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Do frequently fluctuating moods (mirth now, melancholy then) bother you? Perplexed over your emotional state that touches pain and pleasure at intermittent intervals? Could it be Bipolar Disorder?

What is Bipolar Disorder?

According to the World Health Organization (WHO), 45 million people are affected by Bipolar Disorder, globally.
Bipolar Disorder (also known as manic depressive disorder and bipolar disease) is a mental health condition characterized by extreme mood swings (termed as mood episodes), causing shifts in energy levels, concentration and functional abilities of an individual. A person with bipolar disorder might experience intense highs (manic / hypomanic) and terrible lows (depressive). There can stretches of normal and neutral moods as well.

Types of Bipolar Disorder

The major types of bipolar disorder are as follows:

Bipolar I Disorder: A person suffering from Bipolar I Disorder would experience at least one manic episode, which may be preceded or followed by several episodes of depression or hypomania. During the manic episode, the person will be in a heightened mood, where the self-esteem and energy levels would be high.

Bipolar II Disorder: Bipolar II Disorder is characterized by the occurrence of at least one episode of depression and at least one episode of hypomania. The duration of the depressive episode would be at least two weeks and that of the hypomanic episode would be a minimum of four days.

Cyclothymic Disorder: Less intense when compared to Bipolar I Disorder and Bipolar II Disorder, Cyclothymic Disorder (or cyclothymia) is characterized by hypomania and depression of lesser intensity and shorter duration. It is a comparatively rare mood disorder.

Bipolar Disorder due to another medical condition/substance abuse: Sometimes other medications or substances could also induce mood swings.

Symptoms of Bipolar Disorder

What does bipolar disorder feel like?

The signs of bipolar disorder include:

  • Extreme mood swings : Euphoria, sadness, hopelessness, apprehension, guilt
  • Loss of interest in activities that were enjoyed previously
  • Impulsive, restless behavior and affinity towards risks
  • Lack of concentration, slow pace, memory issues and inability to take decisions
  • Unwanted thoughts (sometimes, suicidal)
  • Fatigue and lack of energy
  • Sleep issues – Lack of sleep/excessive sleepiness
  • Fast-paced or lethargic conversations
  • Overconfidence and extremely high self-esteem
  • Disorganized nature
  • Unexplained weight loss/ weight gain
  • Delusions and hallucinations

Causes of Bipolar Disorder

Though the definite cause of Bipolar Disorder is not known yet, the factors that heighten the risk of Bipolar Disorder include:

Genetic: Persons with Bipolar Disorder in the family (parents or siblings with Bipolar Disorder) are more prone to the disorder. Studies have established some genetic correlation between bipolar disorder and other disorders including Schizophrenia and ADHD -Persons with parents/siblings suffering from schizophrenia or ADHD are at a higher risk of bipolar disease.

Biological: Chemical imbalance in the brain, loss or damage of brain cells are the major biological abnormalities that can cause bipolar disorder. Mitochondrial issues are also known to cause bipolar disorder.

Environmental triggers: Stress from the person’s environment is detrimental in causing bipolar disorder. Physical or emotional abuse, loss of a dear one, physical illnesses, financial issues and substance abuse are some of the common triggers.

Gender: Reason not known, women are more likely to experience bipolar disease, than men.

Age: Bipolar disorder is more commonly found in individuals in the age group of 15 to 25.

Is Bipolar Disorder Curable?

Can bipolar disorder go away? Though bipolar disorder is within the scope of treatment, it is not completely curable. The symptoms can be effectively managed with treatment. The treatment, in most cases, cater to be continuous, the course of which could be lifetime.

Diagnosis & Treatment

A qualified mental health professional can diagnose bipolar disorder through the following ways:

Psychiatric Evaluation: A thorough evaluation of your symptoms would be done, assessing your thought patterns and behavior. Your psychiatrist might ask you to record your mood and sleep patterns on a daily basis. With the available information, your symptoms would be checked with the symptoms listed in the American Psychiatric Association‘s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Physical Evaluation: Your psychiatrist may also assess your bodily symptoms to diagnose Bipolar Disorder. Some lab tests may also be prescribed.

As already mentioned, bipolar disease tends to be a lifelong condition. However, treatment can help a lot in managing even the worst symptoms and thereby, help the individual lead a fully functional and productive life.

The basic treatment options for Bipolar Disorder include:

1.Medication

The medications that are generally involved in the treatment of bipolar disease are:

Anticonvulsants: These are the mood stabilizing drugs given to manage mania and depression in Bipolar Disorder. The predominantly prescribed ones are valproic acid and lamotrigine.

Antidepressants: Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) form the major types of antidepressants that have a role in the treatment of bipolar disorder.

Antipsychotics: Antipsychotics (otherwise known as neuroleptics) are prescribed to manage the psychotic symptoms (hallucinations and delusions) that accompany Bipolar Disorder.

Side effects of bipolar disorder medications: The most common side-effects of medication for Bipolar Disorder include weight gain, dry mouth, gastric problems, decreased libido, increased appetite, drowsiness, balance problems, muscle coordination issues, sleep issues etc.

2.Psychotherapy:

The major types of psychotherapies (also known as ‘talk therapies’) that help individuals with bipolar disease are:

Cognitive Behavioral Therapy (CBT): CBT, often used as an alternative when medications do not work or are not sufficient, are designed to effectively manage the symptoms of the disorder. The therapy would identify and act on the triggers that cause the symptoms and implement ideal coping techniques.

Social Rhythm Therapy (SRT): SRT aims at making the daily routine (including the sleep/wake cycle) of the individual more active and consistent, helping to manage the symptoms better.

Interpersonal Therapy: Interpersonal Therapy is a well-structured and systematic approach to resolution of relationship problems that the individual with bipolar disease might be going through. The therapy is based on the principle that mood stability is highly dependent on interpersonal relationships and life events.

3.Continuous supportive care: In some cases, hospitalization might be required in order to ensure mood stability, calmness and safety of the patient.

4.Lifestyle changes: Certain changes in the lifestyle have proven to be highly beneficial, when combined with medical intervention.

a. Get proper sleep.

b. Keep yourself nourished with a proper, balanced diet.

c. Stay active with the right amounts of physical activity.

d. Keep unwanted stress at bay.

e. Refrain from substances (drugs, tobacco, alcohol).