Bipolar disorder is a mental disorder characterized by extreme changes in mood, with fluctuations in energy and activity levels.During these abnormal changes, the patient often finds it difficult to complete daily tasks. Bipolar disorder used to be known as manic-depressive illness .
Bipolar disorder is a serious mental illness that can destroy relationships, undermine career prospects and seriously affect academic performance.
The American Psychological Association says that these emotional changes can become so big that people can choose to commit suicide.
Content of this article:
- What is bipolar disorder?
- Causes of bipolar disorder
- Symptoms of bipolar disorder
- Diagnosis of bipolar disorder
- Treatment for bipolar disorder
Quick Facts About Bipolar Disorder
Here are some key points about bipolar disorder. More details and supporting information are in the main article.
- Bipolar disorder is a serious and relatively common condition
- Millions of people have a diagnosis of bipolar disorder
- Bipolar disorder used to be known as manic psychosis depressive
What is bipolar disorder?
A patient with bipolar disorder has severe mood fluctuations – from depression to mania. Normally, mood is normal between peaks and troughs.
Bipolar disorder has nothing to do with the ups and downs that we all experience in life; It is much more serious, debilitating and disabling.
Fortunately, it is treatable, and with the proper care and the right medication, patients can do well at work and academically and lead full, productive lives.
It is estimated that 2.9% of Americans are diagnosed with bipolar disorder and more than half of all cases begin when patients are aged 15-25 years. Men and women are affected equally.
Causes of bipolar disorder
Most experts agree that bipolar disorder has no single cause. It is more likely to be the result of several factors that work together.
Genetics – Some small studies with twins have indicated that there is a genetic contribution to the risk of bipolar disorder. People with a blood relative who has bipolar disorder are at an increased risk of developing it.
Biological characteristics – experts say that patients with bipolar disorder often show physical changes in their brains. No one is sure why the changes lead to the disorder.
Chemical brain imbalance – neurotransmitter imbalances play a key role in many mood disorders, including bipolar disorder.
Hormonal problems – hormonal imbalances can trigger or cause bipolar disorder .
Environmental factors – abuse, mental stress, a “significant loss”, or some other traumatic event can contribute to the risk of bipolar disorder.
Symptoms of bipolar disorder
Symptoms during manic / hypomanic episodes:
- A feeling of being on top of the world, joy, or euphoria.
- Exacerbated self-confidence, an inflated feeling of self-esteem.
- The patient’s judgment can be impaired.
- The patient talks a lot, and very quickly.
- Thoughts come and go quickly. Sometimes, bizarre ideas come to the patient’s mind, and they act for them.
- At this stage, the individual can be extremely close, sometimes aggressively.
- The individual is more likely to engage in risky behaviors, including promiscuity (greater libido), abuse of illegal drugs and / or alcohol, and to participate in dangerous activities.
- The patient can waste money.
- Easily distracted.
- Absence from work or school and / or underperformance.
Symptoms during depressive episodes:
- A feeling of melancholy , darkness, despair and hopelessness.
- Extreme sadness.
- In severe cases, the patient will think about ending his life, and can act on those thoughts.
- Insomnia and sleep problems.
- Anxiety for trivial things.
- Guilt – a feeling that everything that goes wrong or seems to be wrong is their fault.
- Eating patterns – some people eat more, others eat less.
- Weight loss or weight gain.
- Extreme tiredness, fatigue, apathy.
- Inability to take pleasure in activities or interests that were generally enjoyed.
- Low level of attention .
- Easily irritated – this can be caused by noise, smells, tight clothing and other things that would normally be tolerated or ignored.
- Some patients are unable to go to work or school; Those who do usually perform poorly.
Psychosis – in both manic and depressive episodes there may be psychosis, during which patients cannot differentiate fantasy from reality. The symptoms of psychosis may include delusions (false but strongly felt beliefs) and hallucinations (hearing or seeing things that are not there).
