Bipolar Disorder

April 25, 2021Articles

Bipolar disorder, also known as manic depression, is a mental illness that brings severe high and low moods and changes in sleep, energy, thinking and behavior.

People who have bipolar disorder can have periods in which they feel overly happy and energized and other periods of feeling very sad, hopeless and sluggish. In between those periods, they usually feel normal. You can think of the highs and lows as two “poles” of mood, which is why it’s called “bipolar” disorder.
The word “manic” describes the times when someone with bipolar disorder feels orally excited and confident. These feelings can also involve irritability and impulsive or reckless decision making. About half of people during mania can also have delusions (believing things that aren’t true and that they can’t be talked out of) or hallucinations (seeing or hearing things that aren’t there).
Hypomania describes milder symptoms of mania, in which someone does not have delusions or hallucinations and their high symptoms do not interfere with their everyday life.
The word “depressive” describes the times when the person feels very sad or depressed. Most people with bipolar disorder spend more time with depressive symptoms than manic or hypomanic.
Types-

A person may receive a diagnosis of one of three broad types of bipolar disorder.
• Bipolar I disorder-
For a diagnosis of bipolar 1 disorder –
• The individual must have experienced at least one manic episode
• The person may have had a previous major depressive episode
• The doctor must rule out other disorders, such as schizophrenia and delusional disorder.
Men and women develop bipolar I disorder in equal numbers.
• Bipolar II disorder –
This type of disorder involves periods of hypomania, but depression is often the dominant state.
For a diagnosis of bipolar II disorder, a person must have had –
• one or more episodes of depression
• atleast one hypomanic episode
• no other diagnosis to explain the mood shifts
A person with hypomania may feel good and function well, but their mood will not be stable, and there is a risk that depression will follow.People with bipolar II disorder may experience more frequent episodes of depression than people with bipolar I disorder.Women may be more likely than men to develop bipolar II disorder.
• Cyclothymic disorder –
People with cyclothymic disorder may experience ongoing bipolar symptoms that don’t meet the full criteria for a bipolar I and bipolar II diagnosis. Cyclothymic disorder in considered a less severe form of bipolar disorder. It involves the frequent recurrence of hypomanic and depressive symptoms that never become severe enough to be diagnosed as having bipolar II disorder. These symptoms generally persist for a two year period.
Symptoms –

Symptoms vary between individuals.For some people, an episode can last for several months or years.Others may experience high and lows at the same time or in quick succession.
In rapid cycling bipolar disorder, the person will have four or more episodes within a year.
• Mania or hypomania –
Hypomania and mania are elevated moods. Mania is more intense than hypomania.
Symptoms can include –
• impaired judgement
• sleeping little but not feeling tired
• a sense of distraction or boredom
• underperforming at work or school
• increased anxiety about mines inner libido
• having high levels of self confidence, self esteem and self importance
• jumping from one topic to another in conversation
• having racing thoughts that come and go quickly and bizarre ideas that the person may act upon
• denying or not realizing that anything is wrong
• being sociable and forthcoming, sometimes aggressively so
Some people with bipolar disorder may spend a lot of money, are recreational drugs, consume alcohol and participate in dangerous and inappropriate activities.
• Depressive symptoms –
During an episode of bipolar depression, a person may experience –
• a feeling of
gloom, despair and hopelessness
• extreme sadness
• insomnia and sleeping problems
• anxiety about minor issues
• a sense of guilt, which may be misplaced
• eating more or eating less
• weight loss or weight gain
• extreme tiredness, fatigue and listlessness
• an inability to enjoy activities or interests that usually give pleasure
• difficulty focusing and remembering
• sensitivity to noises, smells and other things that others may not notice
• inability to face going to work or school, possibly leading to underperformance
In severe cases, the individual may think about ending their life, and they may act on these thoughts.
• Psychosis–
If a high or low episode is very intense, the person may experience psychosis. They may have trouble differentiating between fantasy and reality. Psychosis symptoms during a high include hallucinations, which involve hearing or seeing things that are not there and delusions, which are false but strongly felt beliefs. A person who experiences delusions may believe they are famous, have high ranking, social connections or have special powers.
During a depressive or low episode, they may believe they have committed a crime or are ruined and penniless.
Causes-
The exact cause of bipolar disorder is unknown, but several factors may be involved, such as –
• Biological differences –
People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
• Genetics –
Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition.
• Environmental factors –
Life events, such as abuse, mental stress, a significant loss or another traumatic event, may trigger an initial episode in a susceptible person.
Risk Factors –

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include –
• Having a first-degree relative, such as a parent a sibling, with bipolar disorder
• periods of high stress, such as the death of a loved one or other traumatic event
• drug or alcohol abuse
Complications –
Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as –
• Problems related to drug and alcohol use
• Suicide or suicide attempts
• Legal or financial problems
• Damaged relationships
• Poor work or school performance
Diagnosis –

To determine if you have bipolar disorder, your evaluation may include-
• Physical exam
• Psychiatric assessment
• Mood charting
• Match symptoms with criteria for bipolar disorder
Treatment-

Treatment aims to stabilize the person’s mood and reduce the severity of symptoms. The goal is to help the person function effectively in daily life. Treatment involves a combination of therapies including –
• medication
• counseling
• physical intervention
• lifestlyle remedies
Drug Treatment –
Drug treatment can help stabilize mood and manage symptoms. A doctor will often prescribe a combination of –
• mood stabilizers, such as lithium
• antidepressants
• second generation antipsychotics
• anticonvulsants to relieve mania
• medication to help with sleep or anxiety
Psychotherapy and counselling –

Through Cognitive- behaviour therapy (CBT) and other approaches, the individual can learn to –
• recognize and take steps to manage key triggers, such as stress
• identify early symptoms of an episode and take steps to manage it
• work on factors that help maintain a stable mood for as long as possible
• engage the help of family members, teachers and colleagues
These steps can help a person maintain positive relationships at home and work.
Hospital treatment-
Some people may need to spend time in the hospital if there is a risk of them harming themselves or others. If other treatments have not helped, a doctor may prescribe electroconvulsive therapy (ECT).
Lifestyle remedies-
Some lifestlyle choices can help maintain a stable mood and manage symptoms. These include –
• maintaining a regular routine
• following a healthful and varied diet
• establishing a regular sleep pattern and taking steps to prevent sleep disturbance
• getting regular exercise
Ayurvedic Perspective –
Bipolar disorder manifests due to imbalance of the physical doshas vata, pitta and kapha and the mental properties satva, rajas and tamas.
Miraculous Procedures –
• Abhyanga –