Bipolar disorder

Psychological disorders / Category / Emile Du Toit / May 9th 2014

What is bipolar disorder?

Bipolar disorder or bipolar mood disorder is a serious illness that is also called manic-depressive illness. People with bipolar disorder go through unusual mood changes. Sometimes they feel very happy and ‘up’, and are much more active than usual. This is called mania or hypomania, depending on how elevated their mood and behaviour becomes. Equally, people with bipolar disorder can also feel very sad and ‘down’, and can be much less active. This is called depression. Bipolar disorder can also cause changes in energy and behaviour.

Bipolar disorder is not the same as the normal ups and downs everyone goes through. Bipolar symptoms are more powerful than that. They can damage relationships and make it hard to go to school or keep a job. They can also be dangerous. Some people with bipolar disorder try to hurt themselves or attempt suicide. But treatment is available. With help, people with bipolar disorder can get better and lead successful lives.

What causes bipolar disorder?

Several factors may contribute to bipolar disorder, including genetics (the illness often runs in families) and/or abnormal brain structure and brain function. The causes of bipolar disorder aren’t always clear. Current research may help doctors predict whether a person will get bipolar disorder. One day, it may also help doctors prevent the illness in some people.

Who develops bipolar disorder?

Anyone can develop bipolar disorder. It often starts in a person’s late teens or early adult years. But children and adults can have bipolar disorder too. The illness usually lasts a lifetime.

Common symptoms of bipolar disorder

Bipolar mood changes are called ‘mood episodes’. People may have manic episodes, depressive episodes or ‘mixed’ episodes. A mixed episode has both manic and depressive symptoms.

These mood episodes cause symptoms that last a week or two – sometimes longer. During an episode, the symptoms last every day for most of the day. Mood episodes are intense. The feelings are strong and happen along with extreme changes in behaviour and energy levels.

Signs and symptoms of manic or hypomanic episodes

People having a manic episode may do any of the following:

  • they might talk really fast about a lot of different things
  • they might be agitated, irritable, or ‘touchy’
  • they might do risky things, like spend a lot of money or have reckless sex
  • they might feel very ‘up’ or ‘high’
  • they might feel ‘jumpy’ or ‘wired’
  • they might have trouble relaxing or sleeping
  • they might think they can do a lot of things at once and are more active than usual

  • Signs and symptoms of a depressive episode

    People having a depressive episode may do any of the following

  • they might feel very ‘down’ or sad
  • they might feel worried and empty
  • they might feel tired or ‘slowed down’
  • they might have trouble concentrating
  • they might lose interest in fun activities and become less active
  • they might have trouble sleeping
  • they might forget things a lot
  • they might think about death or suicide

  • Common consequences of bipolar disorder

    Sometimes people having very strong mood episodes may have psychotic symptoms. These are strong symptoms that cause hallucinations (when people believe things that are not real).

    People with mania and psychotic symptoms may believe they are rich and famous, or have special powers. People with depression and psychotic symptoms may believe they have committed a crime or that their lives are ruined.

    Several other behaviour problems go along with mood episodes. A person may drink too much or take drugs. Some people take a lot of risks, like spending too much money or having reckless sex. These problems can damage lives and hurt relationships. Some people with bipolar disorder have trouble keeping a job or doing well at school.

    Bipolar often takes years to diagnose

    Some people have bipolar disorder for years before anyone knows. This is because bipolar symptoms may seem like several different problems. Family and friends may not see that a person’s symptoms are part of a bigger problem. Equally, a doctor may think the person has a different illness, such as schizophrenia or depression.

    People with bipolar disorder also often have other health or psychological problems. This may make it hard for doctors to see the bipolar disorder. Examples of other illnesses include substance abuse, anxiety disorders, thyroid disease, heart disease and obesity.

    Types of treatment for bipolar mood disorder

    Right now, there is no cure for bipolar disorder, but treatment can help control symptoms and manage the disorder. Most people can get help for mood changes and behaviour problems. Treatment works best when it is ongoing, instead of on and off.

    Effective treatment usually requires one or preferably more of the following:

    Medication

    Different types of medication can help, and different people respond to medications in different ways. So psychiatrists prescribe psycho-pharmaceuticals to patient depending on their unique symptoms and response to medications. Sometimes a person needs to try different medications to see which are best.

    Medications can cause side effects, and sometimes a person and their psychiatrist or GP may have to try a few medications at different dosages before they can find the best combination that has both maximum efficacy and minimal side effects.

    People with bipolar mood disorder sometimes default (stop taking) on their medication. A person should never stop taking a medication or alter the dose without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.

    Psychological therapy

    Different kinds of psychotherapy can help people with bipolar disorder. Therapy can help them change their behaviour and manage their lives. It can also help patients get along better with family and friends.

    Research has clearly demonstrated that CBT is a very effective treatment for many people with bipolar mood disorder, both in terms of limiting the frequency and length of manic and depressive episodes, and also the degree of the highs and lows.

    Other treatments

    Some people do not get better with medication and therapy. These people may try electroconvulsive therapy, or ECT. Sometimes people take herbal and natural supplements, such as St John’s Wort, 5HTP or omega-3 fatty acids. Some people may also require sleep medications during treatment. Always consult with your doctor before taking any supplement or medication.

    Loved ones of people with bipolar

    When a friend or relative has bipolar disorder, it affects you too. Taking care of someone with bipolar disorder can be stressful. You have to cope with the mood swings and sometimes other problems, such as drinking too much. Sometimes the stress can strain your relationships with other people. Caregivers can miss work or lose free time.

    You cannot help take care of someone with bipolar or indeed any other chronic illness if you do not first take care of yourself!

    If you keep your stress level down you will do a better job, and it might help your loved one stick to his or her treatment. Sometimes it can also be helpful to see a psychologist to help you with these stressors.

    Ways to effectively manage your bipolar condition

    You can help yourself by discovering which treatments are most effective for you and then sticking to them! It takes time, and it’s not easy. But treatment is the best way to start feeling better. Here are some tips:

  • Stay on your medication.
  • Make sure you get enough sleep.
  • Learn to recognise your mood swings
  • Engage in psychotherapy such as CBT or psychoanalysis.
  • Keep a routine for eating and sleeping.
  • Ask a friend or relative to help you stick with your treatment.
  • Talk to your doctor about your treatment.
  • Be patient about your symptoms. Improvement takes time.
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