Bipolar Disorder (A complete guide)

This article provides a comprehensive guide to bipolar disorder. The article will look into the causes, symptoms, diagnosis, and treatment of the bipolar disorder.

What Is Bipolar Disorder?

Bipolar disorder, commonly known as manic depression, is a mental illness characterized by extremely high and low moods and changes in sleep, thinking, behavior, and energy.

People with bipolar disorder can have periods of extreme joy and energy and other periods with extreme hopelessness, sadness, and sluggish behavior. In the middle of these periods, they are often feeling normal. Thinking of the lows and highs as two mood poles, hence the name “bipolar” disorder.

The term “manic” refers to the times when the person feels excited, confident, and overjoyed. These feelings can be accompanied by irritability and reckless or impulsive decision making. Almost half the people during their mania can have delusions or hallucinations

The term “Hypomania” refers to the milder symptoms of mania. In this period, a person does not have delusions or hallucinations, and their extreme symptoms do not interfere with their daily life.

The word “depressive” characterizes the feeling when the person is typically very sad or depressed. The symptoms in these phases are like those of major depressive order or clinical depression, a condition in which someone never has manic or hypomanic episodes.

The majority of people with bipolar disorder spend more time in the depressive phase than the hypomanic or manic phase.

What Are The Types of Bipolar Disorder?

According to the American Psychiatric Association, there are four main categories of bipolar disorder:

  1. Bipolar I disorder: In these manic episodes last for at least seven days and have psychotic or manic symptoms. Episodes of the “extreme down” period usually last for two weeks and pose more of the depressive features.
  2. Bipolar II disorder: It is characterized by one hypomanic episode and one major depressive episode in your lifetime. Common symptoms in the major depressive episode of bipolar II disorder include insomnia or hypersomnia, severe fatigue, uncontrollable crying, recurring death thoughts, or suicidal thoughts.
  3. Cyclothymic disorder: It is the middle form of bipolar disorder. It consists of mood swings. It usually develops in adolescence and stays for one year, whereas in adults, it stays for at least two years. As the symptoms are not so extreme and intense, they function normally but may appear moody or difficult to others.
  4. Bipolar disorder due to another medical or substance abuse disorder: It does not have any specific pattern like the ones mentioned above. Bipolar disorder and alcohol use disorder is known as ‘dual diagnosis’, and thus requires to be addressed with a specialist.

What Are The Symptoms of Bipolar Disorder?

Bipolar disorder does not have a set pattern of the dramatic episodes of highs and lows. Some people may feel the same (manic or depressed) more frequently before transitioning to the other mood. These episodes can occur over a duration of weeks, months, and even sometimes years.

The severity may differ from person to person and also change over time, fluctuating between less to more severe.

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Some symptoms of mania (high episode) are:

  • Overjoy, excitement, and optimism
  • Sudden transition from happiness to being irritable, angry, and violent.
  • Restless behavior
  • High energy and less need for sleep
  • Lack of concentration and rapid speech
  • High libido
  • Poor decision and judgment 
  • Substance and alcohol abuse
  • Impulsiveness
  • Lack of appetite
  • Less need for sleep
  • Easily distracted
  • A large sense of self-confidence and well-being

During depressive episode or the low phase the symptoms may be exhibited as follows:

  • Feeling of hopelessness, worthlessness, and overall pessimist view.
  • Loss of energy
  • Not able to enjoy the things that they previously did.
  • Trouble focusing
  • Forgetfulness
  • Slow speech
  • Less libido
  • Inability to feel pleasure
  • Uncontrolled crying
  • Irritability
  • Insomnia
  • Needing more sleep
  • Trouble in decision making
  • Appetite changes leading to weight gain or weight loss.
  • Death or suicidal thoughts
  • Attempts to suicide. 

What are the Bipolar Disorder Causes?

There is not a single cause of the bipolar disorder. Research has shown there could be a number of factors that can contribute to bipolar disorder in some people.

The main cause of bipolar disorder is believed to be chemical imbalances in the brain. The neurotransmitters serotonin, noradrenaline, and dopamine, one or more of these, experience an imbalance. Moreover, genetics and triggering factors can also contribute to bipolar episodes.

What Are The Risk Factors of Bipolar Disorder?

Usually, bipolar disorder is developed in late adolescence or young adulthood. It is very rare to happen in early childhood.

Bipolar disorder can run in families.

Both men and women are equally likely to have it. Women are slightly more susceptible than men to go through ‘rapid cycling’, which has four or more distinct mood episodes throughout the year.

Females are also likely to have more depressed phases than males with bipolar disorder.

In women, bipolar disorder usually happens later in life, and they are more likely to be hit with Bipolar II disorder and are also prone to seasonal mood changes.

A combination of mental and medical concerns is more common in the female population. The medical conditions can include migraine, thyroid disease, and anxiety disorder.

Some key risk factors in developing bipolar disorder are:

  • Having a family member with bipolar disorder.
  • Drugs or alcohol abuse
  • High stress or traumatic phase
  • Health conditions

People with conditions of drugs or alcohol abuse are susceptible to mania or depression. People with bipolar disorder are also expected to have seasonal depression, co-occurring anxiety disorders, Posttraumatic stress disorder (PTSD), and obsessive-compulsive disorder(OCD).

How is Bipolar Disorder Diagnosed?

