Bipolar Disorder

• Symptoms: Extreme mood swings, loss of interest in everyday activities, sudden feats of anger, forgetfulness, feeling worthless and self-doubt
• Causes: Genetics, external triggers, drugs or medication or alcohol, exposure to extreme stress, childhood trauma
• Risk Factors: Alcohol or drug abuse, individuals who have a first-degree relative with bipolar disorder, individuals going through high periods of stress or trauma
• Severity: Mild to severe
• Which doctor to consult: Psychiatrist and Clinical Psychologist

Overview

Bipolar disorder, also called manic depression, is a mental disorder that causes extreme mood swings in individuals. The mood usually varies between extreme highs, known as mania or hypomania and extreme lows, something similar to depression.

Individuals with bipolar disorder can go through a phase of depression that may last for weeks. When they go through extreme lows, they feel hopeless and do not have the energy to do anything. Either they sleep a lot or have trouble sleeping, get thoughts of self-harm, tend to hide away and do not enjoy life.

When the phase of extreme high strikes, they tend to be always hyperactive. They will act silly, speak so fast that one cannot follow their conversation, not feel the need to sleep, do things without even thinking, try to rush through everything, and believe they have superpower abilities. This kind of personality is extremely risky.

Having bipolar disorder can be challenging not only for the patient but individuals around them. Because of their confusing personality, it becomes difficult for individuals around them to understand them. Getting along with others, making friends, sticking to goals, and concentrating on work or studies can be tricky.

This disorder affects the individual's ability to make decisions, and they often take risks. Suicide, self-harm, and trying to harm others are common among patients with bipolar disorder. They often depend on alcohol or drugs to manage their mood.

The disorder usually affects individuals 25 years or above, but in rare cases, it can occur among teenagers.
Bipolar disorder is a lifelong disease, and there is no cure. But with regular psychological counselling, medicines, assisted living, and a proper treatment plan, bipolar disorder can be managed. The treatment primarily focuses on addressing the mood swings so the patient does not harm themselves.

It is essential to start proper treatment after the disease is diagnosed. Otherwise, the condition worsens.

The causes of the disorder primarily include genetics. If the disorder runs in the family or any siblings or parents, there is a high chance of the individual suffering from bipolar disorder. However, in some cases, the individual may not get it, even if it runs in the family. Another factor is stress or childhood trauma or accident.

When to Consult a Doctor?

It is advised to consult a doctor on the onset of the primary symptoms to prevent the condition from progressing further. However, the symptoms may become severe, and individuals have suicidal thoughts or thoughts of self-harm. They become a danger to themselves and others without realising it. Consult a doctor immediately for help.

Symptoms

Individuals with bipolar disorder experience extreme episodes of mania and depression.

When they go through mania, a period of extreme high, they experience the following symptoms

• Feeling energetic all the time
• Feeling distracted all the time
• Not wanting to sleep
• Having hallucinations
• Having the urge to do plenty of things at once
• Speaking very fast
• Feeling excited or thrilled most of the time
• Not paying heed to others

The period of depression makes the individual go through extreme opposite characteristics. The symptoms in the phase include:

• Feeling worthless, sad, or irritable all the time
• Feeling lethargic to do anything
• Not feeling the urge to do regular activities
• Having self-doubt all the time
• Lack of appetite
• Having difficulty trying to sleep
• Feeling the need to withdraw from everything and everyone 
• Having thoughts of self-harm or suicide
• Having hallucinations or being delusional

Diagnosis

Since bipolar disorder involves changes in mood over time, the doctor usually monitors the patient over a few weeks before diagnosing the disorder. This condition can also overlap with other mental health disorders. So, it is important to identify the right symptoms to diagnose the disease correctly.

The patient must have experienced at least one episode of maniac or depressive symptoms. The challenge here is that patients often overlook mania symptoms as nobody goes to the doctor because they feel elated or overjoyed.

The doctor conducts an interview and asks the patient questions like the different symptoms, the duration of the depression episode, how the mood swings make them behave, how they handle the mood and other similar questions. Before diagnosis, family history and the patient's medical history are considered. In most cases, the doctor asks the patient to maintain a diary to understand their mood swings.

