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Bipolar disorder

Bipolar disorder, formerly known as manic-depressive disorder, is characterized by intense shifts in mood that can last for hours, days, weeks, or months. These mood changes significantly impact one's emotional, mental, and physical energy levels, thought patterns, and behaviors. They can also substantially affect one's daily functioning at work. The World Health Organization (WHO) estimates that bipolar disorder affects 5% of people worldwide, has a 25-year average age of onset across the life span, and affects women more often than men. Bipolar disorder is one of the leading causes of self-harm and suicide. Systematic treatment for bipolar symptoms through the integration of an experienced psychiatrist, medications, and lifestyle modification can help overcome the disorder.

What is bipolar disorder?

Bipolar disorder is a psychiatric condition due to a mood disorder in which the patient alternates between extreme change in emotions, talkativeness, and energy levels or its milder form (mania or hypomania) and depressive episodes. Bipolar disorder has a profound effect on the mind and body, as the patient will be stuck in the up or down mood of bipolar positive or negative emotions persistently for a week without being able to regain the normal mood state, affecting their life, work, family, and social relations with those around them. A holistic treatment approach for bipolar disorder integrated with the encouragement of those around the sufferer will help improve the symptoms and assist the sufferer in regaining a regular life.

How many types of bipolar disorder?

Mental health professionals classify bipolar disorders into four types:

1. Bipolar I disorder is characterized by episodes of both mania and depression symptoms, and it may be hard to distinguish and differentiate this bipolar disorder from certain types of schizophrenia. At least one manic episode must last longer than one week or requires hospitalization due to severity.
2. Bipolar II disorderis characterized by episodes of depression and hypomania, which is not as intense as manic symptoms. The period of depressive symptoms and aggression will only last a few hours or days before returning to normal.
3. Cyclothymic bipolar disorder, also known as cyclothymia, is characterized by alternating episodes of hypomania and mild depression lasting at least two years. When symptoms are present, they will not last long and then disappear.
4. Other specified and unspecified bipolar disorder:The patient exhibits symptoms of bipolar disorder but does not meet the diagnostic criteria for bipolar I, II, or cyclothymic disorder. The abnormal mood swings and back-and-forth switches may be other types of bipolar disorder with a specific pattern caused by drug addiction, brain disease, a physical illness, or an unspecified pattern.

What causes bipolar disorder?

The causes of bipolar disorder can be attributable to several factors. Doctors cannot determine whether it is from single or multiple factors.

1. Disorders in the secretion of neurotransmitters in the forebrain, such as serotonin, dopamine, melatonin, or noradrenalin, that are imbalanced, resulting in abnormalities in the functioning of brain cells in the part that controls emotional levels, such as anger, stress, happiness, and euphoria, or concentrating on doing things.
2. Genetic, such as having a family history of bipolar disorder or previous psychiatric diseases, such as depression or attention deficit hyperactivity disorder (ADHA). These could be risk factors for bipolar disorder as well.
3. Severe emotional trauma, such as the death of a loved one, breaking up with a partner, deep disappointment, trauma, childhood abuse, criminality, and chronic physical and mental illness.
4. Some organic diseases, such as thyroid hormone abnormalities
5. Postpartum depression can cause bipolar disorder.
6. Accumulated stress 
7. Sleep deprivation

What are the signs and symptoms of bipolar disorder?

There are two categories of bipolar disorder symptoms: severe aggressive mood or euphoric mood (mania or hypomania) divided into high and low levels and depression (depressed). Bipolar disorder patients experience unpredictable, alternating up-and-down mood swings of both groups of symptoms; there is no set pattern or time when they will occur. Bipolar symptoms may be short-lived or last for weeks, months, or years.

