Bipolar Disorder

Extreme mood swings, including emotional highs (mania or hypomania) and lows (depression), are symptoms of bipolar illness, formerly known as manic depression.

When you experience depression, you could feel melancholy or hopeless and stop enjoying or being interested in most activities. You might experience mania or hypomania (a less severe form of mania), which can make you feel elated, energized, or particularly irritable. The ability to think clearly, energy levels, activity, judgment, and behaviour can all be impacted by these mood changes.

Mood swing episodes can happen infrequently or repeatedly each year. While the majority of people will have some emotional symptoms in between bouts, some people might not.

Although bipolar disorder is a lifelong diagnosis, by adhering to a treatment plan, you can control your mood swings and other symptoms. Bipolar disorder is typically treated with pharmaceuticals and psychological therapy (psychotherapy).

Depressive episodes and times of manic symptoms alternate for people with bipolar illness.  When having a depressive episode, the person feels down (sad, irritated, or empty) or loses interest in activities for the most of the day, almost every day.  Euphoria or irritation, increased activity or energy, and other symptoms like increased talkativeness, racing thoughts, higher self-esteem, decreased need for sleep, distractibility, and impulsive hazardous behaviour are only a few of the possible manic symptoms.  Suicide risk is higher for those who have bipolar disorder. Nevertheless, there are effective therapeutic methods available, such as psychoeducation, stress reduction and social functioning enhancement, and medication.

Types of Bipolar disorders

Bipolar disorder and its related disorders come in a variety of forms. Depression and mania or hypomania may be among them. Symptoms might bring about erratic changes in mood and behaviour, which can cause serious discomfort and make life difficult.

Bipolar I disorder.

You’ve experienced at least one manic episode, which may have been preceded or followed by serious depression or hypomanic episodes. Mania can occasionally result in a psychotic break (psychosis).

Bipolar II disorder

However, you’ve never experienced a manic episode. Instead, you’ve had at least one major depressive episode and one hypomanic episode.

Cyclothymic disorder

You’ve experienced numerous episodes of hypomania symptoms and episodes of depressive symptoms (though less severe than major depression) for at least two years, or one year in adolescents and teenagers.

Other types

Bipolar illness and other associated disorders that are brought on by certain medicines or alcohol or by a physical condition like Cushing’s disease, multiple sclerosis, or stroke are a few examples of these.

Bipolar II disorder is a distinct diagnosis, not a milder variation of bipolar I illness. People with bipolar II condition can experience prolonged depressive episodes, which can significantly hinder their lives, but the manic episodes of bipolar I disorder can be severe and dangerous.

Although bipolar disorder can affect anyone at any age, it is often discovered in adolescence or the early 20s. Symptoms might change over time and from one person to the next.

Mania and hypomania

Despite being two different types of events, hypomania and mania share the same symptoms. Mania is more severe than hypomania and results in more obvious issues with relationships, employment, school, and social activities. A psychotic break (psychosis) brought on by mania may also necessitate hospitalization.

Both a manic and a hypomanic episode include three or more of these symptoms:

  • Abnormally upbeat, jumpy or wired
  • Increased activity, energy or agitation
  • Exaggerated sense of well-being and self-confidence (euphoria)
  • Decreased need for sleep
  • Unusual talkativeness
  • Racing thoughts
  • Distractibility
  • Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments

Major depressive episode

A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:

  • Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
  • Marked loss of interest or feeling no pleasure in all — or almost all — activities
  • Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
  • Either insomnia or sleeping too much
  • Either restlessness or slowed behavior
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Decreased ability to think or concentrate, or indecisiveness
  • Thinking about, planning or attempting suicide

Other features of bipolar disorder

Other characteristics, such as anxious distress, melancholy, psychosis, or others, may be present together with the classic signs and symptoms of bipolar I and bipolar II illnesses. The onset of symptoms may be accompanied by diagnostic descriptions like mixed or rapid cycling. Bipolar symptoms might also alter with the seasons or appear during pregnancy.

Symptoms in children and teens

Bipolar disorder symptoms in children and teenagers might be challenging to spot. It can be challenging to determine whether these swings in mood are typical, the effect of stress or trauma, or an indication of a mental health issue other than bipolar disorder.

Major depressive, manic, or hypomanic episodes may be different in children and teenagers, although the pattern may differ from that in adults with bipolar disorder. And while having an episode, feelings can change quickly. Between bouts, some kids could experience a period without mood problems.

Severe mood swings that differ from their typical mood swings may be one of the most obvious indications of bipolar disorder in kids and teenagers.

Diagnosis

People with bipolar disorder can have healthy, busy lives with the proper diagnosis and treatment. The initial step is to consult with a healthcare professional. To rule out additional potential causes, the medical professional might do a physical examination and other required medical testing. The health care practitioner may then carry out a mental health examination or refer a patient to a mental health professional who has received training in diagnosing and treating bipolar illness, such as a psychiatrist, psychologist, or clinical social worker.

Bipolar disorder is typically diagnosed by mental health professionals based on a patient’s symptoms, lifetime experiences, history, and, in certain circumstances, family history. Youth diagnostic accuracy is particularly crucial.

Treatments and therapies

Many people, even those with the most severe forms of bipolar disease, can benefit from treatment. A successful treatment strategy typically combines medicine with psychotherapy, sometimes known as talk therapy.

Bipolar disorder is a chronic condition. Maniacal and depressive episodes frequently recur over time. Many bipolar illness sufferers do not experience mood swings in between episodes, while some may continue to experience lasting symptoms. Treatment that is ongoing and long-term can help patients manage these symptoms.

Medications

Bipolar disorder symptoms can be managed with the aid of specific drugs. To identify the drugs that work best for them, some people may need to experiment with various prescriptions and work with their healthcare professional.

Mood stabilisers and atypical antipsychotics are the most popular pharmaceutical classes that medical professionals recommend. Lithium and valproate, two mood stabilisers, can help prevent mood episodes or lessen their severity. The risk of suicide can also be reduced with lithium. As part of the therapy strategy, medical professionals may prescribe drugs that deal with anxiety or sleep problems.

Although antidepressants are frequently used to treat bipolar depression, a mood stabiliser must also be taken since, in people with bipolar illness, taking an antidepressant without a mood stabiliser might result in a manic episode or rapid cycling.

It is crucial for healthcare professionals to carefully review a patient’s medical history to verify that bipolar illness is not misinterpreted for depression because people with bipolar disorder are more likely to seek treatment when they are depressed than when they are going through mania or hypomania.

Psychotherapy

People with bipolar disorder may benefit from talking therapy, often known as psychotherapy. The term “psychotherapy” refers to therapeutic methods intended to assist patients in recognizing and altering problematic feelings, ideas, and behaviours. People with bipolar disorder and their families may benefit from the support, information, and direction offered by this form of therapy.

Effective treatment for depression is cognitive behavioural therapy (CBT), and CBT which has been modified to address insomnia can be especially beneficial when used to treat bipolar depression.

In addition, more recent therapies including interpersonal and social rhythm therapy (IPSRT) and family-focused therapy may be utilized to treat bipolar disease.

Source:

https://www.who.int, https://www.mayoclinic.org, https://www.nimh.nih.gov, https://www.webmd.com

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