Lab Tests

Lab tests or imaging tests are not used to diagnose bipolar disorder. However, the doctor may recommend some blood tests and urine tests to rule out the possibility of underlying medical conditions causing similar symptoms.

Treatment

Proper treatment can help the patient to live a healthy and everyday life. The exact depends on how long the patient has been experiencing the symptoms, the surroundings of the patient, and how the patient reacts to the mood phases.

With the help of treatment, the disorder can be stabilised, and the patient can handle things, even when alone. The treatment can be a combination of medications, psychotherapy, and alternative management.

Different treatments available for bipolar disorder include:

• Psychotherapy

Different types of psychotherapy are administered to treat the symptoms of bipolar disorder. Cognitive behavioural therapy (CBT) reduces stress by helping patients change their thinking patterns. This also helps in better mood management.

• Talk Therapy

This allows the patient to discuss their feelings, mood swings, thoughts, and daily activities with a psychologist. This helps them to improve relationships with their loved ones, understand their mental condition and improve daily functioning.

• Home Care

Small lifestyle changes in everyday life can bring about many positive changes for patients with bipolar disorder. Self-management techniques suggested by psychologists can be highly effective for managing the disorder.

Following are some self-management techniques that individuals with bipolar disorder can adopt at home:

• Keeping track of mood and monitoring what triggers the episodes
• Educating oneself about the disease
• Following a disciplined life
• Managing stress and limiting them
• Attending regular counselling with family or alone
• Following a sleep hygiene
• Practicing workouts and meditation
• Carefully thinking and making decisions
• Reaching out for help whenever required
• Taking prescribed medication timely
• Avoiding alcohol and drugs

Medication

Doctors usually prescribe mood-stabilizing medication to control the disorder's symptoms. Antipsychotic drugs like olanzapine-fluoxetine combo (OFC) or mood-stabilizing medicine like carbamazepine, valproic acid, and other similar medications are prescribed.

This must be mentioned here that only a psychiatrist can prescribe medication for a patient with bipolar disorder. Individuals can go to a general practitioner to discuss the initial symptoms, and they may recommend a psychiatrist.

Surgical Treatment

There is no surgical treatment for patients with bipolar disorder.

Alternative Management

Since stress can trigger the disorder, alternative management is adopted to manage stress. Different calming techniques are adopted as complementary treatments to manage the symptoms. Individuals benefit from massage therapy or daily yoga or meditation to promote calmness.

Individuals are also encouraged to practice aerobics or sports. This is a helpful addition to the overall treatment as this allows the stress to be released.

There are also different support groups that patients can attend either with family or friends or alone to connect with individuals with a similar condition. These groups provide mental and social support to the patient.

Risks & Complications if Left Untreated

If bipolar disorder is left undiagnosed and untreated, it can cause serious problems that can interfere with the individual's social, personal, and work life. The condition worsens over time, and the episodes become more frequent and severe. The individual may consider ending his/her life at one point and attempt suicide.

Problems related to drug or alcohol abuse may also arise. Individuals often think alcohol can help them stabilise their mood. But this will only worsen the condition.

Additional Information

There are different types of bipolar disorder. These affect every individual differently. The type of the disorder also determines the symptoms and period of the episodes.

The difference between the different types of disorders is only sometimes clear as the symptoms may overlap. This is why different doctors use other terms to define the type of the disorder.

The three most common types of bipolar disorder include:

• Bipolar I Disorder

This type of disorder is characterised by at least one episode of mania. While most individuals go through depression, it is not rare. The episode mostly lasts up to 7 days; sometimes, they are so severe that the patient needs to be hospitalised.

• Bipolar II Disorder

In this type, the mania episodes are slowly replaced by episodes of depression. While mood swings become prominent and shift between mania and depression, depression becomes the dominant mood. Also, the episodes are more frequent than in Bipolar I.

• Cyclothymic Disorder or Cyclothymia

This includes both mania and depression, and the mood changes become more or less permanent. Cyclothymia is usually developed when the first two categories of bipolar last for at least two years.

There is also an 'unspecified' category when the symptoms do not fall into either Bipolar I or Bipolar II category. Individuals falling in this category can also exhibit signs of bipolar disorder.