Bipolar Disorder: Symptoms, Causes & Types

Bipolar disorder is a mental condition characterised by extreme fluctuations in a person’s emotions, energy, activity levels, and focus. The disorder was formerly known as manic depressive illness or manic depression. The mood variations can make it challenging to complete daily responsibilities.

Symptoms of Bipolar Disorder

There are three distinct varieties of bipolar disorder, which are characterised by distinct shifts in moods, and energy and activity levels–Mania, hypomania, and depression. The emotions vary from moments of excessively “up,” happy, irritated, or energetic behaviour, which are known as manic episodes, to periods of severely “down”–melancholy, apathy, or hopelessness, known as depressive episodes. And the third category is a hypomanic episode, which is a less intense manic episode.

Many kinds of bipolar disorder are characterised by varying combinations of these symptoms. Individuals who have experienced at least one manic or hypomanic episode are diagnosed with bipolar disorder. Both hypomania and mania are characterised by emotions of enthusiasm, impulsivity, and high energy. The symptoms of mania might interfere with productivity in daily life at work and at home, while the symptoms of hypomania are often less disruptive or severe, although they can still be upsetting. Some individuals with bipolar disorder suffer from significant depression episodes.

Observable Symptoms

Individuals with bipolar illness experience powerful emotional fluctuations, changes in sleep patterns and activity levels, and out-of-character conduct, frequently without understanding the potential negative or disastrous consequences. The phases are known as mood episodes. Mood episodes are markedly distinct from the individual’s typical moods and actions. During an episode, the symptoms persist for the majority of each day. Episodes can sometimes span longer durations, such as days or weeks. The following are the leading three types of emotional fluxes experienced by those with the condition:

• Hypomania & Mania: Mania and hypomania are two separate episodes with similar features. Mania is a stronger symptom than hypomania and affects daily functioning at job, school, and social activities, and can trigger relationship problems as well. Mania can sometimes cause a loss of consciousness (psychosis) and necessitate hospitalisation. A manic or hypomanic episode both comprise three or more of the following symptoms:

• • • Discordantly or oddly happy, jumpy, or wired
    • Overactive, vigour, or over-excitement
    • Exaggerated feelings of well-being and self-assurance (euphoria)
    • Reduced sleep and unusual talkativeness
    • Racing thoughts & easy distractibility
    • Rash decision-making, such as spending excessively, taking sexual risks, or making impractical investments

• Depressive Episode: A major manic depression episode is defined by symptoms that are severe enough to interfere with daily activities such as job, school, social activities, or relationships. An episode consists of some of the following symptoms:

•Display low emotions like sadness, emptiness, hopelessness, or tears–prevalent in teens, and children, who can display low moods, and appear irritable.
• Significant loss of interest or enjoyment in some, or almost all activities
• Substantial weight gain, or weight loss while not dieting, or appetite decrease or rise (in children, failure to gain weight as expected can be a sign of depression)
• Insomnia or excessive sleeping
• Either agitation or slower behaviour
• Fatigue or energy deficiency
• Feelings of worthlessness, as well as excessive or inappropriate regret
• Unable to decide or diminished capacity of thought or focus
• Feeling suicidal, attempts or planning

Bipolar I

The condition is characterised by manic episodes lasting at least a week–almost every day for the majority of the day–or by manic symptoms so severe that the individual requires emergency medical treatment. Typically, depressed episodes also occur, often lasting a minimum of two weeks. Moreover, the episodes of depression with mixed characteristics–exhibiting both manic depressive illness symptoms. Rapid cycling is defined as experiencing four or more bouts of mania or depression within one year.

Symptoms of Bipolar I

The fifth edition of Diagnostic and Statistical Manual of Mental Disorders, states that the following criteria must be met in order to diagnose bipolar I disorder:

• At least one manic depressive illness episode lasting a week
• Symptoms that interfere with regular activity
• Symptoms that are unrelated to another medical illness, a mental health issue, or drug usage

You could also show signs of sadness, mania, or psychosis or mixed symptoms. The symptoms may impede your daily routines and functioning in your life more severely. It’s important to get expert assistance as soon as you can if you have them. Although periods of hypomania or sadness are not necessary for a bipolar I diagnosis, many persons with the condition do report these symptoms.

