"Bipolar is like being on a roller coaster ride. Sometimes you can predict drop-offs and others you just have to hang on because the next turn sends you into an unexpected spiral. Sometimes you are laughing and throwing your hands in the air and then other times you are clinging, simply holding on for dear life screaming at the top of your lungs."

The Mayo Clinic defines Bipolar Disorder as "a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

People with Bipolar disorder experience mood fluctuations that can be poles apart. There are times when they feel extremely happy, energized and ready to take on the world, whereas there are other times when they feel extremely sad, hopeless, and a loss of interest or pleasure in activities. at times, the mood swing may be mixed, wherein one might feel euphoric and depressed at the same time. 

TYPES OF BIPOLAR MOOD DISORDER:

Bipolar Mood Disorders can be of several types, which comprises of mania or hypomania and depression. When it comes to Bipolar Mood Disorder, there are frequent and unpredictable mood fluctuations which also has an impact on the behaviour of the individual. These sudden changes can be very confusing and create a feeling of distress within the individual and his/her life.

1. BIPOLAR I DISORDER: Bipolar I Disorder consists of manic symptoms that last for about 7 days. There is at least one manic episode that may be preceded or followed by either a hypomanic episode or a major depressive episode. People with this type may also experience a depressive episode lasting for at least 2 weeks. There may also be certain cases wherein there are episodes of depression with mixed features; having depressive and manic features at the same time. In certain cases, mania may also lead to Psychosis (loss of reality).
2. BIPOLAR II DISORDER: People with Bipolar II Disorder experience depressive and hypomanic episodes, but there are no manic episodes. Usually, they experience one major depressive episode which lasts for a period of at least 2 weeks and one hypomanic episode that lasts over a period of 4 days.

3. CYCLOTHYMIC DISORDER (CYCLOTHYMIA): In Cyclothymia, there are a number of depressive and hypomanic episodes lasting for a period of at least 2 years (1 year in children and adolescents). The symptoms experienced in Cyclothymia are shorter and much less severe as compared to the ones in Bipolar I and Bipolar II Disorders.

4. OTHER SPECIFIED AND UNSPECIFIED BIPOLAR AND RELATED DISORDERS: This type is defined by Bipolar Disorder symptoms that do not fall under the categories mentioned above. In certain situations, Bipolar Disorder can be induced because of certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.

SYMPTOMS OF BIPOLAR MOOD DISORDER:

Bipolar Disorder does not just affect the individual's mood, it has an impact on the behaviour, functioning, cognition and other such aspects as well. The symptoms of Bipolar Mood Disorder as listed by the Mayo Clinic are as follows:·

1. MOOD: 

  • Mood swings.
  • Sadness.
  • Elevated mood.
  • Anger.
  • Anxiety.
  • Apathy.
  • Apprehension.
  • Euphoria.
  • General Discontent.
  • Guilt.
  • Hopelessness.
  • Loss of interest or pleasure in activities.

2. BEHAVIORAL:

  • Irritability.
  • Risk-taking behaviours.
  • Disorganized behaviour.
  • Aggression.
  • Agitation.
  • Crying.
  • An excess desire for sex.
  • Hyperactivity.
  • Impulsivity.
  • Restlessness.
  • Self-harm.

3. COGNITIVE:

  • Unwanted thoughts.
  • Delusions.
  • Lack of concentration.
  • Racing thoughts.
  • Slowness inactivity.
  • The false belief of superiority.

4. PSYCHOLOGICAL:

  • Depression.
  • Manic episode.
  • Agitated depression.
  • Paranoia.

5. SLEEP:

  • Difficulty falling asleep.
  • Excess sleepiness.

6. WEIGHT:

  • Weight gain.
  • Weight loss.

7. ALSO COMMON:

  • Fatigue or rapid and frenzied speaking.
RAPID CYCLING:

Rapid Cycling is a pattern of frequent, distinct episodes in Bipolar Disorder. Some people having Bipolar Disorder may develop rapid cycling wherein, they may experience four or more episodes of mania or depression within a 12 month period. There can be frequent mood swings switching from high to low and back over a period of days or hours. When it comes to rapid cycling, repeated and distinct episodes of depression are more common with infrequent, shorter periods of elevated or normal mood in between. 

