We all experience a variety of moods such as happiness, sadness, and anger. Unpleasant moods and changes in mood are normal reactions in everyday life, and we can often identify the events that caused our mood to change. However, when we experience extreme mood changes that affect how we behave and function, these changes are often the result of a mood disorder.
Bipolar disorder (formerly known as manic-depressive disorder) is a mood disorder that consists of periods of extremely elevated mood (mania), extremely low mood (depression), and normal mood.
Bipolar disorder typically begins for people during adolescence and early adulthood. It is unusual for bipolar disorder to begin in childhood without strong familial risk factors, and it is rare for its onset to occur after the age of 60 (unless it is associated with another medical condition). Bipolar disorder occurs in about 1% of the adult population, and men and women are affected equally.
There is no single, proven cause of bipolar disorder, but research suggests that it is the result of abnormalities in the way some nerve cells in the brain function or communicate. Researchers also believe that there is a definite genetic link (family history) in which there is a higher risk for people who have a parent or full sibling (i.e., a first-degree relative) with bipolar disorder.
Whatever the precise nature of the cause of bipolar disorder, it clearly makes people with the disorder more vulnerable to emotional and physical stresses. As a result, upsetting life experiences, alcohol, illicit drug use, lack of sleep, or other stresses can trigger episodes of illness, even though these stresses do not actually cause the disorder.
Bipolar disorder is not the fault of the person suffering from it and is not the result of a “weak” or unstable personality. Rather, bipolar disorder is a treatable medical condition.
Bipolar disorder is a condition in which the person’s mood changes in cycles – from extremely high or irritable to extremely low and hopeless – over weeks to months. The nature of these mood changes varies from one person to the next. A person may go through periods of elevated mood, depressed mood, and times when mood is normal. The period of time that the extreme high and low moods are experienced are called episodes of mania and depression.
Mania: During a manic episode, a person will experience a high, irritable, angry, or aggressive mood for at least one week that is not caused by drug abuse, medication, or other medical conditions. The person’s mood disturbance will be severe enough to cause concerns from family or friends, and may warrant a hospital stay to prevent harm to self or other. In addition, they will experience 3 or more of the following:
A manic episode may also include psychotic symptoms such as delusions (firmly believing things that are not true) or hallucinations (hearing, feeling, or seeing things that are not there).
Hypomania is a milder form of mania that has the same symptoms but less severe, and has less negative impact on a person’s daily activities. Symptoms must last for at least 4 consecutive days. During a hypomanic episode, the person may have an elevated mood and be more productive, but the mood is uncharacteristic of the person’s baseline personality. Because these episodes often feel good, the quest for hypomania may even cause some people with bipolar disorder to stop taking their medications. However, a hypomanic episode does not usually last for long and gradually shifts into either mania or depression. Therefore, it is important for hypomania to be treated.
Depression: During a depressive episode, the person experiences feelings of sadness or loses interest in the things they normally enjoy. At least 5 of the following additional symptoms persist for at least 2 weeks and cause clinically significant impairment of social or occupational functioning:
A depressive episode may also include symptoms such as severe anxiety, excessive worry, and other physical symptoms (e.g., pain) as well as psychotic symptoms such as delusions (firmly believing things that are not true) or hallucinations (hearing, feeling, or seeing things that are not there).
Some people with bipolar disorder experience mixed episodes that involve symptoms of both mania and depression together or alternating frequently during the day. Individuals are excitable or agitated as in mania, but they also feel irritable and depressed. Mixed episodes present the highest risk of suicide. Approximately 25% to 50% of all people with bipolar disorder have a lifetime risk of attempting suicide.
Some people with bipolar disorder also experience problems with movement, called catatonic symptoms. These symptoms include physical agitation, immobility, and unusual movements or body positions.
Patterns of bipolar disorder
People with bipolar disorder vary in the types and frequency of episodes that they experience. Some people may have equal numbers of manic and depressive episodes, while others may have mostly one type (usually depression).
While several years can pass between the first few episodes without treatment, most people eventually have more frequent episodes. Episodes can last for days, weeks, months, or sometimes even years. For some people, the episodes have rapid cycling where they experience at least 4 episodes per year in any combination of mania, hypomania, mixed, or depression.
According to the episode patterns, bipolar disorder can be classified as:
A doctor will diagnose bipolar disorder based on a pattern of symptoms. Diagnosis usually involves a thorough medical history, questions about family history, a physical exam, and a psychiatric evaluation that assesses the individual’s history of depression and manic episodes.
Early and proper diagnosis is an important step towards preventing other complications such as suicide, alcohol or substance abuse, marital or work problems, and more frequent cycling episodes.
People with bipolar disorder will receive treatment to manage their current episodes as well as treatment on a long-term basis to prevent future episodes. Components of treatment include medications and psychosocial treatments. Electroconvulsive therapy (ECT) can also be used, but is usually reserved for people who do not respond to treatment with medications for bipolar disorder.
Medications for bipolar disorder must be customized to fit the individual because the patterns and severity of this disorder vary from one person to the next. Long-term medications are commonly used to treat bipolar disorder. Medications used to manage bipolar disorder include:
Other medications may be prescribed to manage symptoms such as trouble sleeping, anxiety, or restlessness.
It is important for people with bipolar disorder to keep taking their medications in order for the medications to work properly in managing this condition. People who stop taking their medications are at increased risk of experiencing another episode (approximately70% in the first year and approximately 95% within five years). This risk increases as time passes. Do not stop taking these medications or adjust the dose on your own without speaking to your doctor or pharmacist first. Talk to your doctor and pharmacist if you have any questions about the medications you are taking and ask about possible side effects.
Psychosocial treatments for bipolar disorder can include psychoeducation, psychotherapy, family therapy, and support groups. Psychosocial treatments help people and their families understand bipolar disorder, learn how to best manage the condition, and learn how to prevent other complications from occurring. Psychoeducation teaches people about bipolar disorder, its treatment, and its management.
Other things that a person with bipolar disorder can do to help reduce symptoms include:
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Bipolar-Disorder