In this article we will look at:
- What is bipolar disorder?
- How does bipolar disorder occur?
- Causes of bipolar disorder
- Who is prone to bipolar disorder?
- Symptoms of bipolar disorder
- Diagnosis of bipolar disorder
- Complications of bipolar disorder
- Treatment of bipolar disorder
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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
- 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
-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.
-Extreme sadness, despair, hopelessness, crying
-Hyper-anxious about trivial things
-Pain and physical problems that do not respond to treatment
-Weight loss/weight gain
-Fatigue and irritability
-Inability to enjoy hobbies
-Low attention span
- An inability to face going to work/school and underperforming
-Insomnia/hypersomnia/ sudden decreased need for sleep while not getting tired
-Excessive desire for sex
-Lack of concentration
-Changes in eating patterns
-Tendency to self-harm
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:
- Substance abuse
- Eating disorders
- heart disease
- Other physical illnesses
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.
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
Questions answered by trusted doctors
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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