Bipolar Disorder

Bipolar disorder is also known as manic depression which is a kind of mental health illness that involves high emotional feelings (mania or hypomania) and lows (depression).
One may feel extremely sad or hopeless when one is depressed, and may lose interest or pleasure in most activities. Sometimes also feel ecstatic, full of energy, or abnormally irritable when mood switches to mania or hypomania (a milder form of mania). Sleep, energy, activity, judgment, conduct, and the ability to think clearly can all be affected by mood fluctuations.
Mood swings can happen once a year or several times a year. While the majority of people will have some emotional symptoms in between episodes.

Bipolar Disorder

Types of Bipolar Disorder

Bipolar disorder 1

Manic episodes with or without depression symptoms describe this kind of bipolar illness. The manic episodes will last a week or longer if you have this type of bipolar. The mania could be so severe that it might need to be hospitalized to alleviate the symptoms. Although you don't have to be depressed to be diagnosed with bipolar 1, you may experience depression for more than two weeks.

Bipolar disorder 2

Manic and depressed episodes are present in bipolar 2 disorder. The mania with this type is usually milder than the mania with bipolar 1 — hence the name hypomania. A significant depressive episode occurs either before or after a manic episode in people with bipolar 2.

Cyclothymic injury

Manic and depressive periods can last for two years or longer if one has cyclothymic disorder. The same is true for children, except that they must experience both for at least a year before being diagnosed. Mania and depression are frequently milder in this disease than in bipolar 1 or bipolar 2. The cyclothymic disorder produces mood swings, with periods of normalcy interspersed with mania and sadness.


Symptoms of Bipolar Disorder

The symptoms can be different in mania, hypomania, or depression episodes. Symptoms can lead to erratic mood and conduct, causing severe distress and problems in daily life.

Hypomania and mania:

Mania and hypomania are two different types of episodes with similar symptoms. Mania is more severe than hypomania, and it produces more problems in day to day activities. Mania can also lead to a disconnection from reality (psychosis), which necessitates hospitalization.

Three or more of these signs are present in both a manic and hypomanic episode:

  • Unusually bouncy, jumpy, or wired activity
  • Increased energy, activity, or excitement
  • Exaggerated feelings of happiness and self-assurance (euphoria)
  • Sleep is reduced
  • Unusual chattiness
  • Thoughts that race
  • Poor decision-making, such as shopping binges, taking sexual risks, or making risky investments

Major depressive episode:

A major depressive episode is defined by symptoms that are severe enough to make daily activities, such as job, school, social activities, or relationships, difficult. Five or more of the following symptoms are present during an episode:

  • Depressed mood, such as sadness, emptiness, hopelessness, or tears (in children and teens, depressed mood can appear as irritability)
  • Lack of interest or pleasure in almost everything.
  • Significant weight loss, weight gain, or a decrease or increase in appetite when not dieting (in children, failure to gain weight, as expected, can be a sign of depression)
  • Insomnia or an excessive amount of sleep
  • Either agitation or a sluggish pace
  • Energy loss or fatigue
  • Feelings of worthlessness or inappropriate or excessive guilt
  • Reduced mental capacity

Symptoms among children and teens:

Bipolar disorder symptoms in children and teenagers can be difficult to spot. It might be difficult to identify whether these are normal mood swings, the effect of stress or trauma, or symptoms of a mental health disease other than bipolar disorder.

Children and teenagers may experience discrete significant depressive, manic, or hypomanic episodes, but the pattern may differ from that seen in adults with bipolar disorder. And sentiments might fluctuate dramatically throughout episodes. Between bouts, some children may experience periods with no mood symptoms.

Severe mood swings that are distinct from their regular mood swings are one of the most noticeable indications of bipolar illness in children and teenagers.


When to see a doctor?

It is difficult to identify the symptoms of bipolar disorder, however, when you notice the first signs and symptoms, immediately consult a mental health doctor to stop worsening of the condition and its progression to a higher stage. Staying aware is the first step you can take to arrest this condition.

  • Sleep disturbances and discomfort in performing day-to-day activities
  • Infection on the skin, red streaks, pus, and/or yellow scabs
  • Despite using home treatments, the skin issue persists
  • Episodes of skin rash are followed by fever

Get treated for bipolar disorder from the best Psychiatrists and mental health experts at Medicover Hospitals.


Causes

There are various factors that can cause bipolar disorders, such as:

Differences in biology

Bipolar disorder patients' brains appear to be changing physically. The importance of these changes is still unknown, although they may eventually aid in the identification of causes.

Genetics

People with bipolar disorder are more likely to have a first-degree family with the illness, such as a sibling or parent. Researchers are looking for genes that may play a role in the development of the bipolar disorder.


