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Bipolar disorder

What is Bipolar Disorder?

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy, or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behaviour, and the ability to think clearly.

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counselling (psychotherapy).

Types of Bipolar Disorder

There are several types of bipolar and related disorders:

  • Bipolar I disorder.

You’ve had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).

  • Bipolar II disorder.

You’ve had at least one major depressive episode and at least one hypomanic episode, but you’ve never had a manic episode.

  • Cyclothymic disorder.

You’ve had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).

  • Other types.

These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing’s disease, multiple sclerosis, or stroke.

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What are the symptoms?

Both a manic and a hypomanic episode include three or more of these symptoms:

  • Abnormally upbeat
  • Increased activity, energy or agitation
  • An exaggerated sense of well-being and self-confidence (euphoria)
  • Decreased need for sleep
  • Unusual talkativeness
  • Distractibility
  • Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments

A major depressive episode includes five or more of these symptoms:

    • Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
    • Marked loss of interest or feeling no pleasure in all
    • Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight, as expected, can be a sign of depression)
    • Either insomnia or sleeping too much
    • Either restlessness or slowed behavior
    • Fatigue or loss of energy
    • Feelings of worthlessness or excessive or inappropriate guilt
    • Decreased ability to think or concentrate
    • Thinking about, planning or attempting suicide

Bipolar disorder’s causes

The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:

      • Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
      • Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.

How we treat bipolar disorder?

The primary treatments for bipolar disorder include psychiatric medications and psychological counselling (psychotherapy) to control symptoms, and also may consist of education and support groups.

Treatment is directed at managing symptoms, and it may include:

Psychiatric medications

      • Medications: continued treatment and day treatment programs.

Medications may include:

      • Mood stabilizers. You’ll typically need mood-stabilizing medication to control manic or hypomanic episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
      • Antipsychotics. If symptoms of depression or mania persist despite treatment with other medications, adding an antipsychotic drug such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon).
      • Antidepressants
      • Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer.
      • Anti-anxiety medications. Benzodiazepines may help with anxiety and improve sleep but are usually used on a short-term basis.
      • Substance abuse treatment. If you have problems with alcohol or drugs, you’ll also need substance abuse treatment.
      • Hospitalization. Your doctor may recommend hospitalization if you’re behaving dangerously, you feel suicidal, or you become detached from reality (psychotic).

When do you address the psychiatrist?

 

Psychotherapy

Psychotherapy is a vital part of bipolar disorder treatment.

Several types of therapy may be helpful. These include:

      • Cognitive-behavioural therapy (CBT). The focus is on identifying unhealthy, negative beliefs and behaviours and replacing them with healthy, positive ones. CBT can help determine what triggers your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.
      • Psychoeducation. Learning about bipolar disorder (psychoeducation) can help you, and your loved ones understand the condition. Knowing what’s going on can help you get the best support, identify issues, make a plan to prevent relapse, and stick with treatment.
      • Family-focused therapy. Family support and communication can help you stick with your treatment plan and help you and your loved ones recognize and manage warning signs of mood swings.

Source: https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

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