Bipolar disorder refers to a mental health condition triggering extreme mood swings. Earlier, doctors used to refer to the condition as manic depression. Due to the mental problem, the affected person can experience emotional highs known as hypomania or mania and extreme lows known as depression. Due to depression, you feel hopeless and sad without any reason. You also lose pleasure or interest in almost all activities. Hypomania (less than mania) or mania is the mood shift making you feel full of energy, euphoric, and unusually irritable. Such mood swings can affect your activities like energy, sleep, judgment, activity, inability to think clearly, and behavior.
People affected by the condition can suffer from episodes of mood swings, multiple times a year or rarely. Most people suffering from the condition can experience certain emotional symptoms in between the episodes, while others may not suffer from any symptoms. You can suffer from manic episodes throughout life. It is incurable. But, you can manage the mood swings as well as other symptoms by following a treatment plan devised by the doctor. The treatment with medications and psychotherapy (psychological counseling) can offer better results.
Symptoms Associated With Bipolar Disorder
You need to understand that there are several classifications of bipolar disorders. It may include mania/hypomania and depression. Due to the mental condition, you can observe unpredictable changes in mood and behavior. So, it results in experiencing significant distress along with troubles in your daily life. Here is the classification linked to the condition.
Bipolar I Disorder
A person who has suffered from at least one manic episode preceded or followed by a hypomanic episode or severe depressive episodes. In some people, the manic episodes can lead to psychosis (a break from reality).
Bipolar II disorder
It is the condition with one major depressive episode along with at least one hypomanic episode. But, the affected person does not suffer a manic episode.
Cyclothymic Disorder
When the affected person has suffered for at least two years (in children or teenagers just one year) of several periods of hypomania episodes along with periods of depressive symptoms, the condition is known as a cyclothymic disorder. The depressive episodes during the condition are less severe than major depression.
 Other Types Of Bipolar Disorder
It includes the episodes suffered due to intake of certain drugs or consumption of alcohol. Some people suffering from underlying medical issues like Cushing’s disease, stroke, or multiple sclerosis can suffer from the episodes.
Bipolar II is not the mild form of bipolar I disorder. They are different. The person affected by bipolar I can suffer from severe and dangerous manic episodes while people suffering from bipolar II feel depressed for a long time. It also causes considerable impairment. While bipolar disorder can affect people at any age, it is more prominent in teenagers and early twenties. The symptoms of the condition vary from one person to another and also over time.
Understanding Mania And Hypomania
You may feel that mania and hypomania are the same, but they are distinct. While they may have similar symptoms, mania is more severe compared to hypomania. So, mania can trigger noticeable issues at school, work, and social activities. It also triggers relationship problems. Mania also causes the affected person to suffer from psychosis, which requires hospitalization. When a person suffers from manic or hypomanic episodes, they can exhibit three or more of the symptoms:
- Increased energy, activity, or feel agitated
- Abnormally jumpy, upbeat, or weird
- Euphoria or exaggerated sense of self-confidence and well-being
- Decreased need for sleep
- Easily distracted
- Unusual talkativeness
- Racing thoughts
- Poor decision making
Major Depressive Episode Due To Bipolar Disorder
An affected person can suffer from a major depressive episode. The episode can make it difficult to perform day-to-day activities due to its severity. So, it starts affecting the school, work, relationships, and social activities. You suffer from a major depressive episode when you exhibit five or more of the symptoms:
- Feeling depressed with signs like sadness, emptiness, hopelessness, and feeling tearful (in children depressed mood appears as irritability)
- Feeling no pleasure or interest in almost all activities
- Sudden loss or increase of weight due to decreased or increased appetite (In children, the sign of depression includes failure to gain weight)
- Either insomnia or sleeping too much
- Either restlessness or slowed behavior
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Thinking about, planning, or attempting suicide
Other features of bipolar disorder
Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis, or others. The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. Besides, bipolar symptoms may occur during pregnancy or change with the seasons.
Symptoms In Children And Teens
In children and teens, it is difficult to identify the bipolar disorder. It is hard to determine if the symptoms are normal ups and downs, the result of excess stress, or the symptoms of any other mental illness. The symptoms in teen and children have a distinct manic, major depressive, or hypomanic episodes, but it differs from the signs exhibited by the adults. Children can suffer from the rapid shift in their moods or have periods without mood symptoms between manic episodes. Severe mood swings distinctive from usual mood swings indicate the presence of the condition.
