Bipolar disorder is a brain disorder and also known as manic-depressive illness as it fluctuates the mood and energy levels of individuals. This disorder produces unusual shifts in mood and negatively affects the ability to carry out day-to-day tasks of individuals. Bipolar disorders are of four types as per the frequency and severity of manic and depressive episodes among individuals. Manic-depressive episodes in individuals can be best explained as mood swings i.e. transition between extreme highs i.e. very excited behavior and extreme lows i.e. periods of sadness and hopelessness (Faedda, Marangoni, Serra et al. 2015).
Bipolar Type I disorder is defined as manic-depressive episodes lasting for at least seven days and severity of symptoms does not subside without immediate hospital care. The depressive phase in type I lasts for two weeks. In this type, continuous transition between manic and depressive symptoms might also occur which is very dangerous for the mental health of the patient. Bipolar Type II disorder is a pattern of depressive episodes and less severe hypomanic episodes which can be managed without immediate hospitalization. Cyclothymic Disorder is another type of bipolar disorder which is defined as a cycle of hypomanic and depressive symptoms which lasts for persistently long periods such as for two years. Children and adolescents also suffer from cyclothymic bipolar disorder for a period of 1 year which is enough for making it a persistent disorder in these populations (Faedda, Marangoni, Serra et al. 2015).
It is already known that mental and cognitive development in children and adolescents is an ongoing process and their immature cognitive development makes this cyclothymic disorder more harmful for their mental health. These cyclothymic episodes of excitement and depression do not categorically meet the diagnostic requirements of a bipolar disorder in latent stages. However, persistent episodes of cyclothymic disorders for more than two years increase the possibility of acquiring a bipolar disorder (Duffy, Horrocks, Doucette, Keown-Stoneman, McCloskey & Grof, 2014).
Symptoms of Bipolar disorder include unusually intense emotions, frequent changes in sleep patterns and activity levels and unpredictable behaviors. Sudden spikes in energy and physical activity routine along with less sleep habits might be subtle signs of bipolar disorder.
Symptoms of Bipolar disorder can be diagnosed by looking for signs of manic and depressive episodes separately. Patients who are suffering from the manic episode period exhibit elated emotions, high energy levels, agitation and irritable behavior. These individuals are inclined towards multi-tasking, take risks, and talk very fast as if they have less time to reflect. The other extreme in individuals suffering from bipolar disorder is a depressive episode. In this episode, individuals suffer from hopelessness, decreased activity levels, have trouble in sleeping and have a shorter concentration span. They might also think about committing suicide and feel useless (Duffy et al. 2014).
Patients who experience both manic and depressive symptoms simultaneously may have mixed diagnostic features. They might be sad and feel extreme energy at the same time. Bipolar disorder is not extreme at all times but might be subtle as experienced in hypomanic episodes. In hypomania, mood swings are less extreme and the patient might be productive with these less severe episodes. However, patients shall be diagnosed and managed at the hypomanic stage to avoid extreme episodes of bipolar disorders. Diagnostic assessment of bipolar disorder is complex because many other mental illnesses mimic symptoms of bipolar disorder. These illnesses include anxiety disorder, eating disorder, obsessive-compulsive disorder and substance abuse (Duffy et al. 2014).
People with bipolar disorder are also at increased risk of getting thyroid disease, migraine headaches, Obesity, diabetes, and heart disease. It is evident through research-based evidence that people with bipolar disorder have certain over-developed genes which distinguish their brain functioning from normal people. Bipolar disorder also tends to run in families and children with parental history of bipolar disorder are more likely to have this disease (Bond & Anderson, 2015).
Treatment of bipolar disorder is long-term but the success rate is high in-terms of gaining control over rapid mood swings and other symptoms. An effective treatment strategy for bipolar disorder patients is a combination of both medications and psychotherapy. Bipolar disorder is a life-long illness because relapse of manic and depressive episodes is very common upon discontinuation of treatment. Many people with this disease could be completely free of extreme episodes of mania and depression, whereas, many patients could have lingering symptoms and sudden relapse across their lifespans. Hence, long-term and consistent treatment is needed to manage and prevent the exacerbation of disease symptoms (Bond & Anderson, 2015).
Medicines that are generally used to treat bipolar disorders include mood stabilizers, A-typical antipsychotics and antidepressants. Disease-related knowledge is necessary for patients who are taking medications for longer periods. Any side effects of these medications shall be immediately reported to the healthcare practitioner. Different doses of these medications shall be tried to find the appropriate dose for individual patients with lesser side effects. Sudden withdrawal of these medications could lead to rebound and worsening of symptoms. Hence, consistent support, education and guidance to people suffering from bipolar disorders is recommended (Goodwin et al. 2016).
Psychotherapy treatments which are effective in treating bipolar disorders are cognitive behavioral therapy (CBT), family-focused therapy, social rhythm therapy and psycho-education. Electroconvulsive therapy (ECT) is also given to patients who did not find any relief in symptoms through medications and psychotherapy. ECT is used in severe bipolar disorder which is difficult to reverse and is found to be effective in many patients. This therapy has some short-term side effects such as disorientation of thoughts, confusion and memory loss (Goodwin et al. 2016). Sleep medications are also given to patients who are suffering from insomnia and have altered sleeping patterns. Sleep regularity is known to improve the effect of psychotherapy and other medications given for bipolar disorder. Lifestyle modifications for the management of bipolar disorders are creating a balanced routine for sleeping and eating. Regular physical exercise and appropriate fluid intake is also helpful in managing mood changes in people who are already taking medications (Harvey, Soehner, Kaplan et al. 2015).
Bond, K., & Anderson, I. M. (2015). Psychoeducation for relapse prevention in bipolar disorder: a systematic review of efficacy in randomized controlled trials. Bipolar disorders, 17(4), 349-362.
Duffy, A., Horrocks, J., Doucette, S., Keown-Stoneman, C., McCloskey, S., & Grof, P. (2014). The developmental trajectory of bipolar disorder. The British Journal of Psychiatry, 204(2), 122-128.
Faedda, G. L., Marangoni, C., Serra, G., Salvatore, P., Sani, G., Vázquez, G. H., … & Koukopoulos, A. (2015). Precursors of bipolar disorders: a systematic literature review of prospective studies. The Journal of clinical psychiatry, 76(5), 614-624.
Goodwin, G. M., Haddad, P. M., Ferrier, I. N., Aronson, J. K., Barnes, T. R. H., Cipriani, A., … & Holmes, E. A. (2016). Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 30(6), 495-553.
Harvey, A. G., Soehner, A. M., Kaplan, K. A., Hein, K., Lee, J., Kanady, J., … & Buysse, D. J. (2015). Treating insomnia improves mood state, sleep, and functioning in bipolar disorder: A pilot randomized controlled trial. Journal of consulting and clinical psychology, 83(3), 564.
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