Bipolar Disorders Symptoms, Causes And Treatment

Bipolar disorder is a mental disorder. It causes extreme mood swings and unusual changes in energy, concentration and activities. It also affects the ability to carry our daily activities. It is also termed as manic depression or manic depressive psychosis (MDP). It comes under the classification of affective disorders. The word manic means over excited or confident. Bipolar disorders are cyclic mood disorders. In this disorder, mood swings predominate so much that the person may be called as high or manic. This disease led to the historical description of manic depression. Depression and bipolar disorder are two different medical conditions. In depression, a person may feel low in mood and negative. But clinically depression is more than just feeling sad or unhappy.  But the person with bipolar disorders experiences extreme mood swings. There are periods in which he is extremely happy or confident but in the next moment he feels low, helpless and sad. It is expected that the recurrent depressive episode will result in bipolar disorder.

Types Of Bipolar Disorders

There are two main types of bipolar disorders,

1.               Bipolar I disorder

2.               Bipolar II disorder

Bipolar I disorder

It is characterized by episodes of severe mania and depression. Mania is a more extreme form. Psychotic symptoms may appear in mania and a person may need hospitalization due to severe symptoms. It is diagnosed by episodes of severe mania and depression that last for at least seven days. In this type, sometimes mania with depression and sometimes depression with mania may occur.

Bipolar II disorder

It is characterized by episodes of severe hypomania and depression. When the mood becomes abnormally changed or elated, then the term hypomania is applied. Hypomania is a milder form of mania. In this disease, there is no need for hospitalization. It is diagnosed by one or more episodes of hypomania and depression.

Symptoms

In depressive episodes, major sign and symptoms of bipolar disorder includes,

•  Insomnia (trouble falling asleep)
•  Hypersomnia (sleeping too much)
•  Little or no energy
•  Severe fatigue and weakness
•  Concentration problem
•  Hallucinations
•  Delusions
•  Continuous thoughts of suicide
•  Extreme changes in weight
•  Reduced sex drive
•  Gastric problems
•  Nonspecific pains

In manic episodes, major sign and symptoms of bipolar disorder includes,

•  Increased energy levels
•  Non Stop talking
•  Insomnia
•  Increased confidence
•  Distraction
•  Interest in risky activities

Sometimes, it is also present with recurrent episodes of,

•  Hypomania
•  Mania with psychotic symptoms
•  Mania without psychotic symptoms
•  Severe depression with psychotic symptoms
•  Severe depression without psychotic symptoms

Causes

The main cause of bipolar disorder is still unknown. But there are different models and theories that explain the causative factors responsible for bipolar disorders.

1. Genetic causes

Some genetic linkage is present in bipolar disorders. There are five DNA regions that might be at risk associated with bipolar disorder. The most particular region is ADCY2 because it codes an enzyme that plays a vital role in sending signals to nerve cells. The incidence of bipolar disorders in first degree relatives is about 20%.

2. Environmental factors

Sometimes environmental factors also contribute to an acute episode of mania and depression. For example, a major life event or someone’s death, accidents or trauma are responsible for the development of bipolar disorders.

3. Biochemical factors

Biochemical factors are also responsible for bipolar disorders. For example, there is an abnormality in catecholamines in one or more sites in the brain. Catecholamine includes norepinephrine, dopamine and serotonin. GABA and acetylcholine also play a major role. Some monoamine oxidase inhibitors and atypical antidepressants also increase the neurotransmitter amines such as norepinephrine.

4. Endocrine factors

Stress causes the hypothalamus to corticotropin releasing factor. It interacts with the pituitary gland to release adrenocorticotropic hormone.  This hormone binds with adrenal glands and releases stress hormones. This results in negative feedback or in severe cases, stress may damage the switch off process.

Treatment

Pharmacologic treatment

The purpose of treatment is to promote recovery. In bipolar disorders, the main focus is to reduce the intensity and duration of mood swings. The quality of life is most important in all cases. The pharmacotherapy plan includes antidepressants, antipsychotics, lithium, electroconvulsive therapy and other mood stabilizers. Antidepressants include imipramine, amitriptyline, nortriptyline, fluoxetine, clomipramine, sertraline, escitalopram, mirtazapine and paroxetine. Lithium is a low therapeutic index drug. It is a drug of choice for recurrent episodes of mania in bipolar disorder. Antipsychotics are prescribed for acute mania episodes. These include risperidone, olanzapine, haloperidol, quetiapine and chlorpromazine.  It is also indicated for delusional depression. Other mood stabilizers include lorazepam, clonazepam, topiramate, lamotrigine, carbamazepine and sodium valproate.

Talk therapy

There are two types of talk therapies depending upon the needs of patients,

•  Psychotherapy
•  Cognitive behavioral therapy

Frequently asked questions

What is bipolar disorder?

Bipolar disorder is a mental disorder that causes extreme mood swings and unusual changes in energy, concentration and activities.

Is bipolar disorder dangerous?

Yes, it is a dangerous and life threatening disease.

Are there any complications of bipolar disorder?

If bipolar disorder is left untreated, it can cause serious complications such as suicidal attempts, relationship problems, social fear and poor performance in work.