Bipolar Disorder

Bipolar Disorder

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By Dr. Vikas Deshmukh, Psychiatry

Bipolar disorder is also known as ‘Maniac Depressive Disorder’ and it refers to the occurrence of extreme mood swings ranging from depression to mania. This is a serious condition which can result in very risky behaviour including suicidal tendencies.

Traditionally, doctors have found it difficult to understand the causes behind bipolar disorder. However, in the recent years, doctors have been able to study the bipolar spectrum which ranges from the lows of major depression to the highs of mania, along with the different moods that lie in between. Bipolar disorders tend to run in the person’s family and thus, a genetic connection might be possible. Quite evidently, lifestyle issues and environment affect the severity of the disorder. Treatment can be made difficult if one experiences life events which are stressful, including drug and alcohol abuse.

Risk Factors-

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:

  1. Having a first-degree relative, such as a parent or sibling, with bipolar disorder
  2. Periods of high stress
  3. Drug or alcohol abuse
  4. Major life changes, such as the death of a loved one or other traumatic experiences

Symptoms of Bipolar Disorder-

Bipolar disorder is characterised by extreme mood swings. These can range from extreme highs (mania) to extreme lows (depression).

Depression:

During a period of depression, your symptoms may include:

  • feeling sad, hopeless or irritable most of the time
  • lacking energy
  • difficulty concentrating and remembering things
  • loss of interest in everyday activities
  • feelings of emptiness or worthlessness
  • feelings of guilt and despair
  • feeling pessimistic about everything
  • being delusional, having hallucinations and disturbed or illogical thinking
  • lack of appetite
  • difficulty sleeping
  • suicidal thoughts

Mania:

The manic phase of bipolar disorder may include:

  • feeling very happy, elated or overjoyed
  • talking very quickly
  • feeling full of energy
  • feeling self-important
  • feeling full of great new ideas and having important plans
  • being easily distracted
  • being easily irritated or agitated
  • being delusional, having hallucinations and disturbed or illogical thinking
  • not feeling like sleeping
  • not eating
  • doing things that often have disastrous consequences – such as spending large sums of money on expensive and sometimes unaffordable items

Patterns of Depression and Mania:

If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa. The patterns aren’t always the same and some people may experience:

  1. rapid cycling – where a person with bipolar disorder repeatedly swings from a high to low phase quickly without having a “normal” period in between
  2. mixed state – where a person with bipolar disorder experiences symptoms of depression and mania together; for example, overactivity with a depressed mood

Treatment-

Bipolar disorders can be treated using:

  1. Mood Stabilizers: Treatment of bipolar disorder involves stabilization of the mood. This can achieve by utilizing medications. Examples of mood stabilizers include ‘Valproic Acid’ ‘Carbamazepine’ and ‘Divalproex sodium’
  2. Psychotherapy: In addition to mood stabilizers, psychotherapy should be recommended in order to help the patient develop workable and appropriate coping plans to combat depressions and increase medical compliance. The types of psychotherapy include Cognitive Behavioural therapy (conversation centric therapy to alleviate toxic thoughts and beliefs, paving the way for a better outlook), Psychoeducation and Interpersonal and social rhythm therapy (IPSRT- focuses on improving their moods in accordance with their biological and social patterns).
  3. Antidepressants and Antipsychotics: In case the mood stabilizers are unable to manage the symptoms, other medicines such as antidepressants and antipsychotics can be included to help in easing the depression or calming the disorder. Examples of Antipsychotics include ‘Ziprasidone’, ‘Olanzapine’ and ‘Lurasidone’. Anti-depressants are usually prescribed along with mood stabilizers and antipsychotics. A medication called ‘Symbyax’ works as both antidepressant and antipsychotic medicine as it combines fluoxetine (antidepressant) and antipsychotic (olanzapine). It is always recommended to consult a psychiatrist before undergoing any treatment plan.