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What is Bipolar Disorder ? Symptoms, Diagnosis, and Risk Factors



Bipolar disorder, also known as Manic Depression and Bipolar Affective Disorder, is essentially a mood disorder whereby an individual’s mood alternatively swings between two extreme poles, namely mania and depression. Manic episode is when the individual experiences a perpetual high all throughout its duration. Depressive episode, on the contrary, is a time of an all-time low. Both of these are generally named mood episodes. Such episodes may not occur in fixed patterns but may alternate in duration, intensity, and the number of symptoms experienced.

The chasm between the two states is very wide, with drastic behavioral changes occurring for each episode. The state of mania is high-energy, euphoric emotional mentality that is manifested through hectic, frenzied behavior and activity. A lesser degree of mania experienced is referred to as hypomania. For some people, being in a state of hypomania may be close to being normal. In such cases, the change in the mood episodes occurs to a lesser extent; hence it gets difficult to detect and diagnose the disorder correctly. Moreover, hypomania runs a risk of later developing into severe mania or depression itself.

Starkly different in nature and characterized by intense sadness and dejection is the depressive episode that follows up closely. A point to note is that such episodes bring out unusual behaviors and activities in people and are clearly distinct from the individual’s normal thoughts, energy levels, traits and disposition. Changes in sleep patterns are also experienced. Sometimes, certain symptoms of both conditions may be experienced at once by a person, and this is known as an episode with mixed features.

Types of Bipolar Disorder

Bipolar disorder is categorized into four main types. Bipolar I Disorder wherein the manic episodes last for at least a period of seven days and their depressive counterparts for a minimum of two weeks. Occurrence of episodes with mixed features may also be observed. The severity of the symptoms of mania in this case is quite high and the patient might need actual hospitalization for the condition. Bipolar II disorder is characterized by hypomania episodes alternating with depressive episodes, with symptoms of lesser intensity. The third type is Cyclothymia wherein the symptoms of either the hypomania or depression are not as severe as the earlier two types to be defiantly diagnosed as bipolar but exist nevertheless and many episodes occur repeatedly for at least two years in adults and a year in children. If symptoms do not match with any of the first three categories, they are classified under the fourth category of Other Specified and Unspecified Bipolar and Related Disorders.

Symptoms of Bipolar Disorder

    Bipolar 1 - Maniac Episodes

  • Excessive elation
  • High levels of energy and activity
  • Insomnia
  • A faster pace of speech
  • Flitting between subjects and thoughts while conversing
  • An agitated mind
  • Irritability
  • A sense of over-confidence and indulgence in reckless behaviors such as extravagant expenditure or even impromptu one-night stands

    Bipolar 2 - Depressive Episodes

  • Feelings of sadness, hopelessness, worthlessness
  • Anxiety
  • Very low energy levels and reduced activity
  • Changes in appetite
  • Insomnia or oversleeping
  • Loss of interest and pleasure in carrying out activities
  • Inability to focus and concentrate
  • Memory loss
  • Suicidal thoughts and tendencies

Risk Factors

The risk factors associated with this disorder are up to 60% to 80% caused by genetic predisposition and heredity; environmental factors like trauma and stress; and alterations in the brain.

Bipolar disorder often gets misdiagnosed as depression as people are more likely to seek treatment when suffering from a depressive episode. Many a times, only one facet of the disorder is noticed and considered, but the maniacal aspect may be considered as normal behavior and thus be ignored. In such cases, conditions may not improve even after reaching out for help, and the patient might continue to suffer. Certain cases exhibit the patient suffering from even psychotic symptoms, such as hallucinations and delusions, and may get misdiagnosed as schizophrenia. Moreover, bipolar disorder often occurs in conjunction with other ailments such as substance abuse, anxiety disorder, ADHD and/or eating disorders. And it also increases the risk of physical disease such as heart disease, diabetes, thyroid, obesity, and headaches and migraines, etc.

Overall, the daily life of person is greatly disrupted for a person with bipolar disorder. One in five people with this disorder commit suicide. The treatment of bipolar disorder aims more to reduce the degree of change between the mood episodes with the help of mood stabilizers rather than to treat each condition separately. This is the adopted approach to counter episodes with mixed episodes as also the liability to increase the severity of the particular episode. All this along with psychotherapy sessions to change harmful thought processes and improve coping skills and bring forth more balanced perspectives and emotional states.