Bipolar II

The condition is characterised by alternating periods of depression and hypomania. In bipolar 1 disorder, hypomanic episodes are less severe than manic ones.

Symptoms of Bipolar II

A bipolar 2 diagnosis can include the following symptoms:

• At least one hypomanic episode lasting four days or more and including two or more hypomanic signs.
• Changes in behaviour and mood associated with hypomania that are noticeable but will not necessarily impact your day-to-day activities.
• At least one major manic depression episode lasting two weeks or more.
• A major depressive episode with five or more core symptoms that significantly affect your day-to-day life.
• Daily symptoms that are unrelated to a different medical disease, mental health issue, or substance abuse.

Psychotic symptoms can also be present in bipolar II, but only when a depressive episode is present. You could also go through a range of moods, where you concurrently feel the signs of despair and hypomania. Yet, mania may not be triggered if you are suffering from bipolar II. A manic episode will result in a bipolar I diagnosis for you.

Cyclothymic Disorder

Also known as cyclothymia, the condition is characterised by recurring hypomanic and depression symptoms that do not meet the criteria for hypomanic or depressive episodes.

Symptoms of Cyclothymic Disorder

Obtaining a cyclothymia diagnosis involves:

• Symptoms of hypomania and despair that have switched back and forth for at least two years–and one year for children and adolescents
• Symptoms that are persistent for at least over a year and show up consistently every one or two months, never meeting the complete requirements for an episode of hypomania or depression.
• Symptoms that are distressing and interfere with everyday living and does not match with another mental or medical health, or substance use condition.

Cyclothymia symptoms may not be as severe as bipolar I or II symptoms. Yet, they usually last longer, so when you have none, you often have less time. Your daily life may not be significantly affected by hypomania. Contrarily, depression frequently results in more severe suffering and impairs daily functioning, even if the symptoms don’t match those of a major depression episode. The diagnosis will probably shift to another form of bipolar disorder or severe depression, depending on the symptoms, if you do encounter enough symptoms to match the requirements for a hypomanic or manic-depressive illness episode.

Other Categories

Occasionally, an individual may exhibit bipolar disorder symptoms that do not fit any of the three categories, which is known as “other specified and unspecified bipolar and associated diseases.”

Often, bipolar disorder is diagnosed in late youth (teen years) or early adulthood. Sometimes, children might exhibit indications of bipolar disorder. Although symptoms may change over time, bipolar illness is often treated for a lifetime. Adhering to a suggested treatment plan can assist patients in managing their symptoms and enhancing their quality of lives.

Why Bipolar Disorder Occurs

The precise aetiology of bipolar illness is still unknown to science. Nonetheless, experts agree that a significant genetic component exists. However, all members of the family may not have it just because the condition is prevailing in a biological family.

Scientists also believe the following elements play a role in the onset of bipolar disorder:

• Brain Changes: According to research, persons with bipolar disorder have different brain structures and functions from those who do not have the condition or any other mental illness. Scientists may be better able to comprehend bipolar disease and choose the most effective therapies if they have a better understanding of these brain distinctions. Nowadays, rather than using brain imaging or other diagnostic procedures, experts base a patient’s diagnosis and treatment strategy on their symptoms and medical history.
• Genetics: According to research, some individuals are genetically predisposed to bipolar illness. Those who have a parent or sibling who has bipolar disorder is more likely to have the condition themselves. No one gene is responsible for the illness; several genes are involved.
• Environmental Elements Like Stress And Trauma: A stressful event can cause a manic or depression episode, including the death of a loved one, a significant illness, divorce, or money troubles. Hence, stress and trauma may also contribute to the emergence of bipolar disorder.

