What is Bipolar Disorder?

Bipolar disorder is a major mental disorder wherein the patient experiences episodes of extreme mood swings and other behavioral changes. At one extreme, the patient can experience symptoms of elated mood, high energy, increased activity levels which characterize a manic episode and at the other extreme, there can be depression which is characterized by low mood, anhedonia, and negative thoughts. These two extremes; mania and depression, form the two poles of the disease, hence, the name Bipolar Disorder. It was earlier known as a manic depressive disorder but with expanding research into the illness, it is now clear that there are many forms of the illness possible between the two extremes. Thus, over many revisions of the ICD (International Classification of Diseases), the nomenclature and also the criteria for diagnosis have changed. Hypomania is a milder form of mania but if left untreated, it can develop into full-blown mania. After an episode is over, the person may be back to the normal self again though the episodes may last for months and could be severe enough to require hospitalization.

Bipolar disorder

Types of Bipolar Disorder:

There are many classifications of bipolar disorder. The most common classification is as follows;

  • Bipolar Disorder I: Episodes of Mania and Depression with intermittent euthymic (normal) periods.
  • Bipolar Disorder II: Episodes of Depression and hypomania
  • Cyclothymic Disorder: There are repetitive episodes of hypomania and depression lasting for about 2 years in adults (and 1 year in children). The mood swing episodes are shorter and milder than bipolar I or II but have lasted for a major part of the year.
  • Mixed episode refers to the occurrence of simultaneous symptoms of opposite mood polarities during manic, hypomanic or depressive episodes. It’s marked by high energy, sleeplessness, and racing thoughts. At the same time, the person may experience hopeless, despairing, irritable, and suicidal feelings.

Risk Factors of Bipolar Disorder:

No certain cause has been identified yet but Bipolar Disorder is found to be more common in persons with

  • Family history of the disease
  • Drug or alcohol abuse
  • Emotional stress or trauma such as loss of a loved one
  • Other medical conditions such as anxiety issues, thyroid, diabetes etc.
  • More prone in teenagers or young adults i.e. before the age of 25yrs.

Symptoms of Bipolar Disorder:

Though the symptoms vary from person to person, the general symptoms experienced during the maniac state includes:

  • Sense of exhilaration and unusually happy
  • Highly energized
  • Feeling important
  • Ability to multi-task
  • Pressure of speech
  • Impulsive or irritable
  • Decreased appetite
  • Less sleep
  • Increased sex drive
  • Easily distracted
  • Poor concentration
  • Indecisiveness

The symptoms of depressive state include;

  • Feeling sad and lonely
  • Withdrawing from others
  • Low energy
  • Inability to perform simple daily activities
  • Loss of interest in everything
  • Nothing excites them
  • Suicidal thoughts
  • Weeping tendency
  • Forgetful
  • Wants to sleep more
  • Decreased sex drive

Diagnosis:

A thorough physical examination to rule out other causes followed by a detailed psychological evaluation is important to make the diagnosis. Diagnosis is made based on the criteria elaborated in ICD-11.

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Treatment:

Bipolar disorder is not completely curable and is a life-long illness but treatment helps in coping up with the symptoms and performing daily activities better.

Pharmacotherapy is the mainstay of treatment of bipolar disorder. Antipsychotics and antidepressants are used to control the acute phase of mania and depression. Mood stabilizers are used to consolidate and maintain the euthymic state. Mood stabilizers also act like prophylaxis and prevent the occurrence of future episodes.

  • Psychotherapy or psychological counseling performs a major role in helping the patient handle the mood swings better
  • Interpersonal and social rhythm therapy (IPSRT) emphasizes following a fixed daily routine of sleeping, eating, etc that keeps the mood stable.
  • Cognitive Behavioural Therapy (CBT) aims at coping strategies to tackle stress and control your actions.
  • Psychoeducation or Family therapy involves the family members to support and help manage the symptoms.
  • Electroconvulsive therapy or shock therapy can be done in severe cases.

Lifestyle changes:

Following certain lifestyle changes can also, help in controlling the symptoms better.

  • Stick to a fixed schedule of basic daily activities such as eating, sleeping
  • Indulge in hobbies or sports.
  • Stay away from negative influences.
  • Exercise regularly
  • Eat healthily
  • Maintain a symptom chart so as to analyze the onset of an episode.
  • Avoid drugs or alcohol
  • Talk to your loved ones
  • Learn to handle stressful situations.
  • Take your medicines religiously

A positive outlook, regular treatment and support from the loved ones can easily help sail through the difficult phases so value the real treasures of life.

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