Bipolar Disorder

Bipolar disorder, also known as manic depression, is a chronic and recurring condition that involves mood swings between highs of mania and the lows of depression. Depression is by far the most common and frequently occurring feature of the illness. The manic phase usually involves a mix of irritability, anger, and depression, with or without euphoria.

Euphoria presents itself as overconfidence and unusual energy in the individual. The two express themselves in many ways including overspending and promiscuity which means that an individual has casual sexual relationships with more than one partner.

• There are two primary types of bipolar disorder: Bipolar 1 and Bipolar 2.
• A major depressive episode may or may not accompany bipolar 1 but always accompanies bipolar 2. 
• People with bipolar 1 have had at least one manic episode, which may be very severe and require hospital care.
• People with bipolar 2 normally have a major depressive episode that lasts at least two weeks along with hypomania, a mania that is mild to moderate and normally does not require hospital care.

DISCLAIMER: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What are the primary symptoms/signs of the condition?

• The defining feature of bipolar disorder is mania. It can be the triggering episode of the disorder, followed by a depressive episode, or it can first manifest after years of depressive episodes.
• The switch between mania and depression can be abrupt, and moods can change rapidly. The difference between bipolar disorder and depression is a manic episode/episode of mania. However, a person experiences a depression state longer than a manic or a hypomanic one.
• Hypomania can be hard to diagnose; it is often experienced as an increase in energy that can feel good and even enhance productivity and creativity. As a result, a person experiencing it may deny that anything is wrong. 
• There is great variability in manic symptoms, but features may include:
  • increased energy, activity, and restlessness
  • extremely happy mood and extreme optimism
  •  extreme irritability
  •  racing thoughts, pressured speech, or thoughts that jump from one idea to another
  • distractibility and lack of concentration 
  • decreased need for sleep
  • an unrealistic belief in one’s abilities and ideas
  • poor judgment
  • reckless behaviour including spending sprees and fast driving, or risky and increased sexual drive 
  • provocative, intrusive, or aggressive behaviour
  • a denial that anything is wrong 
• The duration of elevated moods and the frequency with which they alternate with depressive moods can vary enormously from person to person. Rapid cycling is known as the frequent switching between the two moods. It is not uncommon and takes place at least four times a year.
• Similarly, the duration and degree of depressive symptoms vary from person to person.
• Features generally include lasting sad, anxious, or empty mood; feelings of hopelessness or pessimism; feelings of guilt, worthlessness, or helplessness; a loss of interest or pleasure in activities once enjoyed, including sex; decreased energy and feelings of fatigue or of being “slowed down”; difficulty concentrating, remembering, or making decisions; restlessness or irritability; oversleeping or an inability to sleep or stay asleep; change in appetite and/or unintended weight loss or gain; chronic pain or other persistent physical symptoms not accounted for by illness or injury; and thoughts of death or suicide, or suicide attempts.
• The symptoms of mania and depression often occur together in “mixed” episodes. Symptoms of a mixed state can include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. At these times, a person can feel sad yet highly energized.
• Most people with bipolar disorder develop the condition in their late teens or early adulthood, although symptoms can appear in children as young as six years old. Symptoms in children and teens are similar to those in adults and include the condition’s hallmark mood swings. In some cases, children may display symptoms of irritability.
• Children with bipolar disorder undergo extreme changes in mood and behaviour, feeling unusually happy and energetic during manic episodes and becoming very sad and less active during depressive episodes. Symptoms are often severe enough to interfere with school activities and personal relationships and can lead to self-destructive behaviour.

Please Note: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What factors can be contributing causes? 

• Both genetic and environmental factors can create vulnerability to bipolar disorder. As a result, the causes vary from person to person.
• While the disorder can run in families, no one has definitively identified specific genes that create a risk for developing the condition.
• There is some evidence that having an older father can increase the possibility of new genetic mutations that underlie vulnerability.
• Imaging studies have suggested that there may be differences in the structure and function of certain brain areas in those with bipolar disorder, but no significant differences have been consistently found.
• Similar to other conditions, life events including various types of childhood trauma are thought to play a role in bipolar disorder. Researchers do know that once diagnosed with the disorder, life events can predict its recurrence. Incidents of interpersonal difficulty and abuse are most commonly associated with triggering the disorder.
• Biological factors probably create vulnerability to the disorder within certain individuals, and experiences such as sleep deprivation can kick off manic episodes.

What is the recommended treatment?

• Because bipolar disorder is a recurrent illness, long-term treatment is necessary.
• Mood stabilizer drugs are typically prescribed to prevent mood swings. Lithium is perhaps the best-known mood stabilizer, but newer drugs such as lamotrigene have been shown to cause fewer side effects while frequently removing the need for antidepressant medication.
• Used alone, antidepressants can trigger mania and may accelerate mood cycling. Getting the full range of symptoms under control may require other drugs as well, either short-term or long-term.
• Nutritional approaches have also been found to have therapeutic value. Studies show that omega-3 fatty acids may help lower the number or dosage of medications needed. Omega-3 fatty acids play a role in the functioning of all brain cells and are incorporated into the structure of brain cell membranes.
• Work and relationship problems can be both a cause and effect of bipolar episodes, making psychotherapeutic treatment important. Studies show that such treatment reduces the number of mood episodes patients experience. Psychotherapy is also valuable in teaching self-management skills, which help keep one’s everyday ups and downs from triggering full-blown episodes.
• Treatment for bipolar disorder in children and teens may include medication and family-based therapy.

• A general practitioner (GP) or psychologist can usually diagnose bipolar disorder by asking questions about a person’s medical history and symptoms.
• The GP/psychologist will also inquire about a patient’s physical health to ensure that the switch between depression and mania is not triggered by an underlying medical condition, or by factors such as drug or alcohol use.
• The GP/psychologist will check the symptoms that the patient presents with against the standard criteria for bipolar disorder before making a diagnosis.

• The average age of onset for this disorder is 25 years old.
• According to Our World in Data (2018), an estimated 46 million people in the world had bipolar disorder in 2017, with 52 and 48% being female and male, respectively. 
• Around 15% of those diagnosed with this disorder die by suicide.

• If you are experiencing any of these signs, here are some activities you can do at home until you are able to consult a professional.
• • Exercise
  • Engage in creative outlets such as writing, painting, or music
  • Keep a gratitude journal
  • Talk to a family member or friend about how you are feeling
  • Practice Mindfulness
  • Practice Yoga
  • Engage in a well-balanced diet
  • Maintain a good sleep schedule 
  • Recognise what you can and can’t handle