Bipolar Disorder
What is it?
Bipolar disorder is a mental health condition characterised by extreme mood swings that encompass both highs (mania or hypomania) and lows (depression). Mania is more severe than hypomania and can lead to significant challenges in relationships, employment, school, and social activities. It can even trigger a break from reality.
During a major depressive episode, individuals experience symptoms that significantly interfere with their daily functioning in various areas such as work, school, social activities, and relationships.
Mood fluctuations in bipolar disorder can have a negative impact on sleep patterns, energy levels, judgement, activity levels, conduct, and the ability to think clearly. These episodes of mood swings can occur infrequently or multiple times throughout the year.
Unfortunately, many individuals with bipolar disorder may not recognize the need to seek help from a psychiatrist despite the severity of their mood swings. However, instances of suicidal or self-harming thoughts or actions require immediate psychiatric intervention.
People with bipolar disorder are also more likely to have comorbid conditions such as anxiety, attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), and substance use disorders/dual diagnosis. These additional conditions can further complicate the management and treatment of bipolar disorder.
Causes
The precise cause of bipolar disorder is still unknown to scientists. However, they believe that genetic factors play a significant role in its development. Bipolar disorder is considered highly heritable, as more than two-thirds of individuals with the condition have at least one close biological relative who also experiences bipolar disorder. It’s important to note that having a biological relative with bipolar disorder doesn’t guarantee that an individual will develop the condition.
In addition to genetic factors, scientists believe that other elements contribute to the onset of bipolar disorder. These include :
- Brain changes : Researchers have observed subtle differences in the size or activation of certain brain structures in individuals with bipolar disorder. However, it’s important to note that brain scans cannot be used as a definitive diagnostic tool for the condition.
- Environmental factors, such as trauma and stress : Experiencing a stressful event like the loss of a loved one, a severe illness, divorce, or financial difficulties can act as triggers for manic or depressive episodes in individuals with bipolar disorder. As a result, stress and trauma may also play a role in the development of the disorder.
While the exact interplay between genetic, brain-related, and environmental factors in bipolar disorder is not fully understood, ongoing research aims to shed light on these complex relationships.
Symptoms of manic episode
A manic episode is characterised by a sustained period of at least one week during which an individual displays intense feelings of high spirits or irritability throughout most of the day, accompanied by elevated energy levels and notable changes in behaviour. To be considered a manic episode, the person must experience at least three of the following behavioural changes :
- Decreased need for sleep : Feeling energised and refreshed despite having significantly less sleep than usual.
- Increased or rapid speech : Speaking at an accelerated pace, sometimes with pressured speech, where thoughts spill out quickly.
- Uncontrollable racing thoughts or frequent shifts in ideas and topics during conversations.
- Distractibility : Difficulty maintaining focus or being easily diverted by external stimuli.
- Increased activity : Engaging in heightened levels of physical or mental activity, often with restlessness and multitasking.
- Increased engagement in risky behaviours : Displaying impulsive actions, such as reckless driving, excessive spending, or other potentially harmful activities.
These behavioural changes must be noticeable and different from the person’s usual behaviour, and they are typically evident to friends and family. Symptoms of a manic episode are severe enough to interfere with daily functioning in various areas, including work, family life, social activities, and responsibilities. In some cases, hospital care may be necessary to ensure the person’s safety.
It’s important to note that some individuals experiencing manic episodes may also have disorganised thinking, hold false beliefs, or experience hallucinations. These additional symptoms are referred to as psychotic features.
Symptoms of hypomanic episode
A hypomanic episode is characterised by mild manic symptoms that persist for at least four consecutive days, as opposed to the one-week duration required for a full manic episode. Unlike manic symptoms, hypomanic symptoms do not typically result in significant impairments in daily functioning.
During a hypomanic episode, individuals may experience the following symptoms :
- Elevated or irritable mood : A persistent state of heightened mood, characterised by feelings of euphoria, happiness, or irritability.
- Increased energy and activity : A notable surge in energy levels, leading to heightened productivity and engagement in various activities.
- Decreased need for sleep : Feeling rested and rejuvenated with significantly less sleep than usual.
- Racing thoughts and rapid speech : Thoughts that race through the mind quickly, often leading to rapid and pressured speech.
- Increased distractibility : Difficulty maintaining focus or being easily distracted by external stimuli.
- Engaging in pleasurable activities with potential negative consequences : Exhibiting impulsive behaviours, engaging in risky activities, or pursuing pleasure-seeking behaviours without considering potential negative outcomes.
It’s important to note that although a hypomanic episode may not cause significant functional impairments, it can still have a disruptive impact on a person’s life, relationships, and overall well-being. If you or someone you know is experiencing symptoms of a hypomanic episode, it is advisable to seek professional evaluation and support.
Symptoms of major depressive episode
During a major depressive episode, individuals experience a prolonged period of at least two weeks characterised by the presence of at least five symptoms, including at least one of the first two symptoms listed below :
- Intense sadness or despair
- Loss of interest in activities that were once enjoyed
- Feelings of worthlessness or guilt
- Fatigue or low energy levels
- Changes in sleep patterns, either increased or decreased sleep
- Changes in appetite or weight, either increased or decreased
- Restlessness or slowed speech and movement
- Difficulty concentrating or making decisions
- Frequent thoughts of death or suicide
These symptoms collectively contribute to a significant decrease in the person’s overall well-being and ability to function normally in daily life. It’s important to note that a diagnosis of a major depressive episode requires the presence of these symptoms for a minimum duration of two weeks. If you or someone you know is experiencing these symptoms, it is crucial to seek professional help and support.
Treatment
- Treatment is essential for improving the symptoms of bipolar disorder.
- Pharmacotherapy : The most commonly prescribed medications for bipolar disorder are referred to as “mood stabilisers,” such as lithium. These medications aim to correct imbalances in brain signalling. Since bipolar disorder is a chronic condition characterised by recurring mood episodes, ongoing preventive treatment is recommended. It’s important to note that bipolar disorder treatment is personalised, and individuals may need to explore different medications to find the most effective option for their specific needs.
- Psychotherapy : The primary approach involves medication, which plays a crucial role in managing the condition. Additionally, talk therapy, also known as psychotherapy, can be highly beneficial in helping patients understand their illness and adhere to their medication regimen, ultimately preventing future mood episodes.
- Cognitive Behavioural Therapy : During CBT, a therapist will help you examine and understand your thoughts and emotions. It aims to help the individual identify and change unhealthy emotions, thoughts and behaviours. The individual works with a mental health professional, such as a psychologist. Over several sessions, CBT can help alter harmful thoughts and stop negative habits, perhaps replacing them with healthier ways to cope.
