Bipolar disorder causes a person to experience two different moods:
Periods of mania (feeling excessively happy, impulsive, irritable or irrational) or hypomania (a milder form of mania), and
Periods of major depression (feeling excessively sad).
Bipolar disorder can lead to severe illness and even death by suicide if untreated or treated incorrectly. Several effective treatments are available.
What causes Bipolar Disorder?
The exact cause of bipolar disorder is still uncertain. Studies suggest that it results from an imbalance of chemicals in the brain. These chemicals allow cells to communicate with each other that play an essential role in all brain functions, including movement, sensation, memory and emotions.
People with bipolar disorder typically have cycles of relapse (when depression and/or mania occur) and remissions (when symptoms improve or resolve), often in an alternating pattern.
Family History: People with a family history of bipolar disorder have an increased risk of developing the condition.
Symptoms of Bipolar Disorder
Bipolar Disorder features episodes of mania/hypomania, alternated by depressive episodes.
The person feels abnormally and persistently happy, irritable, hyperactive, impulsive or irrational.
These feelings last for at least one week and may be severe enough to require hospitalisation. Symptoms of mania may include one or more of the following:
• provided that the mania was not caused by other medical conditions or drug abuse;
• feelings of superiority and grandiosity;
• difficulty falling asleep, restlessness;
• excessive talking;
• racing thoughts (“thought pressure”);
• short attention span;
• laughing or joking incessantly; and/or
• inappropriate spending sprees or sexual activity.
Results of Mania:
• Causes a person to have difficulty maintaining relationships with friends and family;
• Interferes with work or other responsibilities;
• During a manic episode, the patient’s mood can change rapidly from euphoria to depression or irritability.
Hypomania is less severe than mania but causes a significant change in mood that is abnormal for the patient.
• Hypomania does not seriously impair the patient’s ability to function or require hospitalisation;
• Hypomania can follow a decreased need for sleep and may lead to a manic or depressive episode.
• It is generally treated with medication.
People with major depression experience significant sadness and difficulty functioning. They are typically depressed most of the day and may have little or no interest in any activity.
Other symptoms may include one or more of the following:
• significant weight loss or gain;
• changes in sleeping patterns, including insomnia or excessive sleeping;
• changes in activity level (including sluggishness, reduced activity or agitation);
• fatigue or loss of energy;
• feelings of worthlessness or guilt;
• difficulty concentrating and making decisions;
• recurring thoughts of death or suicide.
When is it major depression?
To be considered major depression, a patient must have at least five of the above symptoms daily or nearly daily for at least two weeks. In addition, symptoms must not be caused by a medical condition, substance abuse, medication or the loss of a loved one.
Diagnosis of Bipolar Disorder
No blood or imaging test can determine if a person has bipolar disorder. The diagnosis is based upon a comprehensive medical and psychological history and a physical examination. Bipolar disorder may be confused with several other medical and psychiatric conditions, in which case you may need laboratory testing to rule out other diagnoses.
Treatment for Bipolar Disorder
1. Treatment for Mania
Treatment during an episode of mania focuses on managing symptoms and ensuring the patient’s safety. In the early phase of mania (acute phase), a patient may be psychotic/display poor judgment and therefore may be at risk of injuring him/herself or others.
Hospitalisation may be necessary until symptoms are controlled (medical aids still require pre-authorisation to be obtained). Treatment of mania continues until symptoms are entirely resolved and the patient can function normally. However, many patients are maintained on medication indefinitely to prevent a recurrence of mania / manic symptoms. Medication is the primary treatment for mania, and various types of medication available. It is not usually possible to know which medication will be the most effective and cause the least side effects. It may be necessary to try several medications before finding the most suitable one. A person who responds well to the prescribed medication is likely to respond well to the ongoing treatment of the illness.
2. Treatment for Depression
During the initial phase of depression, an anti-depressant is usually the best option for treatment. Anti-depressants may cause manic episodes and are generally used only in the initial phase of bipolar depression combined with a mood stabiliser.
Bipolar Disorder is a complex mental health condition and must be treated by a Mental Health Professional.