Bipolar Disorder: What is it, Causes, Symptoms, Treatment Methods

Bipolar disorder, formerly known as manic depressive disorder, is a bipolar psychiatric disorder characterized by emotional highs and lows and causing exaggerated mood swings.

Bipolar disorder, formerly known as manic depressive disorder, is a bipolar psychiatric disorder characterized by emotional highs and lows and causing exaggerated mood swings. Emotional highs manifest as mania or hypomania, and lows manifest as depression. During the depression period due to bipolar disorder, the person may feel unhappy, depressed and hopeless, and often loses interest in the pursuits they love. When he enters a period of mania or hypomania (less extreme than mania), he may feel euphoric, energized, or unusually irritable. These sharp mood swings; It can negatively affect a person’s sleep, energy, activity, judgment, behavior and ability to think clearly. Mood swings may occur as frequently as a few times a year, or they may occur less frequently. In most patients, some emotional symptoms continue in the periods between attacks, while some may not have any symptoms. Bipolar disorder is a chronic disorder and continues throughout life. However, it is possible to control mood swings and other symptoms by following the treatment plan prepared by the doctor. Bipolar Disorder is often treated with medication and psychotherapy.

What is Bipolar Disorder?

Bipolar disorder; It is a mental health problem that changes a person’s mood, concentration, ability and energy to perform daily tasks. There are three defined subtypes of bipolar disorder. All three types have unusual and significant changes in mood, energy, and activity levels. These mood swings; It consists of periods known as manic episodes, which involve extremely cheerful, irritable, or energetic behavior, and depressive periods, characterized by very sad, apathetic, or hopeless feelings. Manic episodes with less intense emotional elevations are known as hypomanic episodes. Bipolar disorder subtypes can be listed as follows:

1. Bipolar I Disorder: Bipolar I disorder is characterized by manic episodes lasting at least 7 days (occupying most of the day, almost every day) or manic symptoms severe enough to require immediate hospitalization. Depending on the disorder, depressive episodes often also occur, typically lasting at least 2 weeks. It is also possible to experience mixed depression episodes in which depressive symptoms and manic symptoms occur simultaneously. Experiencing four or more episodes of mania or depression in a year is called rapid-cycling bipolar disorder.
2. Bipolar II Disorder: Bipolar II disorder is characterized by a pattern of one depressive and one hypomanic episode. Attacks are less severe than manic episodes in bipolar I disorder.
3. Cyclothymic disorder: This subtype, also called cyclothymia, is characterized by recurrent hypomanic and depressive symptoms that are not intense enough or last long enough to qualify as a hypomanic or depressive episode.
4. Other specified and unspecified bipolar and related disorders: Sometimes a person may experience symptoms of bipolar disorder that do not fit into the three categories listed above. In this case, the disorder is called “other specified and unspecified bipolar and related disorders.”

Bipolar disorder is often diagnosed in late adolescence or early adulthood. Sometimes bipolar symptoms can also be seen in children. Although its symptoms may increase or decrease over time, they usually require lifelong treatment. Following the treatment plan prescribed by the doctor helps patients manage their symptoms and improve their quality of life.

What Causes Bipolar Disorder?

The exact cause of the disease is not yet fully understood. However, it is thought that there may be a strong hereditary transmission. Bipolar disorder is considered one of the psychiatric conditions with the strongest hereditary transmission. Because more than two-thirds of people with bipolar disorder have at least one close biological family member with the same diagnosis. Even though a biological relative has bipolar disorder, this does not necessarily mean that you will develop the same disorder. According to research, some other factors that may predispose to the emergence of the disorder are:

• Structural changes in the brain: Researchers have found that there are small differences in the size or chemical properties of some brain structures in people with bipolar disorder. However, these differences cannot be observed with the help of imaging methods such as MRI or CT.
• Environmental factors such as stress or trauma: Stressful life events such as the loss of a loved one, a serious illness, divorce or financial difficulties; It can trigger a manic or depressive episode. Therefore, stress and trauma may play a role in the emergence of bipolar disorder.

How to Diagnose Bipolar Disorder?

If your family doctor suspects you have bipolar disorder, he or she will usually refer you to a Psychiatrist, a doctor trained in mental and neurological diseases. The psychiatrist first listens to your complaints and questions your symptoms in detail. With your permission, he/she tries to obtain detailed information about your symptoms by talking to a relative. Your doctor will then perform a physical exam and order some tests to determine if there is another underlying disease that may be causing your symptoms.

Symptoms That Occur with Bipolar Disorder

To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania. Both of these involve excitement, impulsivity and high energy; However, hypomania occurs with less severe symptoms than mania. Symptoms of mania may further interfere with your daily life at work or at home, while symptoms of hypomania typically do not cause much disruption to daily life; but it can still be disturbing