When To See A Doctor For Bipolar Disorder
Despite experiencing mood extremes, many people affected by the mental illness may not recognize the extent of the emotional instability in their life. They never get the treatment necessary and the condition starts disrupting their life and the life of their loved ones. Affected people can experience cycles of euphoria and then a productive period. After the euphoria, you suffer from an emotional crash triggering depression, a worn-out feeling, relationship issues, and financial troubles. Since bipolar disorder does not resolve without treatment, you need to get treatment from a mental health professional with experience to treat the condition. With professional help, you can control the symptoms. Emergency help is needed when affected people suffer from suicidal thoughts.
Causes Of Bipolar Disorder
The exact cause of the condition remains unclear. Several factors can trigger mental illness. Some of them are:
Biological Differences Triggering Bipolar Disorder
Affected people suffer from physical changes in their brains. The significance of such changes remains uncertain. But, in the future, it may help pinpoint the exact cause leading to mental illness.
 Genetics
People with close relatives suffering from bipolar disorder can suffer from mental illness. So, people with first degree relatives suffering from the condition like a parent or sibling can develop a mental illness. Researchers are trying to find the exact genes triggering the problem.
 Risk Factors Associated With Bipolar Disorder
Certain factors increase the risk of developing the mental condition or can act as a trigger for the initial episode. Here are the factors:
- Having a close relative with the disorder
- Suffer from a period of extreme stress (like a traumatic episode or death of a loved one)
- Substance or alcohol abuse
Complications Due To Bipolar Disorder
Without treatment, bipolar disorder can result in several serious problems. Such problems will affect all the areas of normal life. So, people can suffer from the following:
- Suicidal thoughts leading to attempted suicide or suicide
- Alcohol or drugs dependency
- Financial or legal problems
- Damaged relationships
- Poor performance in work or school
- Co-occurring Conditions Linked To Bipolar Disorder
People who suffer from bipolar disorder can also suffer from other health conditions. Such conditions need treatment along with manic episodes. Certain conditions worsen the episodes or offer no relief to the people. The condition occurring along with the mental disorder includes:
- Eating disorders
- Anxiety disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Drug or alcohol problems
- Physical health problems like thyroid problems, heart disease, obesity, or headache
Diagnosing Bipolar Disorder
Diagnosing the condition is possible only with medical help. So, you need to see a specialized doctor for evaluation. Here is the diagnostic technique to determine bipolar disorder:
Physical Exam
Your doctor can perform a thorough physical assessment along with different lab tests to identify any medical problems triggering similar symptoms.
Psychiatric Assessment To Diagnose Bipolar Disorder
When you see a physician for the condition, they may refer you to a specialist doctor like a psychiatrist. You have to talk about your feelings, thoughts, and behavior patterns. The doctor will also ask you to fill out a questionnaire or self-assessment form. After asking permission from your family or friends, the doctor will ask them regarding the symptoms you exhibit.
Mood Charting
The doctor will ask you to keep a record of the moods daily. You must also note the sleep pattern along with other factors to diagnose the problem.
Diagnosis Of Bipolar Disorder In Children
While the same criteria used in adults exist for diagnosing mental illness in children and teenagers, certain symptoms may have a different pattern. So, it may not fit well into the diagnostic criteria.
Also, children who have bipolar disorder are frequently diagnosed with other mental health conditions such as attention-deficit/hyperactivity disorder (ADHD) or behavior problems, which can make diagnosis more complicated. Referral to a child psychiatrist with experience in bipolar disorder is recommended.
Treatment For Bipolar Disorder
Treatment for manic episodes is treated by specialized doctors. So, you need to seek the assistance of a mental health specialist like a psychiatrist who can treat the condition and the related disorders. You may require a treatment team consisting of a psychologist, a psychiatrist nurse, and a social worker for diagnosing and treating the problem. Remember, the condition can persist for your whole life. The treatment cannot cure the problem, but it manages the symptoms. Your doctor offers customized treatment depending on the needs.
Medications
Medications are prescribed to treat manic episodes. You need to start taking the medication prescribed to balance your moods immediately. The type and dose of the medication prescribed is based on the particular symptoms suffered by the affected person. The medication may include:
Mood Stabilizers For Bipolar Disorder
The doctor can prescribe mood-stabilizing medication. It is used to control the hypomanic or manic episodes.
Antipsychotics
When you suffer from the symptoms of mania or depression after taking other medications, then your doctor can prescribe antipsychotic drugs to manage the condition better. You can take it along with a mood stabilizer or alone. Follow the doctor’s orders to ensure you get better results.
Antidepressants For Bipolar Disorder
Bipolar disorder can trigger depression. So, the doctor can add an antidepressant to manage the symptoms. But, taking antidepressants can at times trigger a manic episode. Therefore, the doctor prescribes it along with an antipsychotic or mood stabilizer.
