Bipolar Disorder

Bipolar Disorder

Bipolar Disorder

Bipolar Affective Disorder (BPAD), previously known as manic depressive illness, is a mood disorder characterized by periods of depression and/or episodes of extremely elevated and/or irritable moods. Between highs and lows, people with BPAD can be completely symptom free.

Mania

It is called mania if the elated mood episode is:

  • excessive and/or to the degree that a person develops psychosis —such as auditory hallucinations and/or delusional and grandiose beliefs,

and if

  • the symptoms last for seven days (or fewer if hospitalization is required or there is impairment in functioning).

Hypomania

Hypomania — literally “less than mania” — is not as severe or as intense as full-blown mania. Hypomania is characterized by mood elevation (euphoria/frenzy) and persistent lack of self-control. Hypomania is distinct from mania in that there is no significant impairment of functioning.

Coexisting Conditions

BPAD commonly coexists with other conditions such as substance use disorders and generalized anxiety disorders.

Prevalence

Approximately 1% of the global population has BPAD and the male to female ratio is 1:1. The average age of onset of BPAD is 25.

Symptoms of Bipolar Disorder:

The symptoms of mania include:

  • Elevated mood — either euphoric or irritable
  • Flight of ideas and rapid speech
  • Increased energy
  • Reduced need and desire for sleep
  • Hyperactivity

The symptoms of depression include:

  • Low mood
  • Anhedonia— no pleasure in life
  • Reduced energy
  • Thoughts and feelings of hopelessness, worthlessness, and guilt

Diagnosing Bipolar Disorder:

BPAD is characterized as a variation of disorders sharing a common similarity with three specific subtypes:

  • Bipolar I disorder: At least one manic episode (see below) is necessary to make this diagnosis. Depressive episodes are common in most cases with bipolar disorder I, but they are not necessary for a diagnosis to be made.
  • Bipolar II disorder: One or more hypomanic episodes (see below) and one or more major depressive episodes.
  • Cyclothymia: A history of hypomanic symptoms with periods of depression that do not meet diagnostic criteria for hypomania or major depressive episodes.

Causes of Bipolar Disorder

The causes of BPAD are not fully understood, but both genetic and environmental factors have been implicated.

Environmental factors that can increase an individual’s risk of developing BPAD include adverse childhood experiences such as sexual abuse and chronic stress.

Risks factors for Bipolar Disorder:

People with BPAD are at increased risk of suicide and self-harm.

Treatment of Bipolar Disorder:

The treatment of BPAD includes both medication and talking therapy.

  • Medication

    • Antipsychotics such as olanzapine are given during acute manic episodes. Antipsychotics can also be given where mood stabilizers are intolerable or ineffective, or where adherence is poor.
    • Mood stabilizing medicines such as lithium and anti-epileptic drugs (AEDs) such as sodium valproate are used in the long term for relapse prevention.
  • Talking Therapy – Psychotherapy and psychoeducation are also associated with positive treatment outcomes in people with BPAD.
  • Electroconvulsive therapy (ECT) – is effective in acute manic and depressive episodes, especially with psychosis (extreme mental unrest) or catatonia (mute stupor or profound psychomotor agitation).
  • Admission – (which may be involuntary) to a psychiatric hospital may be necessary if a person poses a risk to themself and/or to others.

Symptoms of Bipolar Disorder:

The symptoms of mania include:

  • Elevated mood — either euphoric or irritable
  • Flight of ideas and rapid speech
  • Increased energy
  • Reduced need and desire for sleep
  • Hyperactivity

The symptoms of depression include:

  • Low mood
  • Anhedonia— no pleasure in life
  • Reduced energy
  • Thoughts and feelings of hopelessness, worthlessness, and guilt

Diagnosing Bipolar Disorder:

BPAD is characterized as a variation of disorders sharing a common similarity with three specific subtypes:

  • Bipolar I disorder: At least one manic episode (see below) is necessary to make this diagnosis. Depressive episodes are common in most cases with bipolar disorder I, but they are not necessary for a diagnosis to be made.
  • Bipolar II disorder: One or more hypomanic episodes (see below) and one or more major depressive episodes.
  • Cyclothymia: A history of hypomanic symptoms with periods of depression that do not meet diagnostic criteria for hypomania or major depressive episodes.

Causes of Bipolar Disorder

The causes of BPAD are not fully understood, but both genetic and environmental factors have been implicated.

Environmental factors that can increase an individual’s risk of developing BPAD include adverse childhood experiences such as sexual abuse and chronic stress.

Risks factors for Bipolar Disorder:

People with BPAD are at increased risk of suicide and self-harm.

Treatment of Bipolar Disorder:

The treatment of BPAD includes both medication and talking therapy.

  • Medication

    • Antipsychotics such as olanzapine are given during acute manic episodes. Antipsychotics can also be given where mood stabilizers are intolerable or ineffective, or where adherence is poor.
    • Mood stabilizing medicines such as lithium and anti-epileptic drugs (AEDs) such as sodium valproate are used in the long term for relapse prevention.
  • Talking Therapy – Psychotherapy and psychoeducation are also associated with positive treatment outcomes in people with BPAD.
  • Electroconvulsive therapy (ECT) – is effective in acute manic and depressive episodes, especially with psychosis (extreme mental unrest) or catatonia (mute stupor or profound psychomotor agitation).
  • Admission – (which may be involuntary) to a psychiatric hospital may be necessary if a person poses a risk to themself and/or to others.