WHAT IS BIPOLAR DISORDER?
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes extreme changes in mood, energy and the ability to function. The mood usually swings from ecstatic, irritable and/or aggressive (manic) to sad and hope-less (depression). Periods of fairly normal mood can be experienced between cycles.
DIFFERENT TYPES OF BIPOLAR DISORDER
People with bipolar disorder type I have had at least one manic episode and periods of major depression. This was also called manic depression in the past.
People with bipolar disorder II have never had full mania. They experience hypomania (a mild form of mania) and major depressive episodes.
In cyclothymia there are, for a period of at least two years, hypomania and mild depression, which are never severe enough to be classified as a full manic and depressive disorder.
CAUSES OF BIPOLAR DISORDER
The exact cause of bipolar disorder is unknown, but it may be a combination of biochemical, genetic and psychological factors. Approximately 50% of patients with bipolar disorder have at least one parent with a mood disorder. The following may trigger a manic episode:
- life changes such as childbirth
- recreational drug use
- periods of sleeplessness
- medications such as anti-depressants or steroids
WHO GETS BIPOLAR DISORDER?
Men and women are affected equally. It usually starts between ages 15-25.
Depending on the clinical characteristics bipolar disorder is sub-classified as bipolar disorder, mania; bipolar disorder, depression; bipolar disorder, mixed. The essential characteristic is one or more manic (or hypomanic) episodes.
SYMPTOMS OF A MANIC EPISODE INCLUDE:
- increased energy, activity and restlessness
- excessively high, euphoric mood
- extreme irritability
- spending sprees
- distractibility (cannot concentrate)
- little sleep needed
- racing thoughts, rapid speech
- poor judgment (excessive buying, sexual indiscretions)
- inflated self-esteem
- increased sociability
- binge eating, drinking and/or drug use
- denial that anything is wrong
SYMPTOMS OF A DEPRESSIVE EPISODE INCLUDE:
- persistent depressed mood, most of the day, almost every day
- decreased interest and pleasure in almost all activities
- insomnia or hypersomnia (too little or too much sleep)
- tiredness, listlessness, restlessness or irritability
- feelings of worthlessness, self-reproach, guilt
- concentration impairment
- recurrent thoughts of death, suicidal ideas
- change in appetite and/or unintended weight loss/gain
Bipolar disorder requires long-term treatment, since it is a chronic, relapsing illness. The most effective treatment plan includes a combination of medication, psychotherapy, lifestyle changes and social support. Psychotherapy used to treat bipolar disorder includes cognitive behavioural therapy and family-focused therapy. Psychotherapy may help you gain self-insight, change negative thoughts and feelings, and learn new behaviours and coping strategies. Talking about your emotions with a trained professional can help reduce symptoms.
Diagnosis of this disorder can be tricky and medication should be monitored closely by a psychiatrist. Medication is used to stabilize the extreme mood swings of mania and depression.
Mood-stabilizers provide relief or prevent acute episodes of depression or mania. Anti-depressants treat the symptoms of depression. Anti-psychotics treat psychotic symptoms such as delusions or hallucinations. Long-term treatment is important as maintenance treatment between episodes reduces the severity and frequency of depression and mania.
Bipolar medications are powerful drugs. For this reason, medication should not be stopped without a doctor’s supervision.
WHEN TO CALL THE DOCTOR
Over and above the normal consultations, call the doctor when you experience the following:
- suicidal or violent feelings
- changes in mood, sleep or energy levels
- an increase in medication side-effects
- an acute medical illness, a need for surgery, or a need for other medications
WHAT TO DO AND WHERE TO GO FOR HELP
The vast majority of people with bipolar disorder respond well to treatment. The first step is to discuss your symptoms with an experienced professional, like your family practitioner.