If your or your loved ones have symptoms of bipolar disorder, communicate with a family doctor or a psychiatrist. They’ll ask relevant mental health questions and your family history. You’ll also get a complete psychiatric evaluation to rule out the chances of bipolar disorder or other underlying mental health concerns.

Diagnosis of bipolar disorder is determining whether the symptoms are due to other conditions(alcohol or drugs) or medical issues (low thyroid). How severe are the conditions? What was the duration of these conditions? How frequently are the symptoms?

The most significant symptoms of highs or lows in moods, together with changes in sleep, appetite, energy, thinking, and behavior, can help in the diagnosis.

Diagnosis of children and teenagers can be challenging. Although the symptoms may be the same as adults, they have a risk of being misdiagnosed as attention deficit hyperactivity disorder (ADHD) or even bad temper/behavior.

If you are worried your child might have bipolar disorder, consult and discuss with your doctor for a referral to a child psychologist. 

Treatments For Bipolar Disorder

Bipolar disorder can be treated; it is an ongoing treatment as it’s a long term condition. 

People with four or more mood episodes in a year, or people with alcohol or drug addictions, will be difficult to treat.

Medication

Medication is the primary treatment, majorly involving:

  • Antidepressants
  • Mood stabilizers, like lamotrigine, carbamazepine, valproate, or lithium.
  • Antipsychotic drugs like quetiapine, cariprazine, olanzapine, and lurasidone.
  • Anti-anxiety pills or sleep medicines like benzodiazepines or sedatives.
  • Antidepressant-antipsychotic drugs, a combination of antidepressant and mood stabilizers.

It can take some time to discover the right combination for you. Pregnant and breastfeeding women should talk to their doctor about medications that are safe for safety.

Psychotherapy

Psychotherapy is also recommended, along with medications. Some of the options in this regard are:

  • Interpersonal and social rhythm therapy (ISPRT)
  • Psychoeducation
  • Cognitive Behavioral Therapy (CBT)
  • Family-focused therapy

Other Treatment Options

  • Acupuncture: There is some evidence that acupuncture therapy can help with depression caused by bipolar disorder.
  • Electroconvulsive therapy (ECT): Small dosage of electric shocks can reboot the brain and change the balance of some neurotransmitters. Although it’s a last resort, it’s much safer and controlled, and has fewer side effects and risks, as compared to the earlier days of this treatment.
  • Supplements: Supplementary vitamins can help with bipolar disorder, but they may be possible issues with them. For example, unregulated ingredients can result in side-effects. Be sure to let your doctor know if you are using any supplements.

Lifestyle Changes

  • Some lifestyle changes can also be helpful:
  • Regular exercise and workout regimen
  • Follow a routine
  • Learn to pick your mood swings.
  • Get support from family, friends, or groups.
  • Learn to manage stress.
  • Keep a journal or chart for your symptoms.
  • Find sports and healthy hobbies.
  • Avoid alcohol or recreational drugs.

The more you know about your conditions and symptoms, the better you’ll be able to manage your episodes. It will be helpful to have a compassionate company to manage your condition. Support groups and friends can help you in talking through the situation.

Conclusion

This article provided a comprehensive guide to bipolar disorder. It also looked into the causes, symptoms, diagnosis, and treatment of the bipolar disorder.

Bipolar disorder is a chronic mental illness. It implies you’ll have to cope and live with it for your entire life. The sooner you get the diagnosis, the better will be the outcomes.

Frequently Asked Questions (FAQs): Bipolar Disorder

What are the four types of bipolar disorder?

According to the American Psychiatric Association, there are four main categories of bipolar disorder:

  1. Bipolar I disorder: In these manic episodes last for at least seven days and have psychotic or manic symptoms. Episodes usually last for two weeks and pose more of the depressive features.
  2. Bipolar II disorder: It is characterized by one hypomanic episode and one major depressive episode in your lifetime. Common symptoms in the major depressive episode of bipolar II disorder include insomnia or hypersomnia, severe fatigue, uncontrollable crying, recurring death thoughts, or suicidal thoughts.
  3. Cyclothymic disorder: It is the middle form of bipolar disorder. It consists of mood swings. It usually develops in adolescence. They function normally but may appear moody or difficult to others.
  4. Bipolar disorder due to another medical or substance abuse disorder. It does not have any specific pattern like the ones mentioned above. 

What is the main cause of bipolar disorder?

The main cause of bipolar disorder is believed to be chemical imbalances in the brain. The neurotransmitters serotonin, noradrenaline, and dopamine, one or more of these, experience an imbalance. Moreover, genetics and triggering factors can also contribute to bipolar episodes.

How do I know if I’m bipolar?

To be diagnosed with bipolar disorder, you should have at least one manic or hypomanic experience. The signs and symptoms to watch for are extreme fluctuations in mood, sleep, energy, thinking, and behavior. 

Can bipolar go away?

Although the symptoms of the bipolar disorder come and go, the treatment is lifetime, and it does not go away on its own.

Bipolar disorder can be a major factor in job loss, family discord, and suicide, but proper treatment can lead to better outcomes.

Can a bipolar person truly love?

Yes, a person with bipolar disorder can truly love. However, their symptoms and episodes can get overwhelming. So if you love someone with bipolar disorder, be patient and understanding with them and encourage them for treatment.

References

https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders

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