Bipolar Disorder

Overview

Bipolar disorder, formerly referred to as manic-depressive illness, is a complex mental illness marked by abrupt changes in activity, mood, and energy. People who have bipolar disorder go through phases of stable mood in between times of extreme highs (mania or hypomania) and lows (depression). These incidents may have a major effect on their day-to-day activities, interpersonal connections, and general well-being. A comprehensive assessment by a mental health specialist is necessary to diagnose bipolar disorder.

What is Bipolar Disorder?

Bipolar disorders are mental health conditions characterized by intense emotional states that periodically affect a person's mood, energy, and ability to function. These periods, lasting from days to weeks, are called mood episodes. Mood episodes are categorized as manic or hypomanic when the predominant mood is intensely happy or irritable, and depressive episodes when the mood is intensely sad or the ability to experience joy or pleasure disappears.

There are several types of bipolar disorder, all involving significant fluctuations in mood, referred to as hypomanic/manic and depressive episodes. The main diagnoses within this category are bipolar I, bipolar II, and cyclothymic disorder. Each type has distinct patterns of mood episodes, impacting the severity and duration of these emotional states.

Bipolar disorder often runs in families, with 80 to 90 percent of individuals having a relative with bipolar disorder or depression. Environmental factors such as stress, sleep disruption, and substance abuse can trigger mood episodes in susceptible individuals.

The three main diagnoses of Bipolar disorders are as follows:

1. Bipolar I Disorder
This most prevalent kind is characterized by manic episodes experienced by an extreme increase in energy and mood changes, including feeling extremely happy or uncomfortably irritable. Some episodes are combined with significant depressive episodes or by at least one hypomanic episode lasting a minimum of one week and could also have episodes of neutral mood.

2. Bipolar II Disorder
This diagnosis is characterized by at least one major depressive episode and at least one hypomanic episode ( less severe manic symptoms that need to last only four days in a row rather than a week). Individuals with bipolar II disorder often seek treatment primarily due to their depressive episodes. Those with bipolar II disorder frequently have comorbid mental illnesses, such as anxiety disorders or substance use disorders, which can worsen symptoms of both depression and hypomania.

3. Cyclothymic Disorder
Although it doesn't fully fit the criteria for Bipolar I or II, this milder type contains recurrent episodes of hypomanic and depressive symptoms for at least two years involving many 'mood swings' with the symptoms (mood swings) have lasted for at least half the time and have never stopped for more than two months. It can nevertheless, however, seriously upset people and interfere with day-to-day activities.

Symptoms of Bipolar Disorder

People with bipolar disorder experience episodes of:

Depression: Characterized by profound low mood and lethargy.
Mania: Marked by extreme high spirits and overactivity.

The hallmark of bipolar I disorder is a manic episode lasting at least one week. In contrast, individuals with bipolar II disorder or cyclothymia experience hypomanic episodes. Mood fluctuations in bipolar disorder can span weeks, months, or even years.

Manic Episode
A manic episode involves at least one week of elevated or irritable mood, accompanied by increased energy and at least three of the following behavioral changes:

• Reduced need for sleep (e.g., feeling energized despite significantly less sleep than usual).
• Rapid or pressured speech.
• Racing thoughts or a tendency to switch topics frequently while speaking.
• Easily distracted.
• Heightened activity levels (e.g., restlessness, engaging in multiple tasks simultaneously).
• Risky or impulsive behaviours (e.g., reckless driving, excessive spending, sexual promiscuity).
• Hypomanic Episode
• Some individuals with bipolar disorder experience hypomania, which involves milder manic-like symptoms. This state is noticeable to family and friends, manifesting as changes in mood and activity levels.

Major Depressive Episode
During a major depressive episode, one may feel overwhelming worthlessness, potentially leading to suicidal thoughts. This episode lasts at least two weeks and includes intense sadness or loss of interest in previously enjoyed activities, accompanied by at least four of the following symptoms:

• Feelings of worthlessness or excessive guilt.
• Persistent fatigue.
• Changes in sleep patterns (either increased or decreased).
• Altered appetite (either increased or decreased).
• Restlessness (e.g., pacing) or noticeably slowed speech and movement.
• Difficulty concentrating.
• Frequent thoughts of death or suicide.
• Causes of Bipolar Disorder
• Although the exact cause of bipolar disorder is unknown, research indicates that a combination of genetics, brain chemistry and environmental factors may contribute to its development.

Several other factors are believed to trigger the episodes. These include: