Bipolar disorder (1)

Bipolar disorder, previously known as “manic depression” is a mental sickness that brings abrupt mood swings including emotional lows (depression) and highs (hypomania or mania).

In emotional lows or depression, a person feels hopeless, sluggish, and sad, and loses interest in life activities. When he shifts to hypomania or mania, then he feels euphoric and highly energetic, which is usually irritable. These mood swings influence energy, sleep, behavior, judgment, activity, and thinking ability.

Extreme highs and lows are the two poles of disorder that’s why it is called bipolar disorder.

The onset of bipolar disorder

It usually occurs at the age of 25 but can also begin in the teens and early childhood.

Types

There are various types of bipolar disorder, depending upon the duration and severity of mood swings.

  • Bipolar 1 disorder

It is the most severe type of bipolar disorder. A person with bipolar 1 disorder shows at least one manic or mixed episode and more than one depressive episodes. These episodes last from a week to months and even for years.

  • Bipolar 2 disorder

It is characterized by continuous depressive episodes followed by infrequent hypomanic episodes. In comparison to manic, hypomanic episodes are milder. The chances of suicide are more in this type.

  • Cyclothymic disorder

In this type, an individual exhibits chronic fluctuations of mood with depression and hypomanic episodes. Symptoms are less severe and last for a short period. A person with this disorder may feel at the top of the world one day and feels depression and anxiety the next day.

  • Bipolar disorder not otherwise specified

An individual experiences the symptoms of a depressive and manic episode, but these symptoms do not fall into any of the above types of disorder. This type is known as bipolar disorder not otherwise specified. Like other types, it is also a treatable disorder but cannot be cured completely.

  • Mixed episodes

In this type, a person feels the characteristics of both depressive and manic episodes at the same time. For example, he may experience agitation and excitability of mania along with irritability, sluggishness, and depression. The combination of depression, agitation, euphoria, and energy creates a mixed episode.

Symptoms (2)

In this disorder, the dramatic fluctuations of mood do not follow a specific pattern. Some people experience the same mood for a long time without switching to an alternative mood. These fluctuating cycles take a period of weeks or even months, and sometimes years. However, its severity varies from person to person.

Symptoms of a manic episode (the highs) are:

  • Restlessness
  • Excess energy
  • Excessive hopefulness happiness and excitement
  • Sudden fluctuations from being joyful to being angry hostile and irritable
  • Rapid speech
  • Poor concentration
  • Making unrealistic plans
  • Alcohol and drug abuse
  • loss of appetite
  • Easy distraction
  • A larger sense of well being and self-confidence
  • Poor judgment abilities

Symptoms of a depressive episode (the lows)

  • Loss of pleasure
  • Feelings of worthlessness and hopelessness
  • Sadness
  • Sluggish nature
  • Trouble concentrating
  • Loss of energy
  • Talking slowly
  • Uncontrollable crying
  • Poor ability to make decision
  • Forgetfulness
  • Irritability
  • Insomnia
  • suicidal attempts
  • Suicidal thoughts
  • Appetite changes that make one gain or lose weight

Causes

Bipolar disorder does not have a single cause. The specific triggering cause of the bipolar disorder is still unknown. Some factors increase the risk of one developing bipolar disorder. Such as

  • Biological differences

People With bipolar disorder exhibit certain physical changes in their CNS, such as abnormal brain structure.

  • Genetics

Bipolar disorder is commonly found in people who have their first degree relatives; parents or siblings with this disorder.

Risk factors

Some factors increase the risk of getting bipolar disorder such as:

  • Family history with polar disorder
  • Stress and anxiety
  • Traumatic events such as the death of loved ones
  • Alcohol consumption
  • Drug abuse

Diagnosis

A person with bipolar disorder is referred to a psychiatrist or doctor. These professionals inquire him about the mental illness he has and mental illness running in the family. Bipolar disorder diagnosis is all about the individual’s symptoms and evaluates whether these symptoms may be the consequence of any other disease. Diagnosis is difficult in children or teenagers. The symptoms of bipolar disorder might be confused with just having bad behavior, or attention deficit hyperactivity disorder ADHD.

Treatment

Bipolar disorder is treatable and needs ongoing treatment, because the fluctuating cycles come and go throughout the life.

  • Medication

It is a first-line treatment that involves:

  • Mood stabilisers for example carbamazepine, lithium, valproate, or lamotrigine
  • Antipsychotic drugs, for example, quetiapine, olanzapine, cariprazine, or lurasidone.
  • Antidepressants for example citalopram, or as citalopram, fluoxetine, paroxetine
  • Combination of antidepressant and antipsychotic drugs
  • Anti-anxiety drugs, or sleep medications such as benzodiazepines (alprazolam, diazepam, bromazepam)
  • Psychotherapy

It is also called talk therapy and is recommended in patients who do not respond to medications. There are various types of psychotherapy including:

  • Interpersonal and social rhythm therapy ISPRT It is an idea based therapy in which a daily timetable for sleeping and eating is set, which helps in mood stability.
  • Cognitive-behavioral therapy CBT. This aids the person to replace bad actions and habits with good alternatives.
  • Delivering lessons on bipolar disorders makes the individual and his family manage episodes when occur.
  • Family-focused therapy. It is a support system that provides treatment as well as helps the person to recognize the onset of an episode.

Other treatment approaches for bipolar disorder include:

  • Electroconvulsive therapy

Mild electric shocks are given to the brain to reboot it and modifying the balance of some chemicals. While it is a lost approach when medications and other therapies have not worked, It is much safer and better controlled with fewer side effects and risks than other procedures.

  • Acupuncture

Some pieces of evidence show that this therapy may treat the depressive episode caused by bipolar disorder.

  • Lifestyle changes
  1. Do regular exercise
  2. Scheduled sleeping and eating
  3. Learn to deal with stress
  4. Get help from friends
  5. Engaging in sports

References

  1. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
  2. https://www.webmd.com/bipolar-disorder/default.htm