Major Depressive Disorder, with seasonal pattern – formerly known as seasonal affective disorder ( SAD ). Some patients with bipolar disorder have moods that fluctuate with the seasons.
Symptoms in pediatric cases of bipolar disorder – children and adolescents are more likely to have tantrums, rapid mood swings, outbursts of aggression and explosive anger and reckless behavior.
It is important to remember that bipolar disorder is a treatable mental illness – it is possible to control symptoms with proper care and lead a normal and productive life.
Diagnosis of bipolar disorder
A psychiatrist or psychologist bases the diagnosis on self-reported experiences of abnormalities in the patient’s behavior or reported by family members, close friends, co-workers and teachers, as well as any secondary signs detected by other health professionals.
A series of physical diagnostic tests can be ordered after a physical exam, including blood tests and urine tests.
There are three broad types of bipolar disorder :
1) Bipolar I disorder (type 1 bipolar disorder)
There was at least one manic episode or mixed episodes (with / without previous depressive episodes). Most patients had at least one depressive episode.
They should also rule out clinical mood disorders that are not associated with bipolar disorder, such as schizophreniform disorder , delusional disorder or some other psychotic disorder.
2) Bipolar II disorder (type 2 bipolar disorder)
The patient suffered one or more episodes of depression and at least one hypomanic episode.
A hypomanic state is less severe than a manic. During a hypomanic episode the patient sleeps much less, is very competitive and outgoing, and is full of energy – but they are in good working order; This may not be the case with manic episodes.
Unlike manic episodes, during a hypomanic state, there are no symptoms of psychosis or grandiosity.
3) Cyclothymia (cyclothymic bipolar disorder)
This is seen as a sub-threshold (milder) form of bipolar disorder. There are numerous mood disorders, with crises of hypomanic symptoms that alternate with periods of moderate or mild depression.
At baseline, a patient with cyclothymia may feel stable, but will experience noticeable fluctuations involving emotional highs during hypomanic episodes, with manic-like symptoms (but less severe) and emotional depressions with depressive symptoms, but not severe enough to attend to major depressive episodes.
Treatments for bipolar disorder
The goal of treatment for bipolar disorder is to minimize the frequency of manic / depressive episodes and to reduce the severity of symptoms so that the patient can lead a relatively normal and productive life.
If symptoms are left untreated, an attack of depression / mania can persist for up to 1 year. With treatment, however, improvements are seen within the first 3-4 months.
Changes in mood may still occur in patients who have received continuous treatment. However, if the patient works closely with his medical team and communicates openly, treatment is generally much more effective.
Treatment for bipolar disorder includes a combination of different therapies , which can include medications and physical and psychological interventions.
Hospitalization – this is much less common today. If the medical team believes that there is a risk that the patient may be hurt or harm others, they may be hospitalized until they feel better.
Lithium carbonate – the most commonly prescribed long-term medication for the treatment of long-term episodes of depression, mania / hypomania. Patients usually take lithium for at least 6 months. Experts say compliance with treatment (adherence) is vital for it to work; The patient must follow the doctor’s instructions on when and how to take the medication.
Other treatments include:
- Anticonvulsants – sometimes prescribed to treat episodes of mania.
- Antipsychotics – including aripiprazole, olanzapine and risperidone. Prescribed if the behavior is very disturbed and the symptoms are severe.
- Fast cycle – fast fluctuations from high to low, with no intermediate “normal” periods. Rapidly cycling patients may be advised to take a valproate-lithium combination. If the combination is not effective enough, the doctor may recommend lithium, valproate and lamotrigine in combination.
- Psychotherapy – the objective is to relieve the main symptoms, help the patient to identify and recognize the main triggering factors, minimize the negativity in relationships, recognize the first symptoms that indicate the beginning of an episode and work on the factors that help to maintain the “ normal ”for as long as possible.
- CBT ( cognitive behavioral therapy ) – psychoeducation and family-focused therapy have been found to be the most effective in preventing relapse. Interpersonal and social rhythm therapy, as well as CBT, can also help with depressive symptoms.