Antidepressant-Antipsychotic
Some doctors prescribe medication combining antidepressant and antipsychotic drugs for managing depression. It also acts as a mood stabilizer. Medications like Symbyax combine fluoxetine (an antidepressant) and olanzapine (antipsychotic) are prescribed for this purpose.
Anti-Anxiety Medications
To improve sleep and deal with anxiety, the doctor can prescribe anti-anxiety medication. But, you must only take it for a short time.
The Right Medication For Bipolar Disorder
Finding the right medication or the combination of medication to treat your condition takes some trial and error. You need to try different medications to find the right one working well to manage your condition. So, it requires patience as some medications take some time (from weeks to months) to see the full effect. Your doctor will change only one medication at a time to help identify the exact medication offering relief with the least troublesome side effects. As your symptoms change, the doctor adjusts the medications.
Side Effects Of Medications
When you find the right medication along with the correct dose, mild side effects may go away. Your body will adjust to the medication. But, you need to talk to the mental health provider when you suffer from bothersome side effects. Never stop or make changes in the medication dose as it can cause more harm than good. If you are thinking of changing medication, then consult the doctor and work with the medical professional to work on the right dose that does not make you uncomfortable.
Medications For Bipolar Disorder And Pregnancy
Taking medications for bipolar disorder during pregnancy can result in birth defects. Also, the medication can pass through breast milk to the baby. Certain medications like divalproex sodium and valproic acid are not used during pregnancy due to its severe side effects. People taking birth control medication need to know that when combined with the medication for manic episodes, the birth control medication loses its effectiveness. So, you need to discuss the options of taking the right medications with the doctor before you become pregnant. Also, if you are taking medications to manage manic episodes and think you are pregnant, then see your doctor immediately.
Psychotherapy For Bipolar Disorder
Psychotherapy is the most significant part of the treatment plan to manage manic episodes. It is provided in an individual, group, or family setting. The different treatment plans include:
Interpersonal And Social Rhythm Therapy (IPSRT)
The treatment focuses on the stabilization of daily rhythms like waking time, sleeping, and mealtimes. You need to follow a consistent routine for managing the mood. Establishing a daily routine can manage the symptoms better.
Cognitive Behavioral Therapy (CBT) For Bipolar Therapy
The therapy focuses on identifying negative, unhealthy behavior and beliefs. It is then replaced with healthy and positive ones. CBT can identify the triggers leading to the manic episodes and learn the strategies to cope with them. You also learn to manage stress.
Psychoeducation
Learning about the condition will help you and your loved ones understand it more. With better knowledge, you get good support. It becomes easier to identify problems and develop a plan to avoid relapses while sticking with the treatment.
Family-Focused Therapy
It is a part of psychotherapy involving the family. Good communication and family support will help you stick to the treatment plan. It helps the loved ones learn about your problem and manage warning signs to deal with the condition better.
Substance Abuse Treatment
Some people suffering from manic episodes are addicted to alcohol and drugs. In such cases, substance abuse treatment is suggested by the doctor as the first line of treatment. Without managing substance abuse, it is difficult to manage the symptoms associated with manic episodes.
 Other Treatment Options For Severe Cases
For severe cases, depending on the needs of the patient, the doctor can suggest other treatments. Most of the treatments mentioned focused on managing depression.
Hospitalization For Bipolar Disorder
People who are behaving dangerously need emergency medical help. Hospitalization is required when the affected person becomes psychotic (detached from reality) or feels suicidal. Therefore, such people need treatment in a psychiatric hospital to stabilize the mood of the person and make them feel calm as well as safe.
Electroconvulsive Therapy (ECT)
For people having no success with medications and cannot take antidepressants due to health issues or high risk of suicide, the doctor suggests ECT. During the therapy, a brief seizure is triggered by passing electrical currents through the brain. It will result in brain chemistry changes, which reverses symptoms linked to certain mental illnesses.
Continued Therapy
To control manic episodes, you need to undergo lifelong treatment with medications. You may feel better, but you require medications. When you skip maintenance treatment, you face a high risk of relapse of symptoms. Without continued treatment, your minor mood change can escalate to full-blown depression or mania. Your doctor can also recommend a day treatment program to get the necessary support and counseling for managing the symptoms.
Treatment For Bipolar Disorder In Children And Teenagers
When children and teenagers suffer from bipolar disorder, the doctor decides on the treatment on a case-by-case basis. So, the appropriate treatment depends on the symptoms, side effects of medicines, and other factors. The treatment suggested for this group are:
Medications
The medication prescribed is similar to the ones suggested for adults. But, the safety and effectiveness of the medication on teenagers and children are not researched well. So, treatment decisions are usually based on adult research.
Psychotherapy
Children and teenagers need initial as well as long-term therapy can prevent the symptoms from returning. With psychotherapy, children and teenagers can manage their routine, address learning problems, develop coping skills, overcome the social problem, and form family bonds with good communication. Older children and teens suffering from a substance abuse problem can get the necessary treatment to manage the problem.
