Bipolar disorder is a mood disorder characterized by episodes of mania and depression. Extreme happiness or excitement (mania) and melancholy (depression) are typical symptoms of mood episodes. People with bipolar disorder may have normal moods in between the manic or depressive episodes.
The five types of bipolar disorder are bipolar I, bipolar II, cyclothymic disorder, other specified bipolar and related disorder, and unspecified bipolar and related disorder:
- Bipolar I: Characterized by alternating episodes of severe depression and intense mania. Intense manic episodes may last for 7 or more days and need immediate medical attention. Depressive symptoms may last for about 2 weeks
- Bipolar II: Involves severe depression but less intense mania (hypomania or hypomanic episodes). People with bipolar II tend to get more depressive episodes than those with hypomania.
- Cyclothymic disorder: Characterized by a less severe form of mania and depression. Depression and mania are not as severe as full manic and depressive episodes. Symptoms may last for 2 years.
- Other specified bipolar and related disorder: Refers to a type of bipolar disorder in which there are symptoms that do not fit into the other categories. For example, rapid cycling may occur, where four or more mood episodes occur within 12 months. These episodes must last for some time to be considered distinct episodes. The person may experience four or more episodes of mania or depression in one year.
- Unspecified bipolar and related disorder: Similar to other specified bipolar and related disorder but used when there is not enough information to make a specific diagnosis. The person may experience symptoms of mania and depression at the same time.
What are symptoms of bipolar disorder?
Bipolar disorder does not have a set pattern of symptoms and differs on an individual basis. Patients may feel a particular emotion several times before switching to another state.
Symptoms of mania
- Symptoms are severe enough to interrupt the daily activities of the patient:
- Decreased need for sleep
- Unusual sexual drive
- Patients may feel that they are on the top of the world
- Highly irritable
- Gets distracted easily
- Being loquacious
- Increased energy
- Excessive happiness and excitement
- Perceiving oneself as grand
- Being impulsive
- Making an unrealistic plan
- Drug and alcohol abuse
- Multitasking many activities at once
- Highly risky behavior or reckless thoughts
Symptoms of depression
- Intense melancholy, feeling hopeless and worthless
- Lack of interest in the activities once enjoyed
- Feeling extreme tiredness and fatigue
- Feeling restless
- Sleep problems
- Eating disorder
- Lack of concentration
- Thoughts of suicide and even attempting it
In addition to the above states, there’s a third category known as hypomania, which exhibits symptoms such as mania but with less intensity and duration.
|Manic episode||Depressive episode|
|Feel high, elated, irritable, or touchy||Feel sad, down, empty, worried, or hopeless|
|Feel fidgety or hyper||Feel stuck or restless|
|Have a decreased need for sleep||Have trouble falling asleep, waking up too early, or sleeping too much|
|Having a loss of appetite||May have an increased appetite and weight gain, or may have a reduced appetite|
|Talk in hurry about a lot of different things||Talk very slowly, feel like they have nothing to say, and forget a lot|
|Feel like their thoughts are racing||Have difficulty concentrating or making decisions|
|Think they can do a lot of things at once||Feel unable to do even simple things|
Do risky things that show poor judgment, such as:
Have little interest in almost all activities such as:
|Feel like they are unusually important, talented, or powerful||Feel hopeless or worthless or think about death or suicide|
How is bipolar disorder treated?
Management of bipolar disorder involves a combination of medications and psychotherapy or counseling. Treatment depends on the type of bipolar disorder.
Medications used to treat bipolar disorders include:
- Benzodiazepines: Lorazepam
- Antimanic agents: Lithium
- Anticonvulsants: Carbamazepine and sodium valproate
- First-generation antipsychotics: Haloperidol
- Second-generation antipsychotics: Risperidone
- Dopamine agonists: Pramipexole
- Phenothiazine antipsychotics: Chlorpromazine
In some cases, psychotherapy has proven beneficial in treating mood episodes. Another therapy is psychoeducation in which patients and their families are educated regarding symptoms and importance of medication compliance.
In the case of failed medication and psychotherapy, other methods such as electroconvulsive therapy may be used, in which a small electric current is passed through the brain to treat the disorder.
Recognizing and treating symptoms early are crucial to prevent complications such as addictions and suicide.
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