- What is bipolar disorder?
Bipolar is a mental disorder characterized by extreme shifts in mood, with fluctuations in energy and activity levels.
During these abnormal shifts, the patient commonly finds it difficult to complete everyday tasks. Bipolar disorder used to be known as manic-depressive illness.
Bipolar disorder is a serious mental illness that can destroy relationships, undermine career prospects, and seriously affect academic performance.
The American Psychological Association says that these emotional shifts can become so overwhelming that individuals may choose suicide
People with bipolar disorder have alternating episodes of extreme euphoria (mania) and major depression
A patient with bipolar disorder has severe fluctuations in mood – from depression to mania. Usually, moods are normal in between the peaks and troughs.
Bipolar disorder has nothing to do with the ups and downs we all experience in life; it is much more severe, debilitating, and incapacitating.
Fortunately, it is treatable, and with proper care and the right medication, patients can perform well at work and academically and lead full, productive lives.
Causes of bipolar disorder
Most experts agree that bipolar disorder has no single cause. It is more likely the result of many factors acting together.
- Genetics – some small twin studies have indicated that there is a genetic contribution to bipolar disorder risk. People with a blood relative who has bipolar disorder have a higher risk of developing it themselves.
- Biological traits – experts say that patients with bipolar disorder often show physical changes in their brains. Nobody is sure why the changes lead to the disorder.
- Brain-chemical imbalance – neurotransmitter imbalances play a key role in many mood disorders, including bipolar disorder.
- Hormonal problems – hormonal imbalances might trigger or cause bipolar disorder.
- Environmental factors – abuse, mental stress, a “significant loss,” or some other traumatic event may contribute to bipolar disorder risk.
Symptoms of bipolar disorder
- A feeling of being on top of the world, exhilaration, or euphoria.
- Over-self-confidence, an inflated sense of self-esteem.
- The patient’s judgment may be impaired.
- The patient talks a lot, and very rapidly.
- Thoughts come and go quickly (racing thoughts). Sometimes, bizarre ideas come to the patient’s mind, and they are acted upon.
- In this phase, the individual may be extremely forthcoming, sometimes aggressively so.
- The individual is more likely to engage in risky behavior, including promiscuity (higher libido), abuse illegal drugs and/or alcohol, and take part in dangerous activities.
- The patient may squander money.
- Easily distracted.
- Missing work or school and/or underperforming.
Symptoms during depressive episodes:
- A feeling of gloom, blackness, despair, and hopelessness.
- Extreme sadness.
- In severe cases, the patient will think about ending their life, and may act on those thoughts.
- Insomnia and sleeping problems.
- Anxiety about trivial things.
- Guilt – a feeling that everything that goes wrong or appears to be wrong is their fault.
- Eating patterns – some people eat more, others eat less.
- Weight loss or weight gain.
- Extreme tiredness, fatigue, listlessness.
- Inability to feel pleasure with activities or interests that were usually enjoyed.
- Low attention span.
- Easily irritated – this could be triggered by noises, smells, tight clothing, and other things that would usually be tolerated or ignored.
- Some patients are unable to face going to work or school; those that do typically underperform.
- Psychosis – in both the manic and depressive episodes there may be psychosis, during which patients cannot differentiate fantasy from reality. Symptoms of psychosis may include delusions (false but strongly felt beliefs) and hallucinations (hearing or seeing things that are not there).
- Major Depressive Disorder, with seasonal pattern – previously known as seasonal affective disorder (SAD). Some bipolar disorder patients have moods which fluctuate with the seasons.
Symptoms in pediatric cases of bipolar disorder – children and teenagers are more likely to have temper tantrums, rapid mood changes, outbursts of aggression and explosive anger, and reckless behavior.
Treatments for bipolar disorder
It is important to remember that bipolar disorder is a treatable mental illness – it is possible to control the symptoms with proper care and to lead a normal and productive life.
The aim of treatment for bipolar disorder is to minimize the frequency of manic/depressive episodes and to reduce the severity of symptoms so that the patient can lead a relatively normal and productive life.
If the symptoms are left untreated, a bout of depression/mania can persist for up to 1 year. With treatment, however, improvements are seen within the first 3-4 months.
Mood changes may still occur in patients receiving continuous treatment. However, if the patient works closely with his or her medical team and communicates openly, treatment is usually much more effective.
Treatment for bipolar disorder includes a combination of different therapies, which may include medications and physical and psychological interventions.
- Hospitalization – this is much less common today. If the medical team believe there is a risk that the patient may harm themselves or others, they may be hospitalized until they feel better.
- Lithium carbonate – the most commonly prescribed long-term drug to treat long-term episodes of depression, mania/hypomania. Patients usually take lithium for at least 6 months. Experts say that treatment compliance (adherence) is vital for it to work; the patient must follow the doctor’s instructions on when and how to take their medication.
Other treatments include:
- Anticonvulsants – sometimes prescribed to treat mania episodes.
- Antipsychotics – including aripiprazole, olanzapine, and risperidone. Prescribed if behavior is very disturbed and symptoms are severe.
- Rapid cycling – rapid high-to-low fluctuations with no “normal” in-between periods. Patients with rapid cycling may be advised to take a valproate-lithium combination. If the combination is not effective enough, the doctor may recommend lithium, valproate, and lamotrigine in combination.
- Psychotherapy – the aim is to alleviate core symptoms, to help the patient identify and recognize the key triggers, minimize negativity in relationships, recognize the first symptoms that indicate the onset of an episode, and work on the factors that help maintain the “normal” periods for as long as possible.
- CBT (cognitive behavioral therapy) – psychoeducation and family-focused therapy have been found to be the most effective in preventing relapses. Interpersonal and social rhythm therapy, as well as CBT, can also help with depressive symptoms.
Author: Akwesi Osei
An avid reader and writer who has written articles for HypeNationGh, LoudsoundGh and akwesiosei.wordpress.com.
Currently the blogger and owner of The Health Bro