Experts & Centers (103)

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Summary


Bipolar disorder is a lifelong condition that includes several types. It generally affects the mood of an individual, which can shift from one extreme (emotional highs, mania) to another (emotional lows, depression). These shifts may occur multiple times a year, or each episode may last a few years.

Mania or Hypomania is a period with high excitability, increased self-esteem, decreased need for sleep, full of energy, increased impulsivity, and unusually irritability. These episodes can also include an extreme form of symptoms such as delusions, psychotic episodes, and a developing history of substance abuse.

Depression, and its many subtypes, affect an individual with a range of symptoms. Most people will persistently feel stressed, have sleep disturbances, irritability, anxiousness, sadness, difficulty completing daily tasks, and loss of interest (especially in tasks that a person used to love). In more severe cases, frequent or recurrent thoughts of death, suicidal thoughts, and attempts. This causes the individual to experience noticeable difficulties with day-to-day activities, such as work, school, and social activities.

Due to the nature of the condition, it remains difficult for an individual living with the disorder to maintain a job, and healthy fulfilling relationships. In turn, this also means there is an increased risk of suicide. Some studies have shown that an estimated 25% - 60% of individuals with bipolar disorder will attempt suicide at least once in their lives, and 4%-9% will commit suicide. Therefore it is important to keep note of the warning signs a person may exhibit if there is a risk of self-harm or suicide attempt.

Episodes of Mania can last 3-6 months if left untreated. Episodes of depression can last 6-12 months if left untreated. However, with adequate therapy and medication, learning what the early warning signs of an oncoming episode of mania and depression, can significantly help with reducing the severity of the symptoms. This can also mean the symptom extremes of depression and mania are reduced.

Types


The main types of bipolar disorders are:

  • Bipolar 1: At Least one manic episode, followed by hypomania, or major depression
  • Bipolar 2: At least one major depressive episode, and one hypomanic episode only
  • Cyclothymic: At least on two years of hypomania, and depressive symptoms (less severe than major depression)
  • Other: When the disorder is related to other disorders, which may have been induced by medication, drugs, alcohol, or a medical condition

Causes


The exact causes of Bipolar disorder are not completely known. While most of us experience mood swings and elated feelings, they do not affect our daily activities. The disorder is known to be observable during the teenage years or adolescence. Due to the nature of Bipolar disorder, many people tend to suffer for some time before seeking help.

There are possible risk factors that are associated with bipolar disorder such as:

  • Genetic vulnerability and family history of associated mental health disorders (such as depression, anxiety, schizophrenia)
  • Extreme trauma due to a tragic incident
  • Substance or alcohol abuse
  • Chemical imbalances in the brain

There are other medical and psychiatric come with a list of co-existing conditions such as:

  • Attention-Deficit/Hyperactivity Disorder
  • Anxiety Disorders
  • Substance abuse
  • Obesity: Medications that are recommended to treat Bipolar disorder cause weight gain, and due to the nature of the depression and lack of motivation to engage in activities, adds more risk of obesity.

Increased risk of cardiovascular disease due to a metabolic syndrome. Complications to health due to cholesterol changes, high blood pressure, insulin resistance, and obesity

Symptoms


  • Depression: During a depression phase, symptoms of depression will occur, such as loss of motivation, consistent feelings of sadness and helplessness, suicidal thoughts or ideation, lack of appetite or excessive eating, and sleep disturbances.
  • Mania: During a Manic phase, symptoms of mania will occur such as, Feeling quick, full of energy, creative. There are also increases in self-importance or self-esteem, as well as symptoms of psychotic delusions or episodes
  • Psychotic episodes are periods when a person may not be able to tell the difference between reality and what is going on in their heads. This includes Hallucinations and delusions.
  • Stop taking care of themselves when it comes to hygiene and self-care
  • Unusual and irrational thoughts or beliefs like having an outside force control your feelings and actions
  • Risk-taking behaviors such as substance abuse, risky decisions
  • Rapid cycling between high and low phases without having a “normal” phase in between
  • Mixed states when a person may experience symptoms of both depression and mania together

Diagnosis


The first step to diagnosing any mental health condition is to exclude any possible physical conditions.

A diagnosis requires a qualified professional to examine the individual

Only trained healthcare providers (such as a psychologist, psychiatrist, or pediatrician) can diagnose and/or treat any mental health condition.

There is no direct test for depression, therefore, trained mental health professionals look for symptoms of depression that occur for most of the day, and have occurred for more than two weeks. These symptoms do not improve with time, and they tend to affect an individual in many aspects of their lives, such as work, interests, relationships, and overall well-being.