1. Mania and hypomania, both of which have similar symptoms, mania is more prominent in the intensity and severity of emotions, aggression and one can observe the behavior either at school or at work while doing various activities with the following behaviors:
   • Express oneself fully, brimming with high energy, an overwhelmingly good mood, and an unusual amount of joy and energy.
   • Talk fast, talk a lot, talk non-stop, and talk loudly; change the subject quickly. Many thoughts and words were spewing out.
   • High self-assurance, very self-important, feel superior to others regardless of the people around.
   • Perform multiple tasks at once and work in excessive amounts, unusually diligent.
   • Reacts to stimuli quickly, irrationally, and unconsciously.
   • Negligence, impulsive, misjudgment, prone to risky behavior
   • Extravagant, lack of thoughtfulness
   • Sleeping significantly less than usual, won't sleep, always awake.
   • Hallucinations or optical illusions
   • Have high sexual arousal, have high sex drive, have inappropriate sexual behavior.
   • Aggressive temper, irritability, anger, easily angry
2. Depressed
   • Depressed, gloomy, miserable, discouraged, hopeless, and empty.
   • Uncontrollable crying
   • Inability to complete tasks due to a short attention span; lack of motivation
   • Tiredness, a lack of energy, a lack of vitality, forgetfulness, and a loss of interest in everything
   • Extreme anxiety, paranoia, and interpersonal relationship issues
   • Significant weight loss without dieting
   • Can't eat, can't sleep, or sleeps too much.
   • Nervous, stressed, and restless.
   • Tiredness, fatigue, slow behavior, loss of energy, does not want to do anything. 
   • Feelings of worthlessness, low self-esteem, excessive guilt 
   • Short attention span, slow thinking, inability to make decisions.
   • There may be a family history of bipolar disorder, depression, or another psychiatric disorder.
   • Having a history of substance abuse
   • Having suicidal thoughts, plans, or attempts

Some bipolar patients may experience mixed episodes of both groups of symptoms; mania and depression are predominant together, as follows:

• Negative thoughts are associated with depression, alternating with restlessness and high energy.

How is bipolar disorder diagnosed?

Bipolar disorder diagnosis is derived clinically. The individual must note down the symptoms, dare to admit them, consult with a doctor, and receive treatment properly and systematically. The process for diagnosing bipolar disorder involves the following steps:

1. The doctor takes a health history, including family history, congenital disorders, medication history, and a history of substance abuse, and collects information from family members, close friends, and colleagues about whether the mood and behavior are related to bipolar disorder.
2. The doctor conducts an initial physical assessment, including blood and urine tests, to diagnose conditions that may affect the mood.
3. The psychiatrist performs a psychiatric evaluation to assess the mental state, including taking a psychological test.
4. The psychiatrist may perform lab tests to identify medical issues that could be causing the symptoms of bipolar disorder.
5. The psychiatrist may request daily charting of moods, including sleeping patterns and other behaviors that help diagnose disease and aid in planning the appropriate treatment.

What is bipolar disorder treatment?

Bipolar disorder treatment requires a collaborative effort between psychiatrists, psychologists, a clinical multidisciplinary team, and family members. Treatment of the bipolar disorder is primarily with medication. Those with bipolar disorder should see a doctor and continue to take their prescribed medication for effective treatment outcomes. The drugs and therapies for bipolar disorder include the following: 