 Psychoeducation For Teenagers
It is important to distinguish the symptoms associated with manic episodes and the behavioral issues related to their development. Understanding the symptoms of the manic episodes will help get the necessary support to the child early.
Support For Bipolar Disorder
Teenagers and growing children can get support by working together with the teachers as well as school counselors. But, strong support from the family and friends can help children manage the symptoms and get greater success.
Living With Bipolar Disorder
You need to understand it is an incurable condition. The treatments are usually focused on managing the symptoms like the change in the modes. To get the most from the treatment, you need to get assistance from a care team. A team consisting of your primary physician, psychologist, and psychiatrist can help you cope with the symptoms. They offer medications and other therapy options to cope with the condition. You need to have a strong support system to live with the disease. So, you need to connect with other people living with the disorder to discuss the symptoms and get help when needed.
Finding the right treatment for managing your symptoms requires perseverance. One treatment may not fit all. So, you need to work with your doctor and have the patience to manage the disorder. You need to monitor the mood changes and learn to take the right measures to manage the problem. Work with your care team to live a happy, normal, and healthy life.
Preventing Bipolar Disorder
You no sure method to prevent bipolar disorder. The only way to manage the problem is by getting treatment when you start observing the early signs. It applies to all mental health conditions. So, with early medical intervention, you can prevent complications associated with them. Always follow your medical practitioner’s suggestion when diagnosed with a mental health condition. Here are some of the strategies preventing the minor signs from becoming full-blown episodes of depression or mania:
Pay Attention To Warning Signs
When you see the symptoms, addressing them early on can prevent the episodes from getting worse. Try to find the pattern of such maniac episodes and the trigger causing them. It helps get necessary medical help when you feel like falling into an episode of mania or depression. For tracking the pattern of the episodes, you can involve the family members or friends. They can act as a support system and warn you when the warning signs occur.
Avoid Drugs And Alcohol
The use of alcohol and drugs will only intensify manic episodes. It is because of the sedating effects of alcohol and drugs. So, with each swig of alcohol or intake of recreational drugs, you are increasing the risk of worse episodes of the condition. Since drugs and alcohol increase the severity of mania, many people suffering from it find it extremely pleasurable. So, they become addicted to it. It is better to avoid alcohol or recreational drugs. They worsen the symptoms and increase the chances of recurrence.
Follow Instructions Of A Doctor
You need to take medications as directed by the doctor. Many times, you may feel like stopping the treatment. But, never stop the treatment. Stopping the treatment altogether or reducing the dose of the medication without consulting the doctor can do more harm than good. You can suffer from withdrawal symptoms due to the decision or observe worsening of the condition. Not following the instructions can also increase the chances of recurrence.
Exercise
Do you know exercise can ease hypomanic symptoms? Including exercises will ensure great benefits, Hypomanic symptoms that are less severe compared to manic symptoms can ease with regular exercise. Exercising regularly will help you sleep better. It will offer a calming effect for some people.
Eat A Balanced Diet
You need to eat a balanced diet to get all the essential nutrients. You can make some changes in the diet to manage manic episodes better. Remember, the foods you consume may not cure the condition, but choosing the right ones will help you feel better. You can also handle the condition effectively.
Get Adequate Sleep
While the hypomanic usually gloats over how little sleep he needs, getting by on 3 to 4 hours a night, the lack of quality sleep can wreak havoc on his mood and decision-making abilities. Sleep deprivation results in feelings of malaise, poor concentration, and moodiness, and even accidental deaths. You need to have a good night’s sleep, and keep a consistent schedule. This can help reduce minor mood swings that can lead to more severe episodes of mania.
Manage Stress
Suffering from stress can worsen manic symptoms. So, you are more prone to relapse in symptoms. So, people facing a high risk of manic episodes need to learn stress management techniques. You need to take time to care for yourself. Make some lifestyle choices to avoid stress. Even when it is hard to make such decisions, you need to take proactive steps to deal with negative emotions.
Have An Action Plan
It is better to have an action plan to manage manic episodes. You can consult with your loved ones to support you by following the action plan. It will keep you away from harm and avoid complications during manic episodes.
Conclusion
For most people, a good treatment program can stabilize severe moods and provide effective symptom relief. Continual treatment has proven more effective in preventing relapses. Those who also have a substance abuse problem may need more specialized treatment. With early medical intervention, it is possible to manage the symptoms and lead a good life.
References
https://www.medicalnewstoday.com/articles/37010
https://www.healthline.com/health/bipolar-disorder#What-is-bipolar-disorder?
https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955