Bipolar Disorder: Meaning, Symptoms, and Treatment


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What is bipolar disorder?

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes extreme fluctuations in moods. People with this disorder can feel very high, active and euphoric, (which is also known as the manic state), and suddenly switch to feelings of extreme depression). Their energy levels, activity levels, and the ability to carry out day-to-day tasks is highly inconsistent and unpredictable.

If left untreated, this serious mental illness can destroy relationships, damage career prospects, affect academic performance and also lead to suicide. Though it is treatable and manageable, it is incurable.


How does bipolar disorder occur?

Studies have shown that patients with bipolar disorder have physical changes in their brains, such as chemical imbalances, but the link remains unclear.

Bipolar disorder is characterized by alternating episodes of:

  • mania - in which state the person is in an extremely euphoric state and is highly active and energetic
  • and major depression - where the person experiences extreme hopelessness and even suicidal thoughts

The most noticeable factor among bipolar patients is that they move from the peaks of mania to the troughs of depression quite dramatically. The fluctuations can be severe, but the person may experience normal moods between the peaks and troughs.

There are three basic types of bipolar disorder:

  • Bipolar I Disorder: which is defined by manic episodes that last for at least 7 days, accompanied by abnormal behavior that disrupts life. In some, the manic symptoms are so severe that the person needs immediate hospitalization. Bipolar I Disorder patients also suffer from extreme episodes of depression which last for at least 2 weeks. There is often a there is a pattern of alternating between mania and depression.
  • Bipolar II Disorder: which is similar to bipolar I disorder, with moods cycling between high and low. However, in bipolar II disorder, the euphoric moods never reach full-blown mania. Therefore, the less intense euphoric or elevated moods are called hypomania or hypomanic episodes in bipolar II disorder. Most people in this category have suffered at least one hypomanic episode in his or her life followed by more episodes of depression.
  • Cyclothymic Disorder (cyclothymia): is defined by numerous episodes of hypomania as well as numerous episodes of depression lasting for at least 2 years (1 year in children and adolescents). The symptoms in this category, however, do not meet the diagnostic requirements for a hypomanic episode and a depression episode.

The first episode in men tends to be a manic episode, while women are more likely to first experience a depressive episode.


What are the causes of bipolar disorder?

There is no one particular cause for bipolar disorder. A number of interacting factors could be at play, though they have not been substantiated.

Some of these factors include:

  • Genetics or a family history of bipolar disorder. This may not be visible until a sudden environmental factor such as stress, or trauma triggers an extreme mood swing.
  • Imbalances in neurotransmitters or brain chemicals which play a role in mood swings and many mood-related disorders other than bipolar disorder.
  • Hormonal imbalances
  • Acute stress
  • Abuse
  • Sudden trauma


Who is prone to bipolar disorder?

People who can be at a risk of bipolar disorder include:

  • Those with a family history of bipolar disorder
  • Those who are of a lower socioeconomic status
  • Those who were abused as children
  • Young people who suffer from cyclothymia
  • People who experience sudden severe trauma
  • People who suffer from prolonged stress
  • Women diagnosed with depression


What are the symptoms of bipolar disorder? How is bipolar disorder diagnosed?

Symptoms of bipolar disorder can vary from patient to patient according to the mood:


Symptoms of Mania and Hypomania

Symptoms of Depression

Other Symptoms

-Impaired Judgement

-Distraction or boredom

-Missing school/work and underperforming

-Thinking they are invincible

-The belief that nothing is wrong

-Being aggressively forthcoming

-Engaging in reckless/dangerous behavior

-Feeling euphoric or on top of the world

-Inflated self-confidence, self-importance

-Excessive and rapid talking and quickly jumping to unrelated topics

-Bizarre and grandiose ideas that the person may act upon.

-Racing thoughts

-Psychosis

-Extreme sadness, despair, hopelessness, crying

-Insomnia

-Hyper-anxious about trivial things

-Pain and physical problems that do not respond to treatment

-Overpowering guilt

-Weight loss/weight gain

-Fatigue and irritability

-Inability to enjoy hobbies

-Difficulty remembering

-Low attention span

- An inability to face going to work/school and underperforming

-Thoughts of suicide

-Explosive anger

-Insomnia/hypersomnia/ sudden decreased need for sleep while not getting tired

-Excessive desire for sex

-Lack of concentration

-Frenzied speaking

-Changes in eating patterns

-Restlessness

-Tendency to self-harm

-Disorganized behavior

-Listlessness

-Agitation


Diagnosis


The diagnosis for a bipolar disorder patient is done by a psychiatrist. The diagnosis is done based on the criteria set out in the Diagnostic and Statistical Manual, fifth edition (DSM-5), which is the handbook used by healthcare professionals as the authoritative guide to diagnose mental disorders. DSM contains descriptions, symptoms, and other criteria for diagnosing mental disorders.

The person must meet certain criteria for mania and depression, including elevated or irritable moods, along with persistently increased activity or energy levels. These must have lasted at least seven days. If less than seven days, the symptoms should have been severe enough to need hospitalization.

The family members, friends, teachers, and coworkers should be able to help out by relating instances of the person’s behaviour and moods.

