Understanding Bipolar Disorder: Signs, Symptoms, Types, Causes, Diagnosis and Treatment Options

What is it:

Bipolar Disorder, formerly known as manic depression, is a mental health disorder characterised by mood swings, ranging from emotional highs (mania or hypomania) to lows (depression). These mood swings can significantly impact various aspects of life, including sleep, energy levels, judgement, behaviour and clear thinking. Episodes can occur infrequently or frequently, with onset typically between 15 to 20 years, rarely after 40 years and affecting both genders equally.

Signs and Symptoms of Bipolar Disorder:

The symptoms of Bipolar Disorder can vary, encompassing mood swings known as mood episodes.

• Manic episode symptoms: Feeling excited and energetic, sudden shifts to irritability and short temper, restlessness, rapid thought and speech, increased energy, heightened libido, unrealistic plans, poor judgement, substance abuse, impulsiveness, reduced need for sleep and appetite, inflated self-confidence and easy distraction.
• Depressive episode symptoms: Intense sadness, hopelessness, and loneliness, slow speech or forgetfulness, trouble concentrating, talking slowly, depressed libido, inability to feel pleasure, uncontrollable crying, trouble making decisions, irritability, needing more sleep or insomnia, appetite changes leading to weight loss or gain and thoughts of death or suicide.

Some patients may experience both manic as well as depressive symptoms together, feeling very sad, empty or hopeless while also experiencing extreme energy.

Note: Experiencing four or more episodes of mania or depression in a year is termed "rapid cycling."

Risk factors of Bipolar Disorder:

Bipolar Disorder is believed to develop from a combination of factors:

• May affect individuals with a family history of the condition.
• Imbalances in neurotransmitters or hormones may play a role.
• Life events such as abuse, mental stress, significant loss, or other traumatic events may trigger an initial episode.

How is Bipolar Disorder diagnosed:

Bipolar Disorder is typically diagnosed through observation of behavioural patterns by family members, but accurate diagnosis requires assessment by mental health professionals trained in psychiatric conditions. These professionals employ various tools including:

• Medical history which will include asking about patient symptoms, lifetime history, experiences and family history.
• Medical tests to rule out other underlying conditions.
• Psychological assessment to evaluate thoughts, feelings and behavioural patterns through interviews, questionnaires and mood charting to monitor mood changes over time. With the patient's consent, caregivers, family members, and close friends may be asked to provide information about the patient’s symptoms.

Treatment options for Bipolar Disorder:

Treatment aims to stabilise the person’s mood and reduce the severity of symptoms. The main treatments for Bipolar Disorder include medicines, psychotherapies and lifestyle changes. Always seek professional guidance or treatment from Mental Health Professionals.

• Medications: Antipsychotic drugs, mood stabilisers and antidepressants are prescribed to alleviate symptoms. Do not self-medicate, miss, adjust or stop medications independently or without a doctor's advice.
• Psychotherapy: Talk therapy methods like Cognitive Behavioural Therapy (CBT) can help prevent symptom recurrence, manage routines, develop coping skills, address learning difficulties, resolve social problems and help strengthen family bonds and communication. It can also treat substance abuse problems. Other therapies can be used in cases where standard treatments prove ineffective.
• Psychoeducation: Educates patients and their caregivers and families about Bipolar Disorder, its symptoms, triggers, and effective coping strategies.
• Support system: Involving caregivers, family members, close friends and teachers (if the client is a child) as active participants in the treatment process creates a supportive ecosystem that enhances the individual's ability to manage Bipolar Disorder effectively.

Lifestyle changes that help to cope with Bipolar Disorder:

While there is no known way to prevent Bipolar Disorder, following these lifestyle changes will help to reduce patterns of behaviour that worsen the symptoms in patients.

• Avoid alcohol, recreational drugs, caffeine and tobacco as they can worsen symptoms and interfere with medications.
• Maintain a daily mood chart or diary to track thoughts, feelings and behaviours, aiding in treatment awareness.
• Stick to a consistent sleep schedule to minimise disruptions that can trigger mood episodes.
• Share your feelings with caregivers, friends and family members so they can provide emotional support. Seek support or assistance from your friends, family, caregiver or whoever is near you during a severe attack or when you struggle to manage them.
• Practice relaxation techniques to reduce stress such as mindfulness, meditation, yoga or deep-breathing exercises. Engage in activities and hobbies that bring joy and relaxation.

Lifelong treatment is essential, ensuring symptom management and supporting a healthy, successful life. In India, you can contact the mental health helpline Tele MANAS at 14416 OR 1-800 891 4416 available every day of the week and offering support in multiple languages for guidance and support.