Diagnosing Bipolar Disorder

Your doctor may use a range of tests and methods to diagnose the condition, including:

• A medical check-up
• Asking about your symptoms, life history, experiences, and family history as part of a full medical history.
• Blood tests and other medical procedures to rule out other conditions like hyperthyroidism that might be the cause of your symptoms.
• A mental health check-up. Your doctor could conduct the assessment or might refer you to a psychologist or psychiatrist who specialises in mental health.

A hypomanic or mania episode, or both, must have occurred at least once for the condition to be confirmed. The Diagnostic and Statistical Manual of Mental Disorders is used by mental health professionals to identify the bipolar disorder type that a patient may be experiencing. Your doctor evaluates the pattern and frequency of symptoms and how much they impede with daily functioning during the most severe episodes to determine the bipolar disorder type you may have.

The following mental health issues are more prevalent in people with bipolar disorder:

• Anxiety
• Hyperactive/attention-deficit disorder (ADHD)
• Trauma-related stress disorder (PTSD)
• Dual diagnoses for substance use disorders

It can be challenging for doctors to accurately diagnose persons with bipolar illness due to this and the fact that memory is frequently disrupted during mania, so people can’t recall feeling it. Individuals with bipolar disease who are going through a severe manic episode, experience hallucinations that may be mistaken for schizophrenia. Also, sometimes borderline personality disorder is mistaken for bipolar illness (BPD).

As a result, while speaking with your doctor, it’s crucial to be open and detailed about all of your symptoms and experiences. Include a loved one in your conversations with your doctor who may be able to offer more insights about your mental health history.

Bipolar Illness Treatment

Many people, even those with the most severe types of bipolar disease, can benefit from treatment. The following treatments are frequently combined in an efficient treatment plan:

• Psychotherapy: Talk therapy
• Medications: Your doctor will prescribe meds independently or in conjunction with talk psychotherapy or counselling.
• Self-Management Techniques: Techniques such as education and recognising the early signs of an episode or potential triggers.
• Supporting Activities: Beneficial lifestyle practises including yoga, meditation, and exercise, which can supplement the line of treatment.
• Other Treatments: Other treatments like ECT or electroconvulsive therapy may be used for cases when medicine show no results or symptoms need to be managed effectively to avert injury.

As bipolar illness is a chronic condition, therapy must be ongoing. Sometimes it might take months or even years for you and your specialists to work out a treatment plan that is effective for you. Even though this could be frustrating, it’s crucial to keep up with your therapy.

Maniacal and depression episodes frequently recur over time. Many bipolar illness sufferers do not experience mood swings in between episodes, while some may continue to experience symptoms. Treatment that is ongoing and long-term can help control these symptoms.

It might be more challenging to address the disorders if you already have other mental health issues like anxiety or ADHD in addition to bipolar disorder. For instance, meds like antidepressants are prescribed for obsessive-compulsive disorder (OCD) treatments. Also, stimulants used to treat ADHD or attention deficit hyperactivity disorder can aggravate bipolar disorder symptoms and can trigger a manic episode. Remember, treating these illnesses is not impossible, despite the fact that it may be challenging. Be sure to remain dedicated to locating a therapy strategy that is effective for you.

Therapies To Treat Bipolar Disorder

Psychotherapy: Psychotherapy, also known as ‘talk therapy’ is a useful component of the treatment approach for bipolar illness. Psychotherapy refers to a number of therapeutic methods that seek to assist you in recognising and altering problematic emotions, beliefs, and actions. Engaging with a mental health expert, such as a psychologist or psychiatrist, may offer you and your family support, information, and direction.

