Bipolar Disorder: Symptoms, Diagnosis, Treatment

Overview

Bipolar disorder, also called manic-depressive illness or mania depression, is a brain disorder leading to unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Bipolar disorder is typically a chronic and debilitating condition. Affected people may feel extremely hopeless, frustrated or empty when they experience the depressive period. However, they can be abnormally energetic, irritated or active when their mood switches to manic or hypomanic period. Though it’s a lifelong disease, it can be properly treated with professional medical care.

Types

There are four basic sub-types of bipolar disorder, among which the most common are bipolar type 1 and bipolar type 2. Generally, all of these four types involve obvious shifts in mood, energy, and activity levels. These moods range from elevated periods (manic episodes) to very frustrated periods (depressive episodes). If it is less severe manic period, then it’s called hypomanic episodes.



Bipolar I Disorder

It is characterized with manic episodes lasting at least a week and depressive episodes lasting at least two weeks, or by manic symptoms that are so severe that the person needs to be hospitalized immediately. In some cases, it’s also possible that the patient would experience depressive and manic symptoms at the same time.

Bipolar II Disorder

It is not a milder form of bipolar I disorder, but a separate diagnosis. It is characterized by a pattern of depressive episodes and hypomanic episodes, but manic episodes are not as severe as those mentioned above.

Cyclothymic Disorder (aka. cyclothymia)

People with this type of disorder experience numerous hypomanic periods and depressive periods lasting for at least 2 years (1 year in children and adolescents). However, symptoms of both periods are not yet enough to be used for the diagnostic procedure.

Other Specified and Unspecified Bipolar and Related Disorders

If people affected by bipolar disorder are suffering from symptoms that do not match those of the three types listed above, they may belong to the fourth category. These bipolar and related disorders may include, for example, disorders induced by certain drugs, alcohol or a disease, such as stroke, multiple sclerosis or Cushing’s disease.

Symptoms

It’s a little bit complicated when it comes to the symptoms of bipolar disorder since they vary from types to types, depending on which episode the patient belongs to. Moreover, bipolar disorder is a lifelong illness. People affected may experience recurrent manic and depressive episodes over time. Though many people can lead a normal life between episodes, some may have lingering symptoms.

People experiencing a manic episode may:

  • Have trouble sleeping
  • Feel extremely energetic, agitated, irritable, “high”, “jumpy”, “wired”, or “touchy”
  • Talk pretty fast or have fast-changing thoughts about various things
  • Think they can do a lot of things simultaneously
  • Taking risks doing things such as squandering a great amount of money or have reckless sex


People experiencing a hypomanic episode may suffer from three or more of these symptoms listed below:

  • Becoming unusually talkative or abnormally upbeat, jumpy or wired
  • Being extremely active, energetic or agitated
  • Having trouble concentrating and making decisions
  • Having racing thoughts
  • Having an exaggerated sense of self-esteem and a decreased need for sleep


People experiencing a depressive episode may:

  • Lose interest in everything
  • Become less active and forgetful
  • Always lack stamina and feel fatigued
  • Feel very worried, empty, frustrated or hopeless
  • Have trouble sleeping, eating or concentrating
  • Feel the need to commit suicide or have suicide thoughts
  • Lose weight unintentionally


Signs and symptoms of bipolar I and bipolar II disorders may include other symptoms, such as anxious distress, melancholy, psychosis or others. It’s worth mentioning that the most prominent symptoms in children and teenagers may include severe mood swings that are different from their usual mood swings.

Complications

If left ignored or untreated, bipolar disorder may end up causing severer problems that would make it hard for people to lead a normal life. Possible complications may include:

  • Problems related to drug and alcohol use
  • Damaged relationships
  • Poor work or school performance
  • Legal or financial problems
  • Suicide or suicide thoughts or attempts


Furthermore, people who have bipolar disorder may also be troubled with eating disorders, anxiety disorders, attention-deficit/hyperactivity disorder or even thyroid problems.

Diagnosis

Different from diagnoses for other diseases, the diagnosis for bipolar disorder relies less on lab tests or imaging tests. In fact, the most important diagnostic tool may be talking openly with the doctor about your mood swings, behaviors, and lifestyle habits.

  • Talking with A Professional: If you think you may have bipolar disorder, the first step could be talking with a doctor or other licensed mental health professional. They may ask you about your medical history, your family history or the symptoms that are causing you uneasiness.
  • Physical Exam: Having done the talking part, the doctor may order a physical exam to rule out other conditions that could be causing your symptoms.
  • Psychiatric assessment: If the problems are not caused by other illnesses, the doctor may conduct a psychiatric evaluation or provide a referral to a psychiatrist who is expert in diagnosing bipolar disorder. The psychiatrist may talk to you about your thoughts, feelings and behavior patterns. He/She may compare your symptoms with the criteria for bipolar and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
  • Mood charting: The doctor may ask you to keep a daily record of your moods, sleep patterns or other factors. By doing this, a proper diagnosis and the best solution to your case can be found.

Treatment

Tricky as it sounds, bipolar disorder is a highly treatable condition. With proper treatment, people with this disorder can gradually gain better control of their mood swings and other bipolar symptoms. It proves to be effective to combine medication therapy with psychotherapy (talk therapy).

In fact, treatment can be slightly different depending on which type the patient belongs to. For example, some meds found useful in treating bipolar type 1 may cause episodes of bipolar type 2. Therefore, you should always consult your doctor about what kind of meds that suits you best. Do remember to take the meds as directed.

Medications

Some of the medications that are commonly prescribed to treat different types of bipolar disorder are:

  • Mood stabilizers: usually used to control episodes of mania or hypomania (e.g. Lithium, Depakote, Amical, Tegretol, or Depakene)
  • Mood-stabilizing antipsychotics (e.g. Risperdal, Abilify or Latuda)
  • Antidepressants: used to manage depressive episodes
  • Antidepressant antipsychotic: used as an antidepressant and mood stabilizer (e.g. Symbyax)

Psychotherapy

As is described above, it is also called talk therapy or cognitive behavioral therapy. By applying this method, the doctor will be able to identify the patient’s thoughts, behaviors or other symptoms that are unhealthy. Further, they will help you take up new habits that are more positive.

Healthy Lifestyle

Some of your symptoms can be worsened if one continues the previous unhealthy lifestyle and negative mindset. It’s time that the affected people should make a change in their lifestyles and mindsets. Step by step, they can improve their life quality and relieve their symptoms by getting enough rest, sticking to a healthy diet and conducting regular work-out.

There are also other options for treating bipolar disorder. For instance, if the patient find it hard to fall asleep, the doctor may suggest a change in medications and may prescribe the person sedative or other sleep medications. For cases in which other treatments are not helping or are not available, electroconvulsive therapy (ECT) could be an alternative. It can provide relief for people with severe bipolar disorder, especially for those who are pregnant.

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Keywords: bipolar disorder

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.