With Bipolar disorder, a person must have experienced at least one episode of mania, or hypomania.

Diagnosis will also include a psychiatric assessment, with permission of the individual, family, and close friends may also be asked to provide information about the symptoms.

Treatments


Due to the nature of bipolar disorders, treatment methods typically should entail both medications as well as non-drug treatments in order to cover all the symptoms that come along with it

Treatment for bipolar disorder must include receiving therapy from a mental health professional with experience in the disorder and must receive mood-stabilizing medications. This will help an individual better control their mood swings. The frequent shifts between moods can severely disrupt an individual’s life with instability and place them at risk of suicidal thoughts and behavior.

Medication: 

There are different classes of medications that work for Bipolar disorder. A person should never take any kind of medication unless under the supervision of a trained mental health service provider. They should also ensure that they take it exactly according to the instructions and dosage given to them. Medications for Bipolar works best in combination with an appropriate and individualized therapy, there are several kinds of medications that work for Bipolar Disorder such as:

  • Antidepressants: a type of medication that helps relieve symptoms of depression, anxiety, as well as other conditions. The goal is to correct any chemical imbalances in the brain that are responsible for mood and mood regulation. Different classes of medications work differently in the brain, some work better than others depending on the individual, their age, their reaction to the medication, and what medications are available to them. As with all kinds of medications, side effects exist for all types of antidepressants and must be discussed with their mental health care provider in order to mitigate these side effects. Antidepressants also carry the risk of abuse and addiction if they are mishandled.
  • Antipsychotics: A class of psychotropic medication primarily used to help relieve symptoms of Psychosis, and improve quality of life. They are often used in combination with other medications depending on what is being treated. They work by helping to restore the balance of natural chemicals in the brain. Antipsychotics can usually reduce feelings of anxiety within a few hours. However, symptoms of Delusions and Hallucinations may take up to several weeks to reduce.
  • Mood Stabilizers: A group of medications that are used primarily to treat bipolar disorder, and other mental disorders that may be associated with mood swings. Depending on what type of bipolar disorder an individual has, a qualified doctor will prescribe a combination of medications in order to tackle symptoms. They reduce symptoms of Mania, stabilize mood, and prevent symptom relapses

Psychotherapy: There are many different approaches under psychotherapy that can help someone experiencing Bipolar. Different approaches are successful with different individuals therefore, the process of finding the right approach and therapist may be difficult at first. It can also lead to some people going for the wrong therapist or technique, and thereby leaving therapy altogether. However, people must keep in mind that therapy is not a “one size fits all” process, and sometimes a person may need to try different approaches in order to determine the best one for themselves using the help of a trained mental health professional. Some types of therapy include:

  • Behavior Therapy: The goal is to eliminate unwanted behaviors, and strengthen positive behaviors. This would be usually done in environments that are familiar to the individual, such as at home, school, workplace, and others.
  • Cognitive Behavior Therapy (CBT): The goal of CBT treatment is to eliminate negative, and irrational patterns of thinking for other symptoms that come due to living with the condition. Some individuals may have unhealthy internal dialogues, and CBT helps to eliminate those thought patterns.

Electroconvulsive Therapy (ECT): ECT is a type of treatment that is used for individuals with treatment-resistant Depression or Bipolar Disorder. This means that an individual has tried different treatment methods for some time and has not responded to any of them.

The ECT machine is hooked to a patient's head, and brief electrical volts are applied to the person’s head, while under general anesthesia. This can look very scary and terrifying for an observer, the procedure is uncomfortable but not painful. These electric shocks are given multiple times a week, over the course of a few weeks.

Healthy diet and lifestyle: Research suggests that developing a consistently healthy diet, adequate sleep, and exercise plan can play a big factor in mitigating symptoms and improving the quality of life

Support Groups: A group of people with common mental health conditions who can provide comfort, and advice, knowing that they share similar experiences. These groups can be led with and without a mental health professional. Research has shown that the group can provide a common purpose for its members which lead to many benefits such as:

  • Leaving the isolation of suffering from a mental health condition
  • Being able to talk openly and honestly
  • Gaining control over their emotions
  • Helping others with their experiences therefore also helping themselves

Self Help Techniques: There are plenty of self-help techniques available for any individual to try that may help them deal with their symptoms. Examples include volunteering, positive self-talk, breathing exercises, and meditation

If you or a loved one are experiencing thoughts or are in danger of self-harm, make an appointment with a mental health professional

Resources

References