Bipolar Disorder
An overview

Bipolar disorder is a serious and risky mental illness characterized by extreme mood swings ranging from emotional highs (mania) to depressive lows (depression). A person suffering from bipolar disorder, when in a high state, behaves in an over-excited and reckless manner. Everything from thoughts to speech to movements speeds up, and the patient may have difficulty focusing on tasks and feel irritable and frustrated. When the mood shifts to the other extreme, the same person feels sad and lose interest or pleasure in most activities. Such mood shifts can occur only a few times a year or as frequent as several times in a week.

People with bipolar disorder may have trouble managing everyday life tasks, at school or work, or maintaining relationships. Proper diagnosis and treatment help people with bipolar disorder lead healthy and productive lives.

Famous Australian cricketer Michael Slater and a host of other celebrities like Catherine Zeta-Jones, Honey Singh and Demi Lovator have revealed that they have had been diagnosed with bipolar disorder.

Signs and Symptoms

Bipolar disorder can manifest into different symptoms in different people. The symptoms differs quite a bit in their pattern, severity, and frequency. Some people are more prone to either of mania or depression, while others fluctuate equally between the two types. Some experience frequent mood disruptions, while others much less. People suffering from bipolar disorder, experience four types of mood episodes: mania, hypomania, depression, and mixed episodes. Each type of bipolar disorder mood episode has a unique set of symptoms.

Mania - During the manic phase, people feel high level of energy, creativity, and excitement. People, while in manic phase, talk a lot, sleep little, and are hyperactive. They feel they are all-powerful, and overall good about themselves. However, it has been noticed, that when manic phase goes to its extreme, the overall behavious become reckless and many a times they end up gambling huge money, engage in sexual activity and make foolish investments.

Hypomania is a less extreme form of mania. Though, people in hypomanic state feel energetic and productive, but they carry on with their day-to-day lives and don't lose touch with reality. It may appear to others, that people with hypomania are just in very good mood. However, hypomania often changes to mania or major depressive episode.

Depressive episode involves usual symptoms of depression - feeling of worthlessness, insomnia, change in appetite etc.

Common symptoms of bipolar depression include:
  • Feeling of hopelessness or sadness
  • Irritability
  • Appetite or weight changes
  • Insomnia
  • Inability to focus
  • Difficulty remembering things
  • Fatigue throughout the day
  • Inability to experience pleasure
  • Causes
    Like for most mental health disorders, the exact cause of bipolar disorder is not accurately known, but it is believed that several factors may be involved, such as:
  • Biological Factors - People with bipolar disorder have physical changes in their brains.
  • Neurotransmitters - An imbalance in natural brain chemical called neurotransmitters is linked to bipolar disorder.
  • Hereditary - Bipolar disorder is seen as more common in people who have a sibling or parent, with the condition.
  • Types of Bipolar Disorder

    There are several different types of bipolar disorder ranging from mild to severe, though each of them involves episodes of depression and mania to some degree. Three main types of bipolar disorder are:

    Bipolar I Disorder - Bipolar I is characterized by at-least one full blown frenzied manic episodes lasting for more than a week and the symptoms are severe enough to disrupt the patient’s ability to work and socialize. This may include inflated self-esteem, decreased need for sleep, being more talkative than usual, increase in goal-oriented activity and excessive involvement in risky activities. In several cases, the patient could need hospitalization to stop damage to themselves or others. The patient may lose touch with reality to the point of being psychotic. Another form of Bipolar I is when the patient may experience “mixed” episode i.e experiencing symptoms of both a mania and a depression.

    Bipolar II Disorder - Bipolar II disorder is characterized by at-least one major depressive episode in addition to atleast one hypomanic episode over a period of four days or more. The highs in bipolar II, called hypomanias, are not as high as those in bipolar I (manias) and so the episode doesn't disrupt normal functioning and the patient don't show psychotic symptoms. Bipolar II disorder is sometimes wrongly diagnosed as major depression if hypomanic episodes go unrecognized.

    Cyclothymia - Cyclothymia is a much milder form of bipolar disorder that is characterized by several hypomanic episodes and less severe depression episodes that alternate for two years or more. The severity of this illness keeps changing over time.

    Bipolar Disorder Diagnosis

    Medical science has come a long way in fully understanding different moods experienced in bipolar disorder and hence in making an accurate diagnosis of bipolar disorder. Not too long back, bipolar disorder was often confused with other disorders such as depression or with schizophrenia. Psychiatrists can identify the symptoms of bipolar depression and in most cases, treat the disorder effectively and safely.

    Bipolar disorder diagnosis is made only by carefully noting the symptoms including their severity, length and frequency. The usual "Mood swings" from day to day do not necessarily indicate a diagnosis of bipolar disorder. Rather, the diagnosis is dependent on having periods of unusual elevation in mood that are coupled with increases in energy, sleeplessness, and fast speech. At Juno, the patient’s symptoms are fully assessed using specific criteria from the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-V).

    In order to make the diagnosis, the psychiatrist or psychologist will ask you several questions about your personal and family history of bipolar disorder or other mood disorders. You will be ask detailed questions on your bipolar symptoms, reasoning, memory and ability to maintain relationships.

    If you think you have experienced symptoms of bipolar disorder, then you should visit a psychiatrist immediately. You can also consider bringing your spouse or other family member/friend with you as often the spouse or friend are more aware of a person’s unusual behaviors and be able to describe these in detail.

    Treatment For Bipolar Disorder
    Treatment for bipolar disorder is supervised by a psychiatrist. The treatment team also includes a psychologist who focuses on psychotherapy. Initial Medication - Often, medications are prescribed to balance the moods. Medications may include mood stablisers and antipsychotic drugs
    Maintenance treatment - Bipolar disorder requires lifelong treatment, even in times when the person feels better. People who don't undergo maintenance treatment are at high risk of a relapse of bipolar disorder.
    Psychotherapy For Bipolar Disorder
    Psychotherapy is a very important part of treating bipolar disorder and provided to the individual or to the family. Several types of therapy can be helpful including: Cognitive behavioral therapy - Focus of CBT is identifying negative beliefs and behaviors and replacing them with healthy, positive ones. It helps identify triggers of bipolar episodes and helps patient learn effective strategies to manage stress and to cope with upsetting situations.