What is bipolar disorder?
Raman, an IT professional shared this story: “My colleague behaves strangely sometimes. He becomes ecstatic for a moment, speaks continuously on random topics, or sometimes boasts of highly ambitious plans like owning a company and making millions of dollars. But after a few days, he becomes extremely quiet, does not interact with anyone or complete his work on time.
Once, when we were out for a team lunch, he threw the plate at the waiter because his order was not brought on time. We were shocked at his behavior. Over time, his behavior became unpredictable and it affected his work and relationship with colleagues. Eventually, he was asked to leave the organization.
I was really curious to know why he was behaving in such a manner and after speaking to my family doctor, I understood that my colleague was suffering from bipolar disorder.”
This fictional narrative has been constructed to aid the understanding of this disorder by placing it in a real life situation.
Bipolar disorder, (also known as manic depression) is a serious mental illness that causes unusual and severe mood changes. The person may experience 'highs' (clinically known as mania) and 'lows' (known as depression), which may persist for a few days or many weeks. The person may experience distinct episodes of mania and depression, and these episodes may switch rapidly, even multiple times in one week.
A person with severe bipolar disorder may also have psychotic symptoms such as hallucinations or delusions and may even have thoughts of self-harm or suicide. Bipolar disorder can inhibit the person's ability to function normally in daily life, and can result in damaged relationships, both professional and personal.
Note: Bipolar disorder, like heart disease or diabetes, is a long-term illness that needs to be managed throughout life.
What is not bipolar disorder
All of us experience mood swings and ecstatic feelings now and then, but they may not affect our daily activities. This is not bipolar disorder.
Depression also is not bipolar disorder although some symptoms of both conditions are similar. The main difference is that in bipolar disorder, there are episodes of both mania and depression, as well as extreme mood swings.
What are the symptoms of bipolar disorder?
People with bipolar disorder exhibit two sets of symptoms during the depressive and manic phases.
Manic phase: During periods of mania, the person behaves impulsively, makes decisions without proper judgment, and takes unusual risks. Also, the person ignores or is unaware of any negative consequences of their unpredictable actions.
Depressed phase: During the depressive phase, the person may experience the following:
In case you observe any of these symptoms in someone you know, you can encourage them to consult a mental health expert.
What causes bipolar disorder?
The exact cause of bipolar disorder is still unknown. It is observed that bipolar disorder usually starts during teenage or adolescence. Due to lack of knowledge about the disorder, most people with bipolar disorder suffer for a long time before seeking help.
Possible risk factors could be hormonal imbalance, genetics, extreme trauma due to tragic incident, drugs or substance abuse. Bipolar disorder can co-exist with other illnesses such as acute depression with psychosis or schizophrenia.
Types of bipolar disorder
There are four basic types of bipolar disorder:
Bipolar I Disorder: Manic or mixed episodes that persist for at least seven days, or severe manic symptoms that requires the person to be hospitalized immediately. Also, depressive episodes occur that may persist for at least two weeks.
Bipolar II Disorder: A combination of depressive episodes and hypomanic episodes, but no predominant manic or mixed episodes.
Bipolar Disorder Not Otherwise Specified (BP-NOS): Diagnosed when symptoms of the illness exist but do not meet diagnostic criteria for either bipolar I or II. However, the symptoms are clearly out of the person’s normal range of behavior.
Cyclothymic Disorder or Cyclothymia: A mild form of bipolar disorder where episodes of hypomania and mild depression may persist for at least two years.
Coexisting conditions with bipolar disorder
In some cases, bipolar disorder can co-exist with other disorders such as schizophrenia or severe depression. Also, a person with bipolar disorder may be at a higher risk of thyroid, diabetes, or some other physiological illness.
How is bipolar disorder diagnosed?
Bipolar disorder is often mistaken for schizophrenia or depression due to the similarity in symptoms. Abnormal mood elevation (mania or hypomania) is the most predominant symptom of bipolar disorder.
The mental health expert conducts several tests and assessments to diagnose the condition correctly, and to rule out other underlying problems which could be causing these symptoms. To assess the severity of the symptoms, the expert may ask the person to maintain a daily record of their mood changes, sleep patterns and details of daily activities that could help in prescribing the appropriate treatment.
A psychologist evaluates the person's thoughts, feelings and emotions. The expert may also speak to the family members to collect more information about the person's condition. A psychological self-assessment may also be conducted to analyze the severity of the disorder.
Getting treatment for bipolar disorder
Bipolar disorder, like diabetes or heart disease, is a long-term condition and needs to be managed through a person's lifetime. Proper diagnosis and treatment can help a person lead a healthy and productive life. Treatment can make an enormous difference by reducing the frequency and severity of episodes. A combination of medication, therapy and counseling (cognitive behavior therapy) can be very effective in treating bipolar disorder. Treatment may vary depending on the age, medical history, severity of the condition, or the person's tolerance to medication.
Not getting treatment, or discontinuing the existing treatment or medication can actually worsen the condition or cause a relapse. In some cases, the symptoms may get triggered unexpectedly and the person may not even be aware of it or be able to control it.
The main purpose of the treatment is to:
Note: Some of these symptoms are also seen in depression and schizophrenia. Hence, it is very important to get a thorough assessment and diagnosis from a mental health expert and then proceed with the prescribed treatment.
Important: A person with bipolar disorder may be at a high risk of suicide. Hence, treatment must be started at the earliest.
Coping with bipolar disorder
Bipolar disorder can impact every aspect of your life. Accepting the fact that you have bipolar disorder and learning as much as possible about it can help you cope with the condition.
Caring for someone with bipolar disorder
If you know someone with bipolar disorder, encourage them to consult a mental health expert and get treatment. The person may not be willing to accept that they have a problem. In such a situation, you may have to meet the doctor first and then take the person along.
Caring for the caregiver
Caregivers also undergo a lot of stress and emotional turmoil. Most often, women caregivers feel a lot more stressed, exhausted, and anxious than their male counterparts and may be at risk of developing depression. Caregivers are so concerned about their loved one's health that they forget to take care of themselves.
As a caregiver, you may need help if you are:
Hence, it is very important that you take care of your physical and mental health. It will be beneficial if you can do some of the following: