Everything you need to know about bipolar disorder

Bipolar disorder is a mental health condition characterized by intense mood swings that significantly impact daily life. Individuals with bipolar disorder often experience extreme highs, known as mania or hypomania, and lows, known as depression. However, the nature of these mood swings and the speed at which one transitions between high and low moods vary from person to person.

People with bipolar disorder may undergo mood shifts that seem disconnected from their surroundings, disrupting their ability to function in everyday life.

This condition typically manifests in late teens or early twenties, and symptoms may differ between teenagers, children, and adults. What are the signs and symptoms? Individuals with bipolar disorder oscillate between depressive and manic episodes.

While not everyone with bipolar disorder experiences major depressive episodes, many do. These episodes usually share symptoms with major depressive disorder, including:

• Persistent low mood, often accompanied by feelings of sadness or emptiness
• Fatigue or low energy levels
• Loss of interest in activities, hobbies, or previously enjoyable things
• Feelings of worthlessness or guilt
• Changes in appetite or significant weight fluctuations
• Disturbed sleep patterns, either sleeping excessively or struggling with insomnia
• Difficulty concentrating, focusing, or feeling motivated- Challenges in decision-making
• Suicidal thoughts.

Mania

Mania involves a sustained period marked by heightened energy, impulsivity, and euphoria, lasting over a week. During manic episodes, individuals may experience:

• Elevated self-esteem or a sense of invincibility
• ncreased energy levels- Reduced need for sleep- Heightened goal-oriented behavior, often leading to staying awake all night to accomplish tasks
• Anxiety, racing thoughts, or irritability
• Increased creativity, leading to starting new projects or taking up new hobbies
• Paranoia or psychosis- Impulsive or risk
• taking behavior, such as excessive spending, quitting work impulsively, substance abuse, dangerous sexual activity, speeding, or spontaneous trips
• Excessive use of social media or significant changes in contact with family and friends.

Hypomania

Hypomania mirrors many of the above symptoms but is typically less severe and of shorter duration than mania. Individuals experiencing hypomania may have increased energy, engage in risk-taking behavior, become easily distracted, and undergo changes in self-esteem. While other symptoms may also manifest, they usually do not disrupt daily activities such as work or school.

Bipolar disorder encompasses various types distinguished by the presence of mania, hypomania, and depressive episodes. The duration and intensity of these episodes determine the specific diagnosis:

Bipolar I

Bipolar I is characterized by severe manic episodes that significantly impact daily functioning and can last a week or more. Individuals with this type may also experience psychotic episodes and are more likely to require hospitalization.

Bipolar II

Bipolar II involves mood and functionality-altering symptoms, primarily hypomania rather than mania. While hypomania's symptoms are noticeable to the individual and those around them, they do not typically interfere significantly with day-to-day life. Bipolar II episodes consist of shorter hypomanic periods and longer depressive episodes. A diagnosis requires at least one hypomanic episode lasting at least four days and one depressive episode lasting two weeks or more.

Cyclothymic Disorder

Cyclothymic disorder features milder but prolonged symptoms of hypomania and depression, occurring frequently without defined episodes. Individuals with this disorder seldom experience symptom-free periods. Diagnosis requires ongoing hypomania and depression symptoms over at least two years, with intervals of less than two months without symptoms.

Other Types of Bipolar Disorder

Other less common types include substance/medication-induced bipolar disorder, bipolar and related disorder due to another medical condition, other specified bipolar and related disorder, and unspecified bipolar and related disorder.

Alongside these types, bipolar disorder diagnoses can include specifiers, descriptors that explain specific symptoms but do not constitute separate diagnoses. Specifiers include characteristics like anxious distress, mixed features, rapid cycling, melancholic features, atypical features, mood-congruent psychotic features, mood-incongruent psychotic features, catatonia, peripartum onset, and seasonal patterns.

The exact cause of bipolar disorder remains complex and multifaceted. Several factors contribute to its development, including genetics, brain chemical imbalances, environmental influences, and social experiences such as trauma, stress, or substance abuse.

Genetics

Although no single 'bipolar gene' exists, a family history of bipolar disorder increases an individual's likelihood of developing the condition. While genes do not solely cause bipolar disorder, they play a significant role, accounting for about 80% of the condition's cause.

Chemical Imbalances

Bipolar disorder may involve imbalances in neurotransmitters like serotonin, dopamine, acetylcholine, adrenaline, and gamma-aminobutyric acid (GABA). Abnormal levels of these neurotransmitters can lead to dramatic mood swings.

Environmental Factors

Individuals predisposed to bipolar disorder due to genetics or chemical imbalances may experience triggers from environmental stressors. Stressful life events, such as relationship breakdowns, work-related stress, poverty, assault, or childhood trauma, can initiate or exacerbate bipolar-related episodes.

Bipolar disorder is typically managed through a combination of medication and psychological therapies, with psychological therapy often used alongside medication.

Psychological Therapy

Psychological therapies aid in managing day-to-day life, helping individuals recognize mood changes, improve depressive symptoms, and establish routines and healthy sleep patterns.

Common psychological therapies include cognitive behavioral therapy (CBT), psychoeducation, interpersonal therapy, and social rhythm therapy. The most suitable therapy varies from person to person, and finding the right approach may require some trial and error.

Medication

Several medications, such as mood stabilizers, antipsychotics, and antidepressants, are utilized to manage bipolar disorder. Psychiatrists, specialists in mental health, prescribe these medications after evaluating the individual's specific needs.

Adhering to prescribed medication is vital, even if symptoms improve, as discontinuing medication prematurely can disrupt progress. If issues arise, such as side effects, it's crucial to discuss concerns with the prescribing doctor.

If you suspect you have bipolar disorder or another mental health condition linked to bipolar disorder, consult your general practitioner (GP). Your GP can assess your symptoms, establish a referral, and create a mental health care plan. This plan entitles you to see a psychologist or psychiatrist under the Medicare scheme.

The diagnostic process for bipolar disorder typically spans multiple sessions, during which your moods and symptoms are monitored to accurately identify the specific type of bipolar disorder or related condition you may have.

For additional support, various services, both in-person and online, can provide assistance. Seeking help is the first step toward managing bipolar disorder effectively.