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WHAT IS BIPOLAR DISORDER?

Bipolar disorders are associated with the brain, or a mental health condition, thus known as brain disorders. It has several features such as mood (emotional highs, i.e. mania or hypomania, and lows, i.e. depression), energy, and functional (loss of interest in various activities) alterations.

To date, there has not been any evidence regarding the exact cause of bipolar disorder. But, surely environment, genetics, and altered brain structure play a key role.

The treatment advised for bipolar disorder is usually a life-long journey, often includes a combination of both, psychotherapy as well as medications.

SYMPTOMS

In the case of bipolar I and II disorder, the underlying following criteria have to be diagnosed in case of a manic episode. It is either preceded by or followed by hypomanic episodes.

• Manic Episode A – A period of persistent elevated and irritable mood, abnormally hyped goal-directed energy, lasting for at least a period of 1 week and exists for nearly the whole day.
• Manic Episode B – During the period of elevated energy and mood disturbances, at least the stated symptoms should be present up to a significant degree.
• Hyped grandiosity.
• Insomniac behavior
• Unusually talkative.
• Racing of thoughts.
• Increased distractibility.
• Increased goal-directed activity (s) or psychomotor agitation.
• Over involvement in activities that can cause us severe consequences (i.e. unrestrained buying sprees, foolish business investments, etc).
• Manic Episode C- There is severe mood disturbance so as to cause marked impairment in occupational functioning or to be hospitalized to prevent self-harm or to others.
• Manic Episode D- This episode does not cover the physiological effects of substance use, (i.e., intake of drugs, certain medication, or other treatment.
• A minimum of one episode of mania during the lifetime is required to diagnose bipolar I disorder.
• Hypomanic Episode A- A period consisting of persisting elevated, and irritable mood along with increased activity, lasting for a minimum of 4 consecutive days and stays nearly every day.
• Hypomanic Episode B- The phases of mood disturbance and increased activity, these symptoms must persist for a significant period, causing a noticeable change in the usual behavior.
• Hyped grandiosity.
• Insomniac behavior.
• Unusually talkative.
• Racing of thoughts.
• Increased distractibility.
• Increased goal-directed activity (s) or psychomotor agitation.
• Over involvement in activities that can cause us severe consequences (i.e. unrestrained buying sprees, foolish business investments, etc).
• Hypomanic Episode C. The mood alterations and the functional changes are evident.
• Hypomanic Episode D. During the episode, there is an unequivocal change in the functioning of the individual when asymptomatic.
• Hypomanic Episode E. The episode doesn’t necessitate hospitalization due to its mild nature of existence. The episode is defined as manic if psychotic features exist.
• Hypomanic Episode F. The usage of drugs or any such medications is not taken into consideration.

During treatment using antidepressant (s), (medication, electroconvulsive therapy, etc.) when persists at a fully syndromal level, that makes it an evident hypomanic episode.

PREVALENCE

Twelve-month prevalence has been estimated for the United States, i.e. 0.6% for bipolar I and 0.8% for bipolar II, disorder as per DSM-IV. The lifetime prevalence of bipolar I in the male-to-female ratio is 1.1:1. It’s difficult to establish the prevalence rate of pediatric bipolar II disorder.

GENDER DIFFERENCES

Females are more prone to experience the mixed states, and patterns of comorbidity, as compared to those of males. It may include lifetime eating disorders. Females having bipolar I or II disorder, experience depressive symptoms frequently as compared to those of males. They fall into a higher risk of alcohol usage disorder.

The risk relating to suicidal attempts and infanticide can be put off if there is accurate detection of bipolar II disorder.

CATEGORIZATION OF BIPOLAR DISORDER

Bipolar disorder can be categorized as three separate conditions, i.e. bipolar I, bipolar II, and cyclothymic disorder. The former name of bipolar disorder was manic depression.

People having bipolar disorders, face excessive and intense emotional phases that occur at different times, also termed as mood episodes. These mood episodes can be categorized as manic, hypomanic, or depressive episodes. People having bipolar disorders usually go through phases of normal mood as well.

WHEN TO SEE A DOCTOR

In spite of the mood extremes, people having bipolar disorder fail to recognize that their emotional instability is disrupting their lives along with their loved ones.

People with bipolar disorder; enjoy the euphoric state and their production times. However, this phase is followed by an emotional crash leaving the person depressed, and worn out. Perhaps some financial or legal trouble may also be caused due to their state.

Bipolar disorder doesn’t get better on its own, the only way out is to seek the help of mental health professionals.

CAUSES

The root cause of the bipolar disorder is not known, but several factors may be there:

Biological factors. Physical changes can be observed in their brains of people with bipolar disorder, although their significance is still uncertain.

Genetics. One of the common reasons for this is the prevalence of it in the first-degree relative (s), sibling or parent, with the same condition.

RISK AND PROGNOSTIC FACTORS

• Environmental Factors.
• Bipolar disorder is most prevalent in countries with high-income groups than in low-income countries. Widowed, separated, or divorced individuals fall in the higher risk category of bipolar I disorder, as compared to the married individuals or unmarried, but there is no clear evidence of it.
• Genetic and Physiological Factors.
• Genetic history of bipolar disorder is one of the biggest factors for bipolar disorders. The magnitude of risk gets higher with the degree of kinship. Schizophrenia and bipolar disorder most likely share a genetic origin.
• Course Modifiers.
• Once an individual gets a manic episode along with certain psychotic features, the followed manic episodes have a more likely tendency to include psychotic features.

COMPLICATIONS OF BIPOLAR DISORDER

Bipolar disorder if left untreated, can lead to serious consequences affecting every area of our life:

Drug and alcohol abuse

Suicide attempts

Legal and financial problems

Damage in relationships

Poor work-life balance

DIAGNOSIS OF BIPOLAR DISORDER

To diagnose the presence of bipolar disorder, the evaluation may include:

Physical examination. The doctor or mental health expert may conduct certain lab tests to identify the prevalence of any medical symptoms that could be the causal factors.

Psychiatric assessment. The mental health expert will talk to us about our thoughts and behavior patterns, along with filling up a psychological self-assessment questionnaire (optional).

Mood charting. Keeping a daily record of our moods, sleep patterns, and some other factors may also be therapeutic, that could help us with an accurate diagnosis.

TREATMENT/THERAPY

Treatment is best guided by a mental health specialist (doctor), skilled in treating bipolar and related disorders.

Bipolar disorder stays for a lifetime. Treatment may include:

Medications. Often, medications are required to balance the moods rightly.

Continued treatment. Bipolar disorder is a lifelong disorder, which can be managed well with medications, even during periods of wellness. The maintenance treatment, if skipped carries a huge chance of relapse.

Day treatment programs. The mental health professional may recommend a day-treatment program, to provide the counseling one need while getting the symptoms under control.

Substance abuse treatment. If alcohol or drug consumption is also included, then we’ll also need substance dependence treatment.

Hospitalization. In the case of suicidal or detachment from reality (psychotic) happens, then hospitalization may also be recommended.

COPING MECHANISMS

Some strategies that can help to cope with such challenges:

Educating about bipolar disorder. Education about our condition can empower us and motivate us to stick to the treatment plan.

Fixed goals. Managing bipolar surely takes time. Having fixed goals can help us stick to our action plan, howsoever difficult it may be.

Join a support group. Support groups help us connect to others having similar challenges.

Find healthy outlets. Channelizing our energy in recreational activities such as exercise can help us cope better with the ongoing situations.