Risk factors

The following factors may raise the chance of developing bipolar illness or act as a trigger for the first episode:

  • Having a first-degree relative with bipolar disorder, such as a parent or sibling
  • High-stress events, such as a someone's death or another terrible event
  • Abuse of drugs or alcohol

Complications

Bipolar disorder, if left untreated, can lead to major problems that influence every aspect of life, including:

  • Problems with drug and alcohol abuse
  • Suicide or attempted suicide
  • Financial or legal issues
  • Relationship problems
  • Work or school performance issues

Prevention

Getting treatment for a mental health illness at the first hint can help prevent bipolar disorder or other mental health conditions from worsening. If one has been diagnosed with bipolar illness, then can use the following measures to keep modest symptoms from turning into full-blown mania or depression episodes:

Warning indications

Early intervention can help to prevent episodes from becoming worse. One may have seen a pattern in the bipolar episodes and the events that set them off. If you think you're going through a depressive or manic episode, call your doctor. Encourage family members or friends to keep an eye out for warning indicators.

Drugs and alcohol should be avoided

Using alcohol or recreational drugs can exacerbate symptoms and increase the likelihood of them returning.

Take medicines as prescribed

one might be tempted to discontinue treatment, but resist the urge. Stopping or lowering the medicine on its own may result in withdrawal symptoms, or symptoms may worsen or return.


Diagnosis

Once the person gets the same symptoms mentioned above and the doctor recognises it as a serious mental disorder then the following tests will be recommended in order to diagnose bipolar disorder -

Physical examination

A physical check and lab tests may be performed by the doctor to rule out any medical issues that could be causing symptoms

Psychiatric evaluation

The physician may send you to a psychiatrist, who will discuss your thoughts, feelings, and behaviour patterns with you. A psychological self-assessment or questionnaire can also be completed. Family members or close friends may be asked to submit information on the symptoms with your approval.

Charting the mood

You may be requested to keep a daily journal of your moods, sleep habits, or other aspects that can aid in diagnosis and treatment selection.

Bipolar disorder criteria

The psychiatrist may compare your symptoms to the criteria for bipolar and associated disorders in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Bipolar Disorder Treatment

Children's diagnosis

Although the same criteria are used to diagnose bipolar illness in children and teenagers as they are for adults, symptoms in children and teenagers sometimes have unusual patterns and may not fit neatly into diagnostic categories.
Furthermore, children with bipolar illness are typically diagnosed with other mental health conditions such as attention deficit hyperactivity disorder (ADHD) or behaviour problems, complicating the diagnosis. It is suggested that to see a child psychiatrist who has experience with bipolar disorder.


Treatment

Bipolar disorder is a chronic illness. Symptom management is the goal of treatment. Treatment may involve the following, depending on the needs:

Medications

To regulate the moods, you may need to start taking drugs straight away.

Treatment will continue

Even when you are feeling better, bipolar disorder requires lifetime drug treatment. People who skip maintenance treatment run the danger of relapsing or having small mood swings and growing into full-fledged mania or depression.

Programs for day treatment-

A day treatment program may be suggested by the doctor. These programs offer the support and counselling you require while you work to control your symptoms.

Treatment for substance abuse

Substance abuse treatment is required if you have difficulties with alcohol or drugs. Otherwise, managing bipolar disorder can be extremely tough.

Hospitalization

If you're acting dangerously, feeling suicidal, or becoming distant from reality, your doctor may urge hospitalization (psychotic). Whether you're undergoing a manic or major depressive episode, getting psychiatric care in a hospital can help you be calm and safe while also stabilizing your mood.
Medication and psychological counselling (psychotherapy) are the most common treatments for bipolar disorder, however, education and support groups may also be used.

Medications

Bipolar disorder is treated with a variety of drugs. The medications provided are based on your specific symptoms and dosages.

Mood elevators

To control manic or hypomanic episodes, mood-stabilizing medication is usually required.

Antipsychotics

If symptoms of depression or mania persist despite treatment with other drugs, an antipsychotic medication will be prescribed. Some of these drugs may be prescribed alone or in combination with a mood stabilizer by your doctor.

Antidepressants

To assist treat depression, your doctor may prescribe an antidepressant. Antidepressants are frequently taken in conjunction with a mood stabilizer or antipsychotic since they can sometimes precipitate a manic episode.

Antidepressant-antipsychotic

The antidepressant fluoxetine and the antipsychotic olanzapine are combined as the medicine Symbyax. It serves as a mood stabilizer and a depression treatment

Anti-anxiety drugs

These are used to treat anxiety it can aid with anxiety and sleep, although they're normally only administered for a limited time.

Alternative treatments

Electrical currents are transmitted through the brain during electroconvulsive treatment (ECT), causing a brief seizure. ECT appears to alter brain chemistry, which may help to alleviate symptoms of certain mental diseases. If you don't get better with drugs, can't take antidepressants for health reasons like pregnancy, or are at high risk of suicide, ECT may be a choice for bipolar treatment.For those who haven't responded to antidepressants, transcranial magnetic stimulation (TMS) is being looked into.

