BIPOLAR DISORDER
Bipolar disorder is a mental health disorder that is marked by extreme mood swings.
- These mood swings range from high emotions (mania or hypomania) to low emotions (depression).
- When depression sets in, a person may feel sad, hopeless or lose interest in most activities but when the mood shifts to mania or hypomania, a person may be full of energy, happy or irritated.
- During periods of depression, there may be crying, a negative outlook on life and poor eye contacts with others.
- These shift in moods can affect sleep, behavior, activity, judgment and the ability to think clearly.
- Episodes of mood swing may occur rarely or multiple times a year.
- The condition affects about 1% of the global population and the age of onset for the symptom is usually around age 25.
- There are three main types of bipolar disorder, bipolar I, II, and cyclothymia
- Bipolar I is marked by at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes.
- Bipolar II is marked by at least one hypomanic episode and one major depressive episode, but no manic episodes.
- Cyclothymia is marked by at least one or two years of many period depressive symptoms and hypomania symptoms. These periods are not sufficient to be a major depressive episode or hypomanic episodes.
CAUSES
The exact cause is not known but factors such as biological differences, genetics, environmental factor such as extreme stress, traumatic experience, physical illness, or drug and alcohol abuse, and neurological conditions and injury such as stroke, traumatic brain injury, multiple sclerosis, and porphyria may all be involved.
SYMPTOMS
Depressive episodes may include:
- Feeling sad, hopeless, empty, or tearful
- Suicidal thoughts and behavior
- Decreased ability to think or concentrate
- Loss of energy
- Insomnia or excessive sleeping
- A feeling of worthlessness or inappropriate guilt
- Unintended weight loss or weight gain that may result from a decrease in the increase in appetite
- Loss of interest in almost all activities
Mania and hypomania are two different episodes, but they share the same symptoms. Mania is more severe while hypomania is a milder form of mania. While mania is a period of at least one week of elevated or irritable mood that may impair a person’s ability to socialize or work, hypomania is defined as at least four days of elevated or irritable mood and does not cause a decrease in a person’s ability to socialize or work.
- Increased activity, energy or agitation
- Decreased need for sleep
- Speaking in a rapid, uninterruptible manner
- Racing thoughts
- Abnormally jumpy or wired
- Hypersexuality or excessive spending
- Having trouble being focused or being easily distracted
- An exaggerated sense of well-being and self-confidence (euphoria)
DIAGNOSIS AND TREATMENT
A medical evaluation will be carried out to help rule out other medical conditions, after which further evaluation is carried out by a mental health professional.
Diagnosis is based on:
- A psychological evaluation which aims to assess thoughts, feelings as well as a behavior pattern.
- Mood charting to keep daily records of your mood, sleep patterns and other factors that could help with diagnosis.
- Criteria listed in the DSM-5, published by the American Psychiatric Association as a diagnostic tool to evaluate the disorder.
TREATMENT
Several treatment options are available that can help manage the condition.
Medications such as
- Mood stabilizers such as lithium (Lithobid), valproic acid (Depakene)
- Antipsychotics such as olanzapine (Zyprexa), risperidone (Risperdal)
- Antidepressant-antipsychotic such as fluoxetine-olanzapine (Symbyax)
- Anti-anxiety meds such as Benzodiazepines
Psychotherapy such as interpersonal and social rhythm therapy (IPSRT), cognitive behavioral therapy, psychoeducation, and family-focused therapy.
Other treatments such as electroconvulsive therapy may be added to depression therapy based on your needs. During this therapy, electric currents are passed through the brain.