Bipolar disorder is a serious mental health condition that leads to intense mood swings, including deep sadness and depression, as well as mania or hypomania (a milder form of mania). This condition, sometimes called manic-depression, can affect anyone, but it usually starts in late teens or early adulthood and often needs lifelong treatment.
Just because someone has mood swings doesn’t mean they have bipolar disorder. To diagnose it, a psychiatrist and psychologist must assess how the person handles their mood and how it impacts their daily life.
Key symptoms
The symptoms of bipolar disorder depend on whether the person is going through a manic or depressive phase or both.
Manic episode symptoms:
- Feeling restless, euphoric, and irritable
- Trouble concentrating
- Unrealistic self-confidence
- Odd behaviour
- Drug use increase
- Rapid speech
- Trouble sleeping
- Denial that anything’s wrong
- Increased sexual desire
- Aggressive behaviour
Depressive episode symptoms:
- Feeling sad, anxious, and pessimistic
- Guilt, worthlessness, and helplessness
- Loss of interest in favourite activities
- Constant tiredness
- Difficulty concentrating
- Irritability and restlessness
- Sleep problems
- Changes in appetite and weight
- Chronic pain
- Suicidal thoughts
These symptoms can last for weeks, months, or even years, and they might be there all day, every day.
Types of bipolar disorder Bipolar disorder can vary in duration and intensity, and there are three main types:
Bipolar disorder type 1
People with type 1 bipolar disorder mainly experience manic episodes with extreme happiness, energy, agitation, grandiose thoughts, and little need for sleep. They may also be irritable, aggressive, or paranoid. Because of these symptoms, it’s sometimes confused with schizophrenia.
To identify a manic episode, at least 3 or 4 symptoms must be present for at least a week. These symptoms can cause major problems in the person’s life, and many people need hospitalisation.
Though manic episodes are more common, the person may also have episodes of depression.
Bipolar disorder type 2
Type 2 bipolar disorder involves both depressive and hypomanic episodes. These episodes are milder than type 1 and don’t totally interfere with daily life. Symptoms may include increased sociability, impulsivity, less need for sleep, initiative, energy, and impatience.
If a person has episodes of depression and hypomania without the full-blown mania of type 1, they have type 2 bipolar disorder.
Cyclothymic Disorder
This type has persistent hypomanic and depressive symptoms but is milder than the other types. Symptoms can last for at least 2 years. Because the symptoms are similar to depression, many people are treated for depression instead of bipolar disorder.
Treatment
While there’s no cure for bipolar disorder, it can be managed with treatments like psychotherapy, medication, and even holistic approaches.
Main treatments include:
Medication
A psychiatrist should always prescribe and supervise medication for bipolar disorder. Common medications include mood stabilisers, antipsychotics, antidepressants, and anxiolytics.
Psychotherapy
Psychotherapy is crucial for treating bipolar disorder and can be done individually, with families, or in groups. There are many types, such as interpersonal therapy, social rhythm therapy, and psychodynamic therapy.
Cognitive-behavioural therapy can help identify and replace negative thoughts and behaviours, as well as develop coping strategies.
Family and friends should learn about bipolar disorder to help them cope and intervene when needed.
Phototherapy
This less-common treatment for manic episodes uses different coloured lights to influence a person’s mood. It’s especially useful for cases of mild depression.
Non-drug methods
These methods should be used alongside, not instead of, medical treatment. They aim to reduce stress and anxiety, helping the person feel more balanced and preventing new episodes.
People with bipolar disorder should do regular exercise (like yoga, Pilates, or gentle walks) and enjoy hobbies and leisure activities (like watching films, reading, painting, or gardening). Eating healthily and avoiding processed foods is also important.
Calming drinks (like St. John’s wort tea, passionflower tea, chamomile tea, or lemon balm) and regular massages can help reduce tension too.
Preventing crises
To manage symptoms and prevent bipolar episodes, people need to take their medication regularly. The prescriber should check the medication at specific intervals to make sure it’s still effective. People with bipolar disorder should also avoid alcohol and drugs.
Complications can arise if treatment isn’t followed properly. Not sticking to treatment can lead to severe depression (which might result in a suicide attempt) or excessive mania (which can cause impulsive decisions and spending lots of money). In these cases, hospitalisation might be necessary to stabilise the mood episode.
References
- SOLÉ, B.; et al. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies. Int J Neuropsychopharmacol. 20. 8; 670-680, 2017
- PHILLIPS, M. L.; KUPFER, D. J. Bipolar disorder diagnosis: challenges and future directions. Lancet. 381. 9878; 1663-71, 2013
- HIRSCHFELD, R. M. Differential diagnosis of bipolar disorder and major depressive disorder. J Affect Disord. 169. 1; S12-6, 2014
- MILLER, J. N.; BLACK, D. W. Bipolar Disorder and Suicide: a Review. Curr Psychiatry Rep. 22. 2; 6, 2020
- TONDO, L.; et al. Depression and Mania in Bipolar Disorder. Curr Neuropharmacol. 15. 3; 353-358, 2017
- GRANDE, I.; et al. Bipolar disorder. Lancet. 387. 10027; 1561-1572, 2016
- American Psychistric Association. Manual Diagnóstico e Estatístico de transtornos mentais – DSM-5. 5 ed. Porto Alegre: Artmed, 2014. p. 123, 145–147.
