Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is a serious brain illness. It is also called manic-depressive illness or manic depression. People with bipolar disorder go through unusual mood changes. Sometimes they feel very happy and “up,” and are much more energetic and active than usual. This is called a manic episode. Sometimes people with bipolar disorder feel very sad and “down,” have low energy, and are much less active. This is called depression or a depressive episode.

Bipolar disorder is not the same as the normal ups and downs everyone goes through. The mood swings are more extreme than that and are accompanied by changes in sleep, energy level, and the ability to think clearly.

What are the symptoms of bipolar disorder?

The symptoms of bipolar disorder are that people experience depressed mood and elevated, or elated mood, meaning depression and mania.

In order to meet the criteria for this illness, one has to have had both of these ends of the mood spectrum. Depression is characterized primarily by very sad mood, or lack of interest in things.

It also includes physical and cognitive symptoms. Things like not sleeping well, not eating well, loss of weight, loss of interest in things.

Oftentimes it’s also accompanied by thoughts of death or suicide.

Mania on the other hand is typically thought of as being a rather a elated, or extremely happy mood, more than normal, and might include things like people taking very fast, changing subjects very quickly, doing things like getting involved in risky behaviors.

Driving their car too fast, spending too much money, sexually promiscuous behavior.

The other important thing to know is that mania can also be characterized by a very irritable mood.

That is, when people get very upset easily, very grouchy, sometimes can get in rages or having episodes of violence.

Who Gets Bipolar Disorder?

Anyone can develop bipolar disorder. It often starts in a person’s late teen or early adult years. But children and older adults can have bipolar disorder too. The illness usually lasts a lifetime.

Why does someone develop bipolar disorder?

The cause of bipolar disorder is not entirely known. Genetic, neurochemical and environmental factors probably interact at many different levels to play a role in the onset and progression of bipolar disorder. The current thinking is that this is a predominantly neurobiological disorder that occurs in a specific part of the brain and is due to a malfunction of certain brain chemicals (that occur both in the brain and the body). Three specific brain chemicals have been implicated — serotonin, dopamine and noradrenaline. As a neurobiological disorder, it may lie dormant and be activated spontaneously or it may be triggered by stressors in life.

Is bipolar disorder easy to diagnose?

No. Some people have bipolar disorder for years before the illness is diagnosed. This is because bipolar symptoms may seem like several different problems.

How is Bipolar Disorder Diagnosed?

Psychological Evaluation. A mental health professional is probably the best person to evaluate your symptoms, after you see your regular health care provider. Diagnosis of bipolar disorder is based on:

  • Presence of symptoms over time
  • Absence of medications and medical or neurological illness that may look like bipolar disorder
  • Family history of bipolar disorder

Mania is diagnosed if abnormally elevated mood (lasting at least one week) occurs with three or more of the other symptoms of mania. If your mood is irritable, four additional symptoms must be present.

Depression is diagnosed if depressed mood or loss of interest in pleasure occurs every day (or nearly every day) over the last two weeks, and is accompanied by five or more of the symptoms.

A diagnostic evaluation may include a mental status exam to determine if your speech or thought patterns or memory have been affected, as sometimes happens in the case of bipolar disorder.

You may also be evaluated for other psychiatric conditions such as anxiety disorders and alcohol or drug abuse.

How is bipolar disorder treated?

Right now, there is no cure for bipolar disorder, but treatment can help control symptoms. Most people can get help for mood changes and behavior problems. Steady, dependable treatment works better than treatment that starts and stops. Treatment options include:

1. Medication. There are several types of medication that can help. People respond to medications in different ways, so the type of medication depends on the patient. Sometimes a person needs to try different medications to see which works best.

Medications can cause side effects. Patients should always tell their doctors about these problems. Also, patients should not stop taking a medication without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.

2. Therapy. Different kinds of psychotherapy, or “talk” therapy, can help people with bipolar disorder. Therapy can help them change their behavior and manage their lives. It can also help patients get along better with family and friends. Sometimes therapy includes family members.

3. Other treatments. Some people do not get better with medication and therapy. These people may try electroconvulsive therapy, or ECT. This is sometimes called “shock” therapy. ECT provides a quick electric current that can sometimes correct problems in the brain.

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Dr Somanath CP

Dr Somanath is a leading and eminent psychiatrist based in Kochi. He did his MBBS at Medical College Kottayam and post graduation in psychiatry from NIMHANS Bangalore. He has 20 years of experience in the field of psychiatry and worked as faculty in NIMHANS, SH Hospital Painkulam, Thodupuzha, Child Care Centre Gandhinagar and Lakeshore hospital Kochi. His current research interests are Genetics of Psychiatric disorders, Developmental disorders in children, psychosomatic medicine, Health education & Public awareness programme.

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