Introduction

BIPOLAR DISORDER is a mental health condition which causes changes in mood, concentration, energy and activity levels. Initially, it used to be called manic depression or manic-depressive illness. In bipolar disorder, manic and hypomanic episodes are the main signs of the condition along with presence of depressive episodes.

Facts & Figures

What are the key facts and statistics about bipolar disorder?

• It is a fairly common disorder.
• Approximately more than 2% of the US population are affected by bipolar disorder.
• Globally, it is estimated that around 40 million persons are living with bipolar disorder.
• Usual age of onset is 25 years.
• 6 out of 10 people with this disorder have a drug or alcohol dependence.
• Persons suffering from bipolar disorders are highly likely to also have other mental health disorders such as:

1.  Post-traumatic stress disorder (PTSD).
2.  Anxiety.
3.  Attention-deficit/hyperactivity disorder.

• Bipolar disorder can lead to a reduction in life expectancy by up to 9 years.

 

 Causes

What are the causes of bipolar disorder?

The exact cause(s) of bipolar disorder is unknown.

However, scientists believe that genetics (inheritance) play a major role in causation.

It is estimated that more than 65% of people with bipolar disorder have at least one close biological relative who suffers from the same condition.

 

Apart from the genetic component, there are other various factors which are thought to contribute. They are:

•  Anatomical changes in the brain.
•  Environmental factors such as stress and trauma. For example, experiencing divorce or demise of a family member.

 

 Types, Signs & Symptoms

Types of bipolar disorders and their signs and symptoms

Types

• Bipolar I disorder
• Bipolar II disorder
• Cyclothymic disorder

 

Bipolar I disorder

• Manic episodes, where there is extreme increase in mood alterations such as feeling very happy.
• Depressive or hypomanic episodes.
• Neutral moods

 

Bipolar II disorder

• It is characterized by presence of at least one:

1. Major depressive disorder.
2.   Hypomanic episode.

• Persons with this type may have other mental disorders such as:

1.  Anxiety disorder.
2.  Substance used disorder.

 

Cyclothymic disorder

•  It is a milder form.
• It involves many mood swings, with hypomania and depressive symptoms happening regularly

 

Signs and symptoms

Bipolar I disorder:

• Manic episode. At least 1 week of feeling extremely good moods. There usually is;

1.  Distractability.
2. Restlessness.
3.  Risky behavior.

• Hypomanic episode

1.  It is also known  as hypomania.
2.  There are less severe manic symptoms.
3.  They last at most 4 days.

• Major depressive disorder

Extreme sadness and loss of interest in activities which were once enjoyable.

Other signs and  symptoms are;

1.  Fatigue.
2.  Feeling guilty.
3.  Suicidal thoughts.
4.  Changes in sleep and appetite (increased or decreased).
5.  Restlessness.

 

 Diagnostic Procedures  & Tests

How is  bipolar disorder diagnosed?

Diagnostic strategies include:

• Thoroughly reviewing history of the patient (patient history-taking).
• Conducting a clinical examination.
• Tests such as blood tests to rule out other conditions that may be responsible for the symptoms.
• Mental health assessment and evaluation by a psychiatrist or psychologist.

 

The Diagnostic and Statistical Manual of Mental Disorders is used to provide guidance in diagnosing the kind of bipolar disorder an individual is having.

Experiencing at least one episode of mania or hypomania is a necessary prerequisite for a bipolar disorder diagnosis to be made.

 

 Treatment and Management

How do we treat bipolar disorder?

The following strategies can be combined as part of treatment:

• Psychotherapy;

1.  Psychoeducation.
2.  Cognitive behavioral therapy.
3.  Family-focused therapy.

 

• Medications

These include;

1. Mood stabilizers such as lithium and valproic acid.
2. Anti-depressants.
3. Neuroleptic agents such as lusiradone and cariprazine.

 

• Lifestyle modifications

1.  Quitting smoking tobacco.
2.  Embracing a good sleep routine.
3.  Meditation.
4.  Physical exercise.

 

Prevention

How do we prevent bipolar disorder?

The exact causes of bipolar disorder are not yet known. Therefore, it becomes almost close to impossible to prevent bipolar disorder.

Once an individual starts showing signs and symptoms, it is advisable that early medical attention is provided.