CAUSES OF BIPOLAR MOOD DISORDER:

Scientists have been trying to decipher the causes of Bipolar Disorder, and most of them are of the opinion that there is no single cause which leads to the development of the disorder, in fact, there are a number of factors that could play a role in the development of Bipolar Mood Disorder.

1. BRAIN STRUCTURE AND FUNCTIONING: Studies carried out in the past have indicated certain discrepancies in the brains of people with Bipolar Mood Disorder as compared to people who do not suffer from any kind of mental illness. Certain brain imaging studies highlight physical changes in the brains of people with Bipolar Disorder. There are other studies as well which suggests that neurotransmitter imbalances, abnormal thyroid function, circadian rhythm disturbances and high levels of the stress hormone cortisol could also play a pivotal role in the development of the disorder.

2. GENETICS AND FAMILY HISTORY: People with first degree relatives (parents or siblings) having Bipolar Mood Disorder are most at risk for developing the disorder. However, it is important to note that even though you may have Bipolar Disorder in your family history, it is not necessary that you will develop the disorder too.

3. ENVIRONMENTAL FACTORS AND STRESS: Our body may play a role in the development of Bipolar Disorder but our environment can have a role in it as well. Undergoing extreme periods of stress and traumatic experiences can make one vulnerable to Bipolar Mood Disorder.

4. SUBSTANCE ABUSE: Substance abuse does not cause Bipolar Mood Disorder, but it contributes towards the development of an episode. Drugs such as Cocaine, Ecstasy and Amphetamines are known to trigger mania, whereas, Alcohol and Tranquilizers can trigger depression.

5. SEASONAL CHANGES: Seasonal changes play a role in the development of episodes of mania and depression. Manic episodes are more likely during the summer, whereas, depressive episodes are more likely during autumn, winter and spring.

6. LACK OF SLEEP: Lack/loss of sleep can also be a triggering factor for an episode of mania.

TREATMENT:

1. MEDICATION: Medication is the main treatment when it comes to Bipolar Disorder. Medications usually involve Mood stabilizers like Lithium, Lamotrigine, Valproate or Carbamazepine. Sometimes antipsychotics are also used.

2. PSYCHOTHERAPY: Interpersonal & Social Rhythm Therapy (ISRT) focuses on regulating daily habits, such as sleeping, eating, and exercising and balancing these everyday routines can help one manage the disorder.

3. ELECTROCONVULSIVE THERAPY: ECT is a treatment that involves sending a small electric current through the brain, which helps provide relief to people with severe Bipolar Disorder who have not been able to recover with other forms of treatment. 

CO-OCCURRING CONDITIONS:

There can be certain physical health or mental health conditions along with Bipolar Disorder, which also need to be taken care of and treated.

  • Anxiety Disorders.
  • Eating Disorders.
  • Attention Deficit Hyperactivity Disorder(ADHD).
  • Alcohol or Drug problems.
  • Physical health problems, like heart disease, thyroid problems, headaches or obesity. 

BIPOLAR DISORDER AND SUICIDE:

Suicide is a risk factor when it comes to Bipolar Disorder, due to the severity of the depressive phase that the individual undergoes. The risk of suicide is even higher in people with Bipolar Disorder who have frequent depressive episodes, mixed episodes, a history of alcohol or drug abuse, a family history of suicide, or an early onset of the disease. 

One can look out for certain suicide warning signs which are as follows:

  • Talking about death, self-harm, or suicide.
  • Feeling hopeless or helpless.
  • Feeling worthless or like a burden to others.
  • Acting recklessly.
  • Putting affairs in order or saying goodbye.
  • Isolating yourself.
  • Abusing alcohol or other drugs.
  • Giving away possessions.
  • Seeking out weapons or pills that could be used to commit suicide.
  • Crying more, or becoming less emotionally expressive.

“Which of my feelings are real?

Which of me’s is me?

The wild, impulsive, chaotic, energetic, and crazy one?

Or the shy withdrawn, desperate, suicidal, doomed, and tired one?

Probably a bit of both, hopefully, much that is neither” – Kay Redfield Jamison.