Bipolar Disorder: Types, Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Prevention and Prognosis

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A women in tow conditions once angry and once in stress because she suffer from bipolar disorder

1Overview

There are times you may feel down and sad. On some days, you might feel ecstatic and happy. This is just a normal way to express one’s feelings. However, when this happens spontaneously without triggers, they might signal a more serious condition.

Bipolar disorder is a condition characterized by spontaneous and extreme shifts in mood.
It also involves fluctuations in activity and energy levels that can make daily activities difficult.

Formerly known as manic depression, bipolar disorder is a mental health condition that causes extreme mood swings which include lows or depression and highs, such as hypomania or mania.

The mood shifts include being depressed in some days, wherein the person feels hopes or sad. On the other hand, the person may feel manic in other days, which involves feeling euphoric, unusually irritable and full of energy.

If this condition is left untreated, the symptoms may become worse, leading to problems with relationships, career, academic performance and everyday life. In some cases, it may lead to suicide.

In the United States, bipolar disorder accounts for 2.9 percent of cases and 83 percent of these are considered severe. The diagnosis of bipolar disorder is usually between the ages of 15 and 25 years old. However, the condition may occur at any age, with the prevalence equal among men and women.

2Types

Bipolar I disorder

In this type of bipolar disorder, the patient had at least one manic episode and followed by hypomanic or major depressive episodes.

Bipolar II disorder

The patient had at least one hypomanic episode and one major depressive episode. However, he or she never had a manic occurrence.

Cyclothymic disorder

This is applicable for people who had at least two years of many periods of depressive symptoms but less serious than major depression) and hypomania symptoms.

Other types

The other types of bipolar disorder include the conditions caused by certain drugs, medical problems, and alcohol. Some of the medical conditions related to bipolar disorder include multiple sclerosis, stroke, and Cushing’s disease.

3Symptoms

People with bipolar disorder may experience periods of intense emotions and feelings, unusual behaviors and changes in activity levels and sleep patterns. However, the most distinct ones are called “mood episodes”.

The symptoms and their severity may vary from one person to another. An individual with bipolar disorder may become manic and depression at times. In some cases, a person can even experience both extremes at the same time or in a rapid sequence.

Mania and hypomania symptoms

  • Feel very “high”, “up” or elated
  • Increased energy levels
  • High activity levels
  • Hard time falling asleep
  • More active than usual
  • Talks very fast
  • Feeling as if their thoughts are going very fast
  • Irritable, agitated and touchy
  • Perform risky activities like spending a lot of money or engaging in reckless sex
  • They believe they can do many things at the same time
  • Abnormally jumpy, upbeat or wired
  • Exaggerated sense of self-confidence (euphoria)
  • Distractibility
  • Poor decision making

Depressive symptoms

  • Depressed mood – feels very sad, down, hopeless and empty
  • Have little energy
  • Decreased activity levels
  • Loss of interest or no feeling of pleasure in all activities
  • Unexplained weight loss or weight gain
  • Lack of sleep or too much sleep
  • Feel worried
  • Problem with concentration
  • Forgetful
  • Eat too much or too little
  • Suicidal thoughts
  • Feeling tired

When to get emergency help?

The depressive symptoms of bipolar disorder may lead to suicidal thoughts. This is common among individuals with the disorder. If you have plans of hurting yourself or if you know someone who has suicidal thoughts, call 911 immediately and ask for help.

4Causes

Though the exact cause of bipolar disorder is unclear, some scientists have linked some factors that may be involved in the development of the illness.

Genetics

Bipolar disorder is common in people who have first-degree relatives, as a parent or sibling with the disorder.

Biological factors

Individuals with the condition may have physical changes in the brain, like an imbalance in the neurotransmitters in the brain or an abnormality in the brain’s features.

Moreover, the imbalances of neurotransmitters and hormones may contribute to the development of bipolar disorder. Environmental factors like abuse or a traumatic event may also trigger the illness.

Stress

According to some studies, a stressful event like the death of a family member, a failed relationship, financial woes, divorce or illness, may trigger the development of the illness’s symptoms.

5Risk Factors

Some factors may increase the risk of developing bipolar disorder.