Among the several kinds of treatment for bipolar disorder are:

• Psychoeducation: Psychoeducation is the method through which mental health experts educate individuals about mental health disorders. While bipolar illness is a complicated condition, understanding how it might impact your life will help you and your loved ones better manage and live with it.
• Interpersonal And Social Rhythm Therapy (IPSRT): The treatment is aimed to enhance your emotional balance by helping you understand and deal with your social and biological rhythms. IPSRT is a successful treatment for mood disorders, such as bipolar disorder. It stresses ways to increase medication adherence (consistently taking medicine), handle stressful life events, and minimise disturbances to social rhythms (day-to-day differences in habitual behaviours). The IPSRT provides methods that allow you to protect yourself from future manic or depression episodes. The therapy is for adults and children with bipolar illness, as well as their carer-givers. Throughout this treatment, your loved ones will participate with you in psychoeducational sessions addressing bipolar disorder, communication development training, and problem-solving skills training.
• Cognitive Behavioural Therapy (CBT): CBT is a goal-oriented, organised kind of treatment. Your therapist or psychologist assists you in examining your ideas and emotions in depth. You will realise how your ideas influence your behaviour. During CBT, bad beliefs and behaviours may be unlearned, and healthy thought patterns and habits can be learnt.
• Electroconvulsive therapy (ECT): ECT can be utilised in some situations when medicine and psychotherapy have failed to assist. During ECT, the patient is under anaesthesia, and a small electrical current is repeatedly administered to the scalp, causing a brief, controlled seizure. Seizures brought on by ECT are thought to alter brain signalling networks.
• Support Groups: Family members may also gain from professional services, particularly mental health advocacy and support groups, as bipolar disorder may adversely hamper an individual’s everyday life and lead to a challenging home environment. These resources may teach families coping mechanisms and how to get involved in the treatment process and get support.
• Repetitive transcranial magnetic stimulation: In a series of therapy sessions, repetitive transcranial magnetic stimulation (rTMS), a form of brain stimulation, employs magnetic waves to treat depression. rTMS has a low risk of memory and cognitive problems while not being as effective as ECT and not requiring general anaesthesia.
• Light Therapy: Seasonal affective disorder (SAD) can be treated with light therapy. Bipolar depression that has worsened during a less severe seasonal episode may also be treated with light treatment.

Medications For Bipolar Disorder

Bipolar disorder symptoms can be managed with the aid of certain drugs. With the help of your specialist, you might need to test out a number of different drugs before deciding which one is most effective.

The following drugs are frequently prescribed by medical professionals to treat bipolar disorder:

• Mood Stabilisers
• ‘Atypical’ second-generation neuroleptics or antipsychotics
• Antidepressants

If you are treating your bipolar illness with medication, you can consider the following guidelines:

• Speak with your doctor. Any prescription medications, over-the-counter medicines, or dietary supplements you are currently using should be disclosed to your primary doctor.
• Learn more about the dangers, side effects, and advantages of the medicine
• Inform your specialists if you have side effects. They might need to try a new drug or adjust your dose.
• Keep in mind that you must continuously take your bipolar disorder medication as directed.

Antidepressants For Bipolar Disorder

To control manic or hypomanic episodes, people with bipolar illness often need mood-stabilising medication.

Mood stabiliser meds include:

• Acid Valproic Lithium
• Lamotrigine, Carbamazepine, and Divalproex sodium
• One of the drugs that has been examined and often prescribed for the treatment of bipolar disorder is lithium. After two weeks of beginning treatment, lithium, a natural salt, will lessen mania symptoms; nevertheless, it may take many weeks or even months for the symptoms to be completely controlled. At times, medical professionals frequently recommend additional medications like antipsychotics or antidepressants to treat symptoms.

Patient Guidelines

To learn about the dangers and advantages of the medicine, speak with your doctor. Any prescription/s, over-the-counter medicines, or dietary supplements the patient is currently using should be disclosed to their primary doctor. Inform your specialist immediately if you have any concerns regarding side effects.

Keep in mind that even when feeling well, bipolar disorder medication must be taken consistently and exactly as directed. Before quitting a prescription drug, it is crucial to speak with a doctor. Sudden medication withdrawal might cause symptoms to return or get worse.