The doctor may ask the person to undergo tests such as, blood and urine tests and also carry out a physical examination. The tests are to rule out other possible causes, such as substance abuse.

The doctor and healthcare workers specifically look for signs of mania in the person’s history to prevent misdiagnosis. Since bipolar patients experience psychosis, they might be diagnosed with schizophrenia, if they or their family members do not mention the symptoms of mania.


What are the complications of bipolar disorder?

If the person refuses treatment or is left undiagnosed and untreated bipolar disorder can lead to complications such as:

What is the treatment of bipolar disorder?

Treatment for Bipolar Disorder

Treatment for bipolar disorder aims to make the illness manageable. It aims to minimize the frequency of manic and depressive episodes, and thus reduce the severity of symptoms.

Without treatment, a manic phase can last upto a year. With treatment, the period can be reduced to around 3 months.

Treatment for this disorder involves medications, and a combination of therapies such as behavioural therapy, cognitive therapy, interpersonal therapy and so on.

Exercise

Exercising can not only improve physical health but also mental health. Regular exercise can help prevent episodes of bipolar depression and also prevent anxiety, self-esteem issues, and addictions in bipolar patients. Exercises such as swimming, aerobic exercises, walking, and running, can be immensely beneficial for bipolar patients.

In The Spotlight

Would you like to consult a doctor for Bipolar Disorder ?

Patient Experiences

Saurabh Singhal
Dr Anshita took detailed notes for my case and identified the problem. She was sympathetic enoug
Dr Anshita took detailed notes for my case and identified the problem. She was sympathetic enough to understand the burning pain in throat and constant coughing due to silent acidity(LPR) and prescribed medicines accordingly. Initial few weeks the problem percentage went down steadily but later few weeks the graph was constant. Homeopathy treatment took 2-3 months to bring down problem ** *** after which I was impatient and I resolved to allopathic treatment and it was gone in a week. Even allopathic doctors had told that it would take time to resolve this problem so I guess am happy with her treatment even though it was not able to bring it to full closure. I think I will still go to her as I believe homeopathy do not have side effects like alopathy....Read Less
Doctor in this story :Dr. Anshita Singh Rathore
Dr. Anshita Singh Rathore's Homeopathy & Counseling Center
Seemant
Satisfied With Therapy for Bi-polar Disorder
I had been diagnosed as bipolar disorder 15 years back, and have visited many psychiatrists and psychologists in this period, however I am greatly satisfied with treatment and counseling by Dr. Sugandha. In addition to medication her manner of talking, taking out time, and explaiing complicated medical terms in simple ordinary language have impressed me maximally. She gives ample time for me and my family to understand and ask questions. Her calm and unhurried manner has helped me a great degree. I am likely to continue in her care and am assured of my care being in best hands. My heartfelt thanks to the doctor, and may my blessings be with her.....Read Less
Doctor in this story :Dr. Sugandha Gupta
Delhi Mind Clinic

Questions answered by trusted doctors

Verified User
What is bipolar disorder and how to identify if a person is having that. If a women is having that will it affect kid as well? What are the behaviours that will give clue the person might need attention?
Dr. Kiran Shandilya
Psychiatrist, Mumbai
Bipolar Disorder is a mood disorder. In this, the affected person may have episodes of Depression which is characterized by sadness, loss of interest, suicidal thoughts, lethargy, poor sleep or appetite, low self esteem. Or, there may be an episode of Mania which is characterized by over confidence, excessive talking, excessive energy, no need for sleep, excessive spending, poor judgment, reckless and risk taking behavior, may even get violent. Intermittently the person may be absolutely normal.
Verified User
I visited Dr.Madhukar of Cadabams, JP Nagar in Feb 2016 when I was suffering from depression cycle of Bipolar disorder. I had quit my job as I could no longer focus and concentrate on work due to anxiety stress & depression. I was totally cut off from friends & collegues. I was sleeping all the day ruminating about the failure at my proffessional front. I was prescribed Licab 300mg along with Serta 50. I am feeling stable now. Able to focus and concentrate but in the process I have stopped sleeping at night. I am awake the whole night watching football Euro 2016. I feel this is the trigger for hypo mania.
Dr. Antara Gupta
Neuropsychiatrist, Aligarh
Yes you are right. It may be the beginning of high episode. Ask your psychiatrist to increase the dose of licab . First have a serum lithium level done.
Dr. Sannidhya Varma
Psychiatrist, Chandigarh
It is good to know that you have recovered from the previous episode of depression. However it is important to remember that poor sleeping pattern can be the first symptom of the next episode of bipolar disorder or it can precipitate the same. It would be best to cut down on the use of television, mobile phone or computer after 10 in the night as well as tea, coffee or cold drinks after 5 in the evening. If the lack of sleep still persists, it would be advisable to visit your treating doctor as soon as possible.
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Did you know?

Bipolar disorder patients worldwide

At any one time as many as 51 million people worldwide suffer from bipolar disorder.

Patients in India

Approximately 13 million people in India suffer from bipolar disorder.

Average onset age

The average age of onset of bipolar disorder is 18 in men and 25 in women. Bipolar disorder onset is very rare for children under 10 years of age, or adults over 40 years of age.

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