  • Periods of increased stress levels due to traumatic and sudden stressful events
  • Drug or alcohol abuse
  • Having a first-degree family member with the illness

6Complications

If bipolar disorder is left untreated, it may lead to serious complications including:

Suicide or suicide attempts

Suicide is a long-term complication in people with bipolar disorder. Some studies have shown that the suicide risk in people with bipolar disorder is about 15 to 20 times greater than those without the illness. Moreover, some studies have shown that as many as 25 to 50 percent of people with the disorder had suicidal attempts at least once in their lifetime.

Other complications

  • Problems related to drug abuse and alcohol abuse
  • Financial and legal problems
  • Relationship problems
  • Poor academic performance
  • Poor work performance

Co-occurring conditions

In some people, they may have bipolar disorder and other psychiatric conditions including:

7Diagnosis

The doctor will request the following diagnostic tests:

Physical examination and medical history

The doctor will conduct a thorough physical examination, including an interview with medical history.

Psychiatric exam

The doctor may also refer the patient to a psychiatrist for a psychiatric examination.

Mood Charting

The patient will be asked to keep a daily record of the moods and feelings. The patient also needs to record his or her behavior patterns.

The psychiatrist or psychologist will base the diagnosis of the disease on the criteria called the Diagnostic and Statistical Manual Fifth Edition (DSM-5).

8Treatment

Bipolar disorder requires long-term treatment because it can relapse. Hence, it is important to start the treatment and continue it even when the patient is feeling better. Moreover, patients with the disorder need to take the medication to prevent new episodes and stay symptom-free.

The treatment involves more than just medications. Drugs alone are not enough to fully control the disease’s symptoms. One of the most effective ways for bipolar disorder is a combination of therapy, medicines, lifestyle changes and social support.

Medicines

Lithium carbonate is the most commonly used long-term medicine for the symptoms of bipolar disorder, including depression and mania. Usually, the patient will take medicine for about six months.

The other drugs used to treat bipolar disorder include mood stabilizers, antipsychotics, antidepressants, anti-anxiety medications and antidepressant-antipsychotics.

Psychotherapy

Aside from medications, one important part of the treatment regimen for bipolar disorder is psychotherapy. The several types of therapy include cognitive behavioral therapy, interpersonal and social rhythm therapy, family-focused therapy, and psychoeducation.

Hospitalization

Hospitalization is rare now than in the past because of new methods of treating bipolar disorder. Usually, hospitalization may be recommended for patients with high risks of harming themselves or others.

Electroconvulsive therapy (ECT)

ECT may help if other treatment options are not effective. During ECT, electrical currents are passed through the brain to stimulate a short seizure attack. This has been seen to reverse some symptoms of mental illnesses.

Transcranial magnetic stimulation (TMS)

The treatment is being studied as an option for those who haven’t responded to medications.

9Prevention

Bipolar disorder attacks may be managed by self-help strategies and preventive measures including:

Learn about the disease

Learn as much as you can about the disease.

Exercise regularly

Exercise has a good effect on the mood and emotions of individuals. One of the most effective exercises includes aerobic exercise because this activates the movement of extremities including walking, swimming, dancing, running, and drumming.

Limit stress

Stress is a trigger for bipolar symptoms. You can keep stress at bay by maintaining a healthy work-life balance, avoiding extreme stress and engaging in relaxation techniques such as yoga, meditation, and deep breathing exercises.

10Prognosis

Bipolar disorder can be serious and chronic. In some cases, it can be mild and has intermittent attacks. A typical patient may experience about eight to ten episodes or attacks in a lifetime.

However, people with this disorder may have higher death rates from heart problems, suicide, and death from all causes compared to those without the condition. Some people with the disorder may show productivity and creativity during manic attacks.

However, in children and teens, it is still unclear if the condition will persist into adulthood. It’s also unknown if treating bipolar disorder in childhood will prevent the occurrence of the disease in later life.

More often, however, during manic attacks, people may engage in reckless and impulse behavior including spending money without thinking leading to bankruptcy, angry and paranoid behaviors and promiscuous behaviors.

Also, people with the condition may have low self-esteem and guilt during depressed stages. All these may lead to ruined relationships, financial ruin, and tensions in social life.

Any form of the psychiatric condition may lead to serious emotional, social and mental effects.