judge if a person has a bipolar disorder. There are several test batteries and examinations that take place before a person is given a bipolar diagnosis.

  • Physical exam, blood test, urine test, and full physical examination might be conducted by your doctor in order to rule out any other possible causes.
  • A mental health evaluation may be ordered by your doctor who can refer you to a psychologist or psychiatrist.
  • Most importantly, to be correctly diagnosed with this disorder, the symptoms are judged against the outlines provided in the Diagnostic and Statistical Manual of Mental Disorders (DSM V).

Bipolar disorder can have two extremes, and so to be diagnosed with it you must have experienced them both.

While the period of high can be any of Mania or hypomania, there also must be a marked period in which the person feels depressed. This is not to be confused with depression, which is it different disorder altogether.

A few main periods associated with this disorder: Mania, hypomania, and depression.
Usually associated with bipolar 2 disorder, hypomania is very similar to mania but is not as serious as mania. It may not create any issues at work or in relationships. However, there is always a noticeable change in the mood.

While it is not a rare condition the varied symptoms and the time involved also make bipolar disorders quite hard to diagnose. Also, it is really hard to diagnose bipolar disorder in adolescents and also in children due to frequent and big changes in their moods.

Treatment
Bipolar disorders are treatable. They may be long-term and recurring, but they can be regularised if taken care of.

Here are the treatments involved:

Medication: as the name suggests, it involves medicines, usually:

  • Mood stabilizers like lithium (lithobid)
  • Antipsychotic drugs
  • Antidepressants
  • Anti-anxiety medication like Xanax (alprazolam)

A combination of the above medicines can also be used in the treatment.

If the person has drug abuse issues, the disorder can be more harder to treat.

Psychotherapy, like cognitive behavioural therapy (CBT), is one of the positive coping strategies used to treat bipolar disorder

Psychoeducation, which is a kind of counselling that helps people near you understand the disorder, can be very helpful during the post-diagnosis stage of the disease.

Also, Interpersonal Social Rhythm Therapy (IPSRT) can help you manage the disorder better as it focuses on regulating daily habits.

Other treatments may include

  • electroconvulsive therapy (ECT)
  • sleep medication
  • meditation
  • acupuncture

For most people the treatment can provide a semblance of relief, but there are others who require more specialised treatment. While there is no cure for bipolar disorder, there are a lot of treatment options available that can help the patient manage everyday life tasks like school office or even relationships.