A manic- depressive state with unusual fluctuations in mood, activity and behavior is described as Bipolar Disorder. The highs of mania and the lows of depression are experienced as there is a frequent mood shifting in such a disorder. The mood changes have an intense effect on regular activities. The disordered person may feel highly energetic or deeply sad. Both the symptoms of mania and depression occur at the same time. This condition might last for hours, days, weeks or months. In severe cases, bipolar disorder can be treated with medications and psychotherapy.
Bipolar Disorder can be mild or severe depending on the mood swings. The following episodes might proceed with this disorder:
Bipolar I: It is an admixture of depression and mania. Rarely the patients experience the manic stage. Insomnia, disturbed thoughts, hallucination, irritability are some of the symptoms of Bipolar I.
Bipolar II: Bipolar II is often observed with severe depression and mild manic state called hypomania. People stop consuming drugs with hypo manic episode but this worsens the situation as it becomes more difficult to control the situation for the second time. This is said to be a milder from of bipolar disorder than bipolar I. The suicidal rate is higher in people with bipolar II.
Cyclothymic disorder:The cyclothymic condition may not be as severe as hypomania and mild depression. It might continue with the same symptoms of bipolar I and II for a longer period. It may transform into severe bipolar disorder in the later stages.
Rapid cyclic disorder: Severe symptoms of mania and depression might be experienced in rapid cyclic disorder. The mood might swing from high to low several times in a day.
Mixed Episode: The stage of mania and depression might be experienced at the same time. People may feel highly excited in manic condition along with depression. Mixed episode is said to be more risky as it develops suicidal tendency in the depressive state.
A wide difference is experienced in the symptoms of Bipolar disorder.
Symptoms in Manic phase:
- Optimistic thoughts
- Rapid speech
- Racing thoughts
- Increased physical activity
- Inability in judging
- Goal setting
- Less sleep
- Excessive use of alcohol
- Over spending
- Poor concentration
Symptoms in depressive phase:
- Deep depression
- Losing hope
- Suicidal tendency
- Unknown pain
- Loss of interest in activity
In some cases, seasonal changes might affect the mood resulting in bipolar disorder. Quite often some people experience manic episodes in summer while getting depressed in winter. Others might experience the reverse effect. However, several episodes of mania and depression might lead to psychosis where people get deluded and hallucinated.
It is a matter of great difficulty in understanding the exact cause for Bipolar disorder as both biological and psychological factors contribute to its existence. The biological factor shows that bipolar disorder can be inherited. Children are more likely to have such disorder from their parents. This can be found more clearly in the case of twins. An imbalance in the neuron transmitting system may be the possible cause for bipolar disorder. It is observed that neurotransmitters and mood disorders are closely linked with each other. An imbalanced hormone level might also trigger such disorders. Environmental factors like stress, social abuse and tragic experiences in one’s life prove to be the element causing bipolar.
A physical examination along with lab tests like blood test or brain scan may not identify bipolar disorder. A complete evaluation can be performed only by a trained mental health professional like a psychiatrist. The complete family history is considered to treat such mental illness. The swings in mood and behavior are often observed. The patient may be asked to fill a psychological assessment sheet to understand the behavioral patterns. Thyroid problems or drug levels are thoroughly checked in the laboratory. Observation of mood episodes and sleep patterns would help in the diagnosis of the disorder.
Bipolar disorder is a complex mental condition that may not respond to the treatment in the same manner in every patient. The treatment suggested by the psychiatrist might take a too longer period to relieve from its symptoms and behave normally at home and at work. In case of psychotic patients, hospitalization would be more suggestible as the urge for suicide raises its heights. In most cases of bipolars, medications seem to control the mood variations followed by a long-term treatment. Anticonvulsant medications are used as mood stabilizers in such disorders. Lithium has been suggested as the best medicine for depressive episodes. Antipsychotic medications like Olanzapine, Aripiprazole, Risperidone and Ziprasidone relieve the disordered patients from severe mania.
Psychotherapy is said to be the most effective treatment for bipolar disorder along with mood-stabilizing medications. Cognitive behavioral therapy aims at changing the negative thoughts in such patients. Family members are allowed to participate in such therapies which provide mental strength and emotional support to the patients. Group therapies provide better communication. In cases of severity, electroconvulsive therapy proves to be more effective where electrical shocks improve the condition of the brain.
The best way to prevent bipolar disorder is to provide treatment at the earliest. A keen observation in the behavioral patterns with respect to mood changes would help in preventing worse situations. It is better to avoid alcohol and other drugs. Using the dosage of medicines in the right manner as prescribed by the psychiatrist would improve the condition to a large extent.
Use of alcohol and other drugs need to be discarded. Maintaining relationships with people who have a positive outlook would help in gaining mental stability. Regular exercise can also help in controlling mood changes in bipolar disorders. In addition a good sleep is suggested to such disordered patients to manage mood variations and maintain a serene mind.
However, the motivating factor for a disordered patient is to stay focused on his goals and developing an optimistic attitude.