Key Types and Causes of Bipolar Disorder
Bipolar Affective Disorder or Manic-depressive disorder (MDD), often known as Bipolar Disorder (BD), is a chronic and complicated mood illness characterised by a mix of manic, hypomanic, and depressive episodes, as well as subsyndromal symptoms present in the interim. It is one of the primary causes of disability and morbidity around the world. Bipolar Mood Disorder has been linked to major medical and psychiatric complications, early mortality, significant degrees of functional disability, and a poor quality of life.
Types of Bipolar Disorder
Bipolar disorder is categorised into Bipolar disorder I (BD I) and Bipolar disorder II (BD II). The manifestation of at least one manic episode is the defining feature of BD I; whereas depressive episodes are prevalent, only one manic episode in a lifetime is sufficient to diagnose BD I. One must have at least one hypomanic episode without a history of manic episodes to be diagnosed with BD II. Both of these manifestations must occur in the absence of any substance, iatrogenic agent, or organicity since existing associations would indicate a diagnosis of drug/medication-induced bipolar and associated disorder’ and 'bipolar and related disorder due to another medical condition', respectively.
Causes of Bipolar Disorder
Bipolar disorder is most commonly detected in late adolescence or early adulthood. Bipolar symptoms might arise in children on occasion. Bipolar disorder can develop during a woman's pregnancy or after she gives birth. Bipolar Disorder normally necessitates lifetime therapy, despite the fact that the symptoms may change over time. People can manage their symptoms and enhance their quality of life by following a specified treatment plan.
Risk Factors
The reasons for bipolar disorder are being investigated by scientists. Most experts agree that there is no single cause and that a person's risk of developing the illness is likely to be influenced by a number of factors.
Brain Structure and Functioning: According to various researches, people with bipolar disorder have brains that are different from persons who do not have a bipolar illness or any other mental condition. Understanding these distinctions may aid scientists in better understanding bipolar disease and determining which treatments will be most effective. At this moment, health care clinicians rely on a person's symptoms and history rather than brain imaging or other diagnostic procedures to make a diagnosis and treatment plan.
Genetics: According to some study, those who carry particular genes are more prone to develop bipolar disorder. People who have a parent or sibling with bipolar disorder have a higher risk of developing the disease themselves, according to research. There are numerous genes involved, and no single gene can be blamed for the condition. Researchers may be able to design novel treatments by learning more about how genes play a role in bipolar disease.
Bipolar Disorder Symptoms
Signs of Bipolar Disorder: People with bipolar illness have times of exceptionally high mood, changes in sleep patterns and activity levels, and uncommon actions, which they don't always recognise as harmful or undesired. The term "mood episodes" refers to these separate intervals. Mood episodes deviate significantly from the person's normal moods and behaviours. Symptoms last for most of the day every day during an episode. Longer episodes, such as several days or weeks, are also possible.
Bipolar Symptoms For Different Episodes:
Those experiencing a manic episode may-
Feel angry, or touchy, or feel exceedingly "up," "high," or elated.
Feeling "jittery" or "wired"
Have a loss of appetite and a decreased need for sleep
Talk quickly on a wide range of topics.
Feel as if their minds are rushing
They believe they can do a lot of things at the same time.
Do things that show poor judgement like excessively eat and drink, spend or give away a lot of money, or engage in unsafe sex
They have the impression that they are unusually important, brilliant, or powerful.
Those Experiencing a Depressive Episode Start-
Feeling gloomy, depressed, empty, worried, or hopeless
Feeling sluggish or restless
Have difficulties going asleep, waking up too early, or sleeping too much
Have a higher appetite and gain weight
They speak slowly as if they had nothing to say, and they frequently forget things.
Have difficulty focusing or making decisions
Feeling unable to complete even the most basic tasks
Have a low interest in practically all activities, a low or absent sex drive, or an inability to enjoy pleasure (“anhedonia”)
Feeling forlorn or unworthy, contemplating death or suicide.
In some cases, persons have both manic and depressed symptoms at the same time. An episode with mixed features is the name given to this type of episode. People who are experiencing a mixed-feature episode may feel depressed, empty, or hopeless while also feeling incredibly invigorated.
Even if a person's symptoms aren't as severe as others, they may have bipolar disorder. Hypomania, a milder version of mania, is experienced by certain people with bipolar illness (Bipolar II). During a hypomanic episode, a person may feel great, be able to accomplish tasks, and function normally. Although the individual may not notice anything is wrong, family and friends may notice changes in mood or activity levels that indicate bipolar illness. People with hypomania can develop severe mania or depression if they are not treated properly.
Diagnosis of Bipolar Disorder
People with bipolar disorder can live healthy and productive lives with the right diagnosis and treatment. The first step is to speak with a doctor or other professional health care practitioner. To rule out other illnesses, the health care practitioner can perform a physical examination and order the required medical tests. The health care provider may then conduct a mental health evaluation or refer you to a skilled mental health care provider with experience diagnosing and treating bipolar illness, such as a psychiatrist, psychologist, or clinical social worker.
