Bipolar disorder is a mood disorder with or without psychotic symptoms. It is a disorder characterized by recurrent episodes of mania and depression in the same patient at different times; it is usually accompanied by abnormalities in thinking and perception arising out of mood disturbance.
Bipolar disorder, also sometimes referred to as manic depression is a Bipolar mood disorder in which both the stated mania and depression exist at different times. Sometimes someone suffering from bipolar disorder will likely to experience a period of mania followed by a period of depression. These shifts usually follow a set of pattern with mood changes occurring anywhere from one every few months to in some rare cases, once every few hours. Additionally for someone suffering from a bipolar disorder characterized by both mania and depression state co-existing.
Type of Bipolar Disorder
- Bipolar I disorder: The occurrence of at least one manic or mixed episode (includes both manic and depressive elements at the same time) with or without episodes of major depression.
- Bipolar II disorder: The occurrence of at least one episode of major depression and one episode of hypomania (a milder form of mania). The patient must have never experienced a manic and mixed episode. This disorder may develop into bipolar I disorder if a manic episode occurs.
- Cyclothymic: Repeated mood swing with hypomania and lows in mood that doesn’t mean the criteria for major depressive episodes. This disorder is chronic and lasts for at least two years. It may develop into bipolar I if manic episodes occur or into bipolar II disorder if major depression episode occurs.
- Bipolar disorder, Nos: Symptoms of bipolar disorder that do not meet the criteria for any other bipolar diagnosis. This may be more common in early-onset bipolar disorder.
Causes of Bipolar Mood disorder
- Biochemical factors: Abnormalities in the regulation of these neurotransmitters, particularly more-epinephrine, serotonin and dopamine (acetylcholine, GABA etc)
- Genetic factors: individuals who have relatives with the history of mood disorder are at higher risk of developing either the same or a different mood disorder. This is especially true for 1st-degree relatives, (eg. Parents, children, siblings).
- Environmental Factors: Such as stressful events disturbances in seasonal or cardiac rhythm
- Gender: Women have nearly twice as much risk of developing major depression as men.
Sign and symptoms
It is important for you to know the sign and symptoms of the bipolar disorder so that you can help others to know themselves to get better treatment.
- Depressive episodes are characterized by
- Altered mood: The patient may experience sadness anxiety anger, irritability or apathy. They made pessimistic or discouraged and may experience crying spells or excessive sensitivity.
- Anhedonia: The patient may experience a reduction or loss of interest in activities they once found pleasurable, such as food, sex, work, friend, hobbies, and entertainment.
- A significant change in appetite or weight: Either increased or decreased appetite
- Changes in sleep patterns (insomnia or hypersomnia)
- Changes in physical or verbal activity
- Fatigue and loss of energy
- Diminished self-worth (feeling of worthlessness)
- Self- reapproach or excessive or inappropriate guilt
- Impairment concentration ( diminished ability to think or concentrate)
- Death thoughts: suicidal ideation
- Heaviness/ pain in different body parts
- Mania episodes are characterized by
- Euphoria and elevated high feeling or irritability
- Uncharacteristically elevated self-esteem, feeling of grandiosity or unrealistic confidence.
- Decreased need for sleep
- Flight of ideas
- Increased activity or physical restlessness
- Intrusive or aggressive behavior
- Social dis-inhibition/ loss of normal social inhibition
Hence, bipolar disorder is characterized by mood swings from profound depression to extreme euphoria (mania) with involving a period of both. According to ICD-10, it is an episode disorder comprising of two or more discrete episode of mania with or without a discrete episode of depression. BPAD is an episodic illness with a tendency to recover.
The selection and management depend upon the type of disorder the patient is presenting along with the severity of illness. Sometimes hospitalization may need.
- Hospitalization or emergency management: Emergency care or management is needed if a patient is excessively violent and may cause harm to oneself or others. So, if you found anyone who is experiencing this type of symptoms then call your near hospital immediately.
- Electroconvulsive therapy (ECT): It is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure.
- Pharmacological management: your doctor will prescribe you the drugs as per your symptoms or disease conditions such as antipsychotic medication, anticonvulsants drugs etc.
- Psychotherapy: It is an effective way for the treatment of major depression especially when combined with medication.
- Cognitive Behavior therapy: Patient learns to change and control inappropriate thought patterns and behavior that contribute to or result from their disorder. It helps to reduce a frequency of bizarre, disturbing behavior and increases socially appropriate behavior. Adaptive behavior is reinforced by praises or privileges.
- Psych education: Teaches patient about their mood disorder, its treatment and how to recognize early sign and symptoms of early episodes so that easily intervention can be done.
- Family therapy: Reduces the level of distress within the family may contribute to or result from the symptoms of a mood disorder. Interpersonal and social rhythm therapy improve the interpersonal relationship between bipolar patient and regularize their daily routine and sleep schedules to give them more control of their lives and their conditions.
- Group therapy: Therapeutic group therapy help patient for interactions and orientation to reality. Self-help means a group of people with similar problem. Such group help solves and shares the problem with each other. Group therapy should be lead in a supportive manner rather than competitive manner.
- Psychodynamic therapy: Focuses on resolving the conflicts in patients feeling such as the desire for praise coupled with a feeling of worthlessness. This therapy is often reserved until symptoms are significantly improved.