• Medications: Bipolar disorder is due to the disordered secretion of neurotransmitters. The treatment, therefore, focuses primarily on drugs to help balance the secretion of brain neurotransmitters. The doctor may consider a mood-regulating drug group, anti-psychotic drug class, or antidepressant group. However, to see results, the patient should take the prescribed medicines for at least 2-4 weeks and not stop taking the drug abruptly to prevent a recurrence or aggravation of symptoms.
• Psychotherapy: This is a type of talk-therapy in which a psychiatrist or psychologist has a one-on-one conversation with a patient who has bipolar disorder to assess their mental state, identify the underlying issue that is causing them distress, and find a solution to it. They also work on developing the patient's coping mechanisms and life skills.
• Interpersonal and social rhythm therapy (IPSRT) is a form of psychotherapy that enables the patient to communicate with those around him. The doctor sets up a daytime occupational therapy program where participants help one another by listening to problems, offering suggestions, and offering support in the battle against bipolar disorder.
• Psychoeducation is sharing knowledge about bipolar disorder, symptoms, and treatment by physicians, psychiatric professionals, and psychologists so that those with bipolar disorder can learn about it, understand it, and be able to manage their emotions, thoughts, and behaviors so they can coexist in society.
• Family-focused therapy (FFT)is a type of therapy that emphasizes the patient's family, participating as close friends in the treatment to reduce tension within the family and lead to an adaptation to living together while coping with bipolar disorder. Family members play a crucial role in improving the patient's condition.
• Cognitive-behavioral therapy (CBT) is a type of therapy performed by a psychiatrist and psychologists who focus on reshaping the automatic negative thoughts and behaviors that lead to bipolar disorder and adopting positive thinking habits to promote mental health and help control and combat symptoms of bipolar disorder.
• Electroconvulsive therapy (ETC)is a treatment that uses electrical currents to stimulate the brain for the treatment of bipolar disorder or depression, especially in those who do not respond to drug treatment or require immediate treatment to prevent harm if the patient is suicidal or might be harmful to others.
• Thyroid medications: If diagnosed by a doctor, thyroid hormone dysfunction is one of the causes of bipolar disorder. The doctor will treat it by administering medication to help balance it. Studies have shown positive results in reducing bipolar symptoms.
• Ketamine treatment: Bipolar disorder treatment by administering a low dose of ketamine through a vein is effective against acute, severe bipolar depression to help alleviate symptoms in those who harbor suicidal thoughts.
• Rehabilitation: If the bipolar disorder patient is a drug addict, addicted to alcohol, or has a history of drug abuse, the doctor may consider a substance abuse or alcohol abstinence program. Otherwise, bipolar disorder will be hard to treat.
• Hospitalization is necessary when a person with bipolar disorder is in danger of hurting themselves, engaging in risky behavior, or considering suicide. Doctors may hospitalize the patient for close monitoring by a psychiatrist and medical professionals to help patients feel safe, calm down, and help stabilize their mood.

What are the complications of bipolar disorder?

Bipolar disorder is due to an imbalance of neurotransmitters in the brain that affects mood, mind, and body. Complications of bipolar disorder may precipitate the following diseases and symptoms.

• Risk of drug or alcohol addiction
• Cardiovascular disease
• Diabetes
• Obesity, overweight issues
• ADHD
• Thyroid disease
• Chronic headaches.
• Anxiety
• Risk of committing crimes or having behaviors leading to financial issues
• Dysfunctional relationships with people in their close circle
• Suicidal attempts

What is the prevention of bipolar disorder?

Doctors do not have a foolproof way to prevent bipolar disorder. However, we can do self-evaluations and come to a deeper understanding of ourselves by regularly listening to the opinions of those around us. If you suspect bipolar symptoms, you should see a doctor for early treatment. The following are some ways of preventing bipolar disorder:

• Observing the bipolar disorder warning signs and symptoms: It's important to always pay attention to your behavior and mood; for instance, if you frequently go to the extremes, exhibit excessive anger and laughter, or often do risky things without thinking about the consequences, you should probably see a doctor.
• Avoid using drugs and drinking alcohol: These substances are risk factors for bipolar disorder. It can also lead to a recurrence.
• Complete prescription: Treatment failure can result from skipped doses, drug discontinuation, or dose reduction, which can fail a bipolar disorder treatment and precipitate a recurrence.
• Regular exercising is the best way to prevent bipolar disorder. At least 3–4 times per week, engage in 30-minute exercise for the brain to release endorphins, or "happy chemicals," which help the body feel relaxed, lower stress from daily life and promote restful sleep.

Is it possible to treat bipolar disorder?

Bipolar disorder is treatable. There are highly effective medications with excellent therapeutic effects. They will help to balance neurotransmitter secretion in the brain, allowing you to resume your normal daily activities. The treatment typically lasts between 6 months to two years. Bipolar symptoms can worsen and become potentially fatal if not treated properly from the beginning.

Bipolar disorder—a treatable condition.

Bipolar disorder is a mental health condition that manifests in various forms. Bipolar disorder mood swings can alternate between high and extreme euphoric or aggressive moods and depressive episodes. They can last weeks, months, or even years, interfering in all aspects of life and relationships. Therefore, those who have bipolar disorder must receive early diagnosis and care from trained psychiatrists and psychologists to treat them holistically and methodically. The main treatment objective for bipolar patients is to help them understand themselves, their condition, and the treatment process, including behavioral modification to overcome the illness, regain emotional control, and return to regular life.

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