Bipolar disorder is diagnosed by mental health professionals based on a person's symptoms, past experiences, and, in certain circumstances, family history. The importance of accurate diagnosis in children and adolescents cannot be overstated.
Bipolar Disorder and Other Conditions
Because certain Bipolar Disorder Symptoms are similar to those of other disorders, it can be difficult for a doctor to make a diagnosis. Furthermore, many persons with bipolar disorder also have another mental illness or disease, such as anxiety, substance abuse, or an eating issue. Thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical problems are more common in people with bipolar disorder.
Psychosis:
Psychotic symptoms, such as hallucinations or delusions, can occur in people who are suffering from extreme mania or depression. The psychotic symptoms usually correspond to the person's low mood. Consider the following scenario:
During a manic episode, people who are experiencing psychotic symptoms may have the irrational idea that they are famous, wealthy, or possess exceptional abilities.
People experiencing psychotic symptoms during a depressive episode may mistakenly feel they are bankrupt and penniless, that they have committed a crime, or that they are suffering from an undiagnosed medical illness.
As a result, bipolar illness patients with psychotic symptoms are occasionally misdiagnosed as having schizophrenia. When persons exhibit bipolar disorder symptoms and also have bouts of psychosis that are independent of mood episodes, schizoaffective disorder may be the correct diagnosis.
Anxiety: It's not uncommon for people with bipolar disorder to also suffer from anxiety.
Attention-Deficit Hyperactivity Disorder (ADHD): People with bipolar disorder are more likely to have ADHD.
Misuse of Drugs or Alcohol: During manic periods, people with bipolar disorder may abuse alcohol or drugs, as well as engage in other high-risk behaviours. Although the negative consequences of alcohol or drug abuse may be most obvious to family, friends, and healthcare providers, it is critical to recognise the presence of a mental condition.
Eating Disorders: Bipolar disorder is sometimes accompanied by an eating issue, such as binge eating or bulimia.
Bipolar Disorder Treatment
Many people, including those with the most severe forms of bipolar disease, can benefit from treatment. Medication and psychotherapy, commonly known as "talk therapy," are frequently combined in an effective treatment plan.
Bipolar disorder is a chronic illness that lasts a lifetime. Mania and sadness episodes tend to recur over time. Many people with bipolar disorder experience no mood changes in between episodes, however, some people may experience persistent effects. People with these symptoms may benefit from long-term, consistent treatment.
Medication
Certain drugs can aid in the treatment of bipolar disorder symptoms. Some people may need to test a variety of drugs and work with their doctor to identify the ones that work best for them.
Mood stabilisers and second-generation (“atypical”) antipsychotics are commonly used to treat bipolar disorder. Medications for sleep or anxiety may also be included in treatment strategies. Antidepressant medication is frequently prescribed to treat depressive episodes in bipolar disorder, with the antidepressant being combined with a mood stabiliser to avoid precipitating a manic episode.
Those Who are on Medication Should:
speak with their doctor to learn more about the medication's risks and advantages.
Any prescription pharmaceuticals, over-the-counter medications, or supplements they are currently taking should be disclosed to their health care physician.
Any concerns concerning side effects should be immediately reported to a health care professional. The doctor may need to adjust the dosage or try an alternative drug.
Even when one is feeling well, it is important to remember that bipolar disorder medication must be taken consistently and exactly as recommended.
Stopping a medicine without first consulting a doctor is a bad idea. Stopping medication abruptly can cause symptoms of bipolar disorder to "rebound," or worsen.
Psychotherapy
Psychotherapy, sometimes known as "talk therapy," can be an important aspect of a bipolar illness treatment regimen. Psychotherapy is a phrase that refers to a variety of treatment approaches aimed at assisting a person in identifying and changing problematic emotions, ideas, and actions. It can offer persons with bipolar disorder and their family support, education, and guidance. Therapies such as cognitive-behavioural therapy (CBT) and psychoeducation, which are used to treat a number of diseases, may be employed in treatment.
Newer therapies created expressly for the treatment of bipolar disorder, such as interpersonal and social rhythm therapy (IPSRT) and family-focused therapy, may also be used.
Other Treatments
Some patients may benefit from alternative treatments to help them manage their bipolar symptoms, such as:
Electroconvulsive Therapy (ECT):
ECT is a type of brain stimulation that can help patients with bipolar disorder find respite from their symptoms. A person receiving modern ECT usually undergoes a series of treatment sessions spread out over several weeks. ECT is a safe procedure that is performed under general anaesthetic. It's useful for treating severe depressive and manic episodes, which usually happen when medicine and psychotherapy aren't working or aren't safe for the patient. When a quick response is required, such as in the case of suicide risk or catatonia, ECT can be beneficial (a state of unresponsiveness).
Additional research is required to assess the effects of various treatments, such as:
Transcranial Magnetic Stimulation (TMS):
Magnetic waves are used in TMS, a newer method of brain stimulation. It is given to an awake patient on a daily basis for one month. TMS appears to be beneficial for many patients suffering from various types of depression, according to research, although its function in the treatment of bipolar disorder is still being investigated.