Treatment in children and teenagers

For children and teens treatment options can be a little bit different-

Medications

Children and teens with bipolar disorder are often prescribed the same types of medications as those used in adults. There's less research on the safety and effectiveness of bipolar medications in children than in adults, so treatment decisions are often based on adult conditions

Psychotherapy

Initial and long-term therapy can help keep symptoms from returning. Psychotherapy can help children and teens manage their routines, develop coping skills, address learning difficulties, resolve social problems, and help strengthen family bonds and communication. And, if needed, it can help treat substance abuse problems common in older children and teens with bipolar disorder.

Psychoeducation

Psychoeducation can include learning the symptoms of bipolar disorder and how they differ from behaviour related to your child's developmental age, the situation and appropriate cultural behaviour. Understanding bipolar disorder can also help you support your child.

Support

Working with teachers and school counsellors and encouraging support from family and friends can help identify services and encourage success.


Do’s and Don’ts

When a person has bipolar disorder, there are certain things that need to be taken care of. Following are some do’s and don’ts that one must follow when they are suffering from bipolar disorder

Do’s Don’ts
Continue your treatment and medicines. Compare yourself with others.
Get regular diagnosis and tests. Be afraid of socializing.
Proper exercises to stay active and fresh. Panic in every situation.
Eat a good healthy diet with nutritional carbs, vitamins etc. Make an important decision during episodes of depression or anxiety.
Laugh and smile more to stay positive and feel happy. Feel self-pity for yourself every time, it will make you feel worse for yourself.
Engage yourself in creative arts and following hobbies. Underestimate your health condition.
Read good books so that it empowers and inspires you. Get addicted to alcohol or drugs.
Listen good music it soothes and enlightens the mood. Do anything that triggers your mental issues; notice what triggers your symptoms.
Seek help from support groups. Ignore your symptoms of bipolar disorder.

While battling with Bipolar Disorder, the patient is himself/herself the best help. Family members should extend support for faster recovery of the patient while seeking medical care.


Bipolar Disorder Care at Medicover

At Medicover Hospitals, we have the most trusted team of doctors and mental health experts who provide highly personalized treatment for bipolar disorder by designing a holistic treatment and care plan for the patient. With the involvement of addiction therapists, nutritionists, psychologists, psychiatrists, counsellors, and emotional health experts, we develop a multi-disciplinary approach towards the treatment of this condition which ensures real health benefits and positive outcomes for our patients. We also use the most advanced medical technology for the diagnosis and treatment of various other mental disorders.

Citations

https://www.sciencedirect.com/science/article/abs/pii/S014067361500241X
https://www.sciencedirect.com/science/article/abs/pii/S0140673613608570

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Frequently Asked Questions

1. What is bipolar disorder?

Extreme mood swings, such as manic (high mood and energy) and depressive (low mood and energy) phases, are a characteristic of the mental health disease bipolar disorder.

2. What are the primary types of bipolar disorder?

The main types are Bipolar I, characterized by manic episodes, and Bipolar II, characterized by hypomanic and depressive episodes. Cyclothymic disorder involves milder mood swings.

3. What are the symptoms of a manic episode?

Symptoms may include increased energy, decreased need for sleep, racing thoughts, impulsive behavior, grandiose beliefs, and high irritability.

4. What are the symptoms of a depressive episode?

Low mood, loss of interest in activities, exhaustion, changes in eating or sleep, problems focusing, and suicidal or death thoughts are only a few possible symptoms.

5. What causes bipolar disorder?

The exact cause is unclear, but genetics, brain structure, chemical imbalances, and life experiences can contribute to its development.

6. How is bipolar disorder diagnosed?

A mental health professional assesses symptoms, medical history, and family history. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is used as the basis for the diagnosis.

7. Can bipolar disorder be treated?

Yes, bipolar disorder can be managed with a combination of medication, therapy (such as cognitive-behavioral therapy), lifestyle changes, and support.

8. What medications are used to treat bipolar disorder?

Depending on the specific phase (manic or depressed) and intensity of symptoms, mood stabilizers, antipsychotics, and antidepressants may be administered.

9. What role does therapy play in treatment? Therapy, including cognitive-behavioral therapy (CBT) and psychoeducation, aids in symptom management, the development of coping mechanisms, and a better understanding of the patient's situation.

10. Can lifestyle changes help manage bipolar disorder?

Yes, maintaining a regular sleep schedule, managing stress, avoiding alcohol and drugs, and engaging in regular exercise can contribute to symptom management.

11. Is bipolar disorder a lifelong condition?

Bipolar disorder is a chronic condition, but with proper treatment and management, individuals can lead fulfilling lives and experience periods of stability.

12. Can bipolar disorder affect relationships and work/school life?

Yes, untreated bipolar disorder can impact relationships and work/school performance. However, effective treatment can help individuals manage these challenges.

13. Can children and adolescents develop bipolar disorder?

Yes, bipolar disorder can develop in childhood or adolescence, often with slightly different symptoms than in adults.

14. Are there support groups for individuals with bipolar disorder?

Yes, support groups provide a safe space for individuals to share experiences, coping strategies, and encouragement.

15. How important is early intervention in bipolar disorder?

Early intervention is crucial to prevent the worsening of symptoms and potential complications. Seeking help when noticing mood changes is advised.