What is Bipolar Disorder?

Bipolar disorder is a serious medical illness. Also known as manic-depressive illness, it is a mental illness involving episodes of serious mania and depression. The person’s mood usually swings from overly “high” and irritable to sad and hopeless, and then back again, with periods of normal mood in between.

Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as an illness and people who have it may suffer needlessly for years or even decades.

Effective treatments are available that greatly alleviate the suffering caused by bipolar disorder and can usually prevent its devastating complications. These include marital breakups, job loss, alcohol and drug abuse, and suicide.

How does one know if one has Bipolar Disorder?

Bipolar disorder can be hard to detect. Some people may go 10 years or more before being diagnosed. There are many reasons that make diagnosing bipolar disorder difficult, such as how patients describe symptoms and what types of symptoms they experience first.

When people are feeling manic or hypomanic, they are full of energy. They can feel good. They may feel “high on life” and don’t always seek help. But they may seek help when they fall into depression. At that time, they may describe only symptoms of depression to their healthcare provider. Therefore, it’s common for a person to be incorrectly diagnosed with depression instead of bipolar depression.

Bipolar disorder also shares many of the signs and symptoms associated with other illnesses, such as anxiety disorders and schizophrenia. This can complicate the diagnosis even more.

The symptoms of bipolar disorder can vary from one person to another. People with bipolar disorder should talk with their healthcare providers about their symptoms at each visit. Symptoms of depression and mania (formerly referred to as manic depression symptoms) include the following:

Depression:

• Feeling sad or blue or “down in the dumps”
• Loss of interest in things the person used to enjoy, including sex
• Feeling worthless, hopeless or guilty
• Sleeping too little or too much
• Changes in weight or appetite
• Feeling tired or having little or no energy
• Feeling restless
• Problems concentrating or making decisions
• Thoughts of death or suicide

Mania:

• Increased energy level
• Less need for sleep
• Racing thoughts or mind jumps around
• Easily distracted
• More talkative than usual or feeling pressure to keep talking
• More self-confident than usual
• Focused on getting things done, but often completing little
• Risky or unusual activities to the extreme, even if it’s likely bad things will happen

Risk Factors

Scientists don’t really know what causes bipolar disorder. They do believe that genetics plays a role. For instance, more than two thirds of people with bipolar disorder also have a relative with the same condition or some other mood disorder. But genetics alone does not cause someone to develop bipolar disorder. The other causes are still being researched on.

Bipolar disorder most commonly starts in teenagers and young adults. But it can also first occur in children and older adults. But it can also first occur in children and young adults. Bipolar disorder equally affects people of all races and ethnic groups.

What happens when you have Bipolar Disorder?

This is what we do know about bipolar disorder:

Special chemicals in the brain, called neuro-transmitters, may be involved in the disease. If the levels of these chemicals are out of balance, it may be harder for brain cells to work normally.

Bipolar disorder may be related to problems with hormone levels. For instance, experts have noticed a link between thyroid hormone levels and bipolar disorder. Certain parts of the brain may have a different size or shape in people with bipolar disorder. The changes could be a cause or symptom of the condition. In some cases, other illnesses may play a role in bipolar disorder.

Recognizing triggers of Bipolar Disorder

Mood swings can be triggered by events and emotions in your life. If you have to cope with some unpleasant, sad or even happy events you may be at greater risk for manic and depressive episodes.

Triggers, also called stressors, are anything that may help cause a mood swing. Some common triggers include:

• Not having a regular sleep schedule
• Misusing alcohol or drugs
• Stopping your medication
• Starting medicines for depression (in some cases) or medicines and herbal products
• Having thyroid problems and other medical conditions

Not everyone’s triggers are the same. Some people find that triggers can be things like:

• Seasonal changes
• Holidays
• Illness
• Disagreements with family or friends
• Problems at work
• The death of a loved one
• Starting College
• Starting a new job
• Marriage

Keeping track of moods and triggers

It’s important to figure out what your own triggers are. One way to do this is to keep a Mood Chart. They are ways of recording your emotions over time along with important events in your life.

After you keep a mood chart for a while, you may start to notice patterns. For instance, you may see that you seem to get depressed when you’re away from home, or manic when the school year begins.

Figuring out your triggers on your own can be tough. It may be helpful to talk over the possibilities with your trusted friends and family.

Seeing a healthcare provider or therapist can help you figure out your triggers. Talking to a professional, who isn’t part of your personal life, may help you see things more clearly.

Avoiding triggers

Once you figure out what may trigger your mood swings, the next step is to learn how to avoid them when possible. That involves taking action.

For instance, you may notice that not getting enough sleep causes you to become depressed. Try to plan a regular sleep schedule.

You should also consider discussing your triggers with family and friends. That way, they can help you avoid your triggers too.

How is Bipolar Disorder diagnosed?

Bipolar Disorder, as well as other psychiatric illnesses can be diagnosed by a thorough history and mental status examination by a psychiatrist. There are no laboratory examinations to confirm such illness. If someone feels that he has the mentioned symptoms and relatives see signs that the patient might have the illness, one must seek professional help (or see a psychiatrist).

What are the available treatment options?

The first medical breakthrough in the treatment of bipolar disorder came in the 1950s. Treatment has made great strides since then. Today, there are many medications and therapies used to manage bipolar disorder. People with bipolar disorder can hold jobs, raise families, and live normal lives.

Although bipolar disorder has a number of common symptoms, treatment can vary. What works for one person may not work for someone else. That’s why it’s especially important to work with a healthcare provider to find the right treatment, or combination of treatments. There are three basic parts of treatment for bipolar disorder. They are medication, therapy, and self-care.

What are the possible complications of Bipolar Disorder?

Because manic-depressive illness is recurrent, long-term preventive (prophylactic) treatment is highly recommended and almost always indicated. Some people with untreated bipolar disorder have repeated depression and only an occasional episode of hypomania (bipolar II). In the other extreme, mania may be the main problem and depression may occur infrequently. In fact, symptoms of mania and depression may be mixed together in a single bipolar state.

Suicide is a serious risk for people with bipolar disorder. By learning more about suicide, you’ll be taking an active step in understanding more about your illness.

Bipolar Disorder and Suicide

Most suicide attempts occur during a depressed or mixed episode.

Suicide may also occur during an episode of mania, or when a person is going into or coming out of depression or mania. This can happen even if he or she seems to be feeling better.

About 25% to 50% of people with bipolar disorder make at least one suicide attempt.

Nearly one in five people with bipolar disorder commits suicide.

People with bipolar disorder who misuse alcohol or drugs have an increased risk of suicide.

Considering suicide means you need to get help to control your bipolar disorder symptoms.

What are the related services available in TMC?

The Medical City (TMC) has one of the best rosters of psychiatrists who may be consulted for mood disorders. You may set an appointment with anyone of them to inquire about the nature of this disease, either for yourself, or for your loved one.

Out-patient services through the Department of Psychiatry are offered to those who should undergo psychotherapy but have difficulty obtaining services from consultants. And for patients who have difficulty controlling their symptoms, in-patient care is also offered.

Note: This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment.
References: The Medical City Department of Psychiatry, Kaplan and Saddocks Synopsis of Psychiatry 9th edition