Supplements:
Although various nutrients and herbs have been reported to aid, there hasn't been enough research done to fully understand how these nutrients influence persons with bipolar disorder.
All prescription pharmaceuticals, over-the-counter medications, and supplements that a patient is taking must be disclosed to a health care professional. When some drugs and supplements are combined, they can have unfavourable or hazardous side effects.
FAQs on What Is Bipolar Disorder?
1. What is bipolar disorder from a biological perspective?
Bipolar disorder, previously known as manic depression, is a mental health condition characterised by extreme and intense shifts in mood, energy, and activity levels. From a biological standpoint, it is considered a brain disorder. These shifts involve periods of elevated mood known as manic or hypomanic episodes, and periods of low mood, or depressive episodes. These are not typical mood swings but are severe enough to interfere with daily functioning, relationships, and work or school performance.
2. What are the main symptoms that differentiate a manic episode from a depressive episode?
The symptoms of bipolar disorder are defined by the specific mood episode an individual is experiencing. The two primary episodes have distinct characteristics:
Manic Episode Symptoms:
Feeling unusually high, euphoric, or extremely irritable.
Increased energy, activity, and restlessness.
Decreased need for sleep.
Racing thoughts and talking very fast.
Impulsive behaviour and poor judgement, such as spending sprees or reckless decisions.
Depressive Episode Symptoms:
Feeling intense sadness, hopelessness, or worthlessness.
Loss of interest or pleasure in almost all activities.
Significant fatigue and loss of energy.
Difficulty concentrating and making decisions.
Changes in sleep patterns and appetite.
3. What causes bipolar disorder?
While the exact cause of bipolar disorder is not fully understood, it is believed to result from a combination of factors rather than a single cause. Key contributing factors include:
Genetics: The disorder often runs in families, indicating a strong genetic component. Individuals with a first-degree relative with bipolar disorder have a significantly higher risk.
Brain Chemistry and Structure: An imbalance in naturally occurring brain chemicals called neurotransmitters (like serotonin, dopamine, and noradrenaline) is thought to play a crucial role. Differences in brain structure and function have also been observed in individuals with the disorder.
Environmental Factors: Periods of high stress, traumatic events, physical illness, or substance abuse can trigger manic or depressive episodes in a genetically predisposed person.
4. What is the difference between Bipolar I, Bipolar II, and Cyclothymic Disorder?
These are the primary types of bipolar disorder, distinguished by the severity and nature of the mood episodes:
Bipolar I Disorder: Defined by the presence of at least one full manic episode. This manic episode may be preceded or followed by hypomanic or major depressive episodes. The mania is severe and often requires hospitalisation.
Bipolar II Disorder: Defined by a pattern of major depressive episodes and hypomanic episodes. Individuals with Bipolar II have never had a full manic episode. Hypomania is a less severe form of mania.
Cyclothymic Disorder: A milder form of bipolar disorder where individuals experience numerous periods of hypomanic symptoms and depressive symptoms for at least two years. However, the symptoms are not severe enough to meet the criteria for a full hypomanic or depressive episode.
5. How is bipolar disorder diagnosed if there is no specific medical test for it?
Diagnosing bipolar disorder is a comprehensive process, as there is no single blood test or brain scan that can confirm it. A healthcare professional, typically a psychiatrist, will conduct a thorough evaluation that includes:
A physical exam to rule out other medical conditions that could be causing the symptoms.
A psychiatric assessment where the professional will ask detailed questions about thoughts, feelings, and behaviour patterns.
A detailed review of personal and family medical history, including any history of mental illness.
Mood charting, which involves tracking daily moods, sleep patterns, and life events to identify the distinct patterns of highs and lows.
The diagnosis is based on the patient's reported symptoms and their alignment with the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
6. Why is a combination of medication and therapy considered the most effective way to manage bipolar disorder?
A combination approach is the gold standard for treatment because it addresses both the biological and psychological aspects of the disorder. Medication, such as mood stabilisers and antipsychotics, works at a biological level to correct the imbalance of neurotransmitters in the brain, thereby stabilising moods and preventing future episodes. Psychotherapy, such as Cognitive Behavioural Therapy (CBT), helps individuals develop practical coping skills. It teaches them to recognise episode triggers, manage stress, change negative thought patterns, and maintain healthy routines. This dual approach ensures that brain chemistry is managed while the individual is also equipped with the strategies needed to navigate the challenges of the illness, leading to better long-term outcomes.
7. Is bipolar disorder considered a curable condition, and what does long-term management look like?
Bipolar disorder is a chronic, lifelong illness and is not considered 'curable' in the way an infection might be. However, it is a highly treatable and manageable condition. The goal of treatment is not to cure the disorder but to manage the symptoms effectively so that an individual can lead a healthy, stable, and productive life. Long-term management typically involves a continuous and consistent treatment plan, which includes medication, ongoing therapy, and important lifestyle adjustments like maintaining a regular sleep schedule, managing stress, avoiding alcohol and drugs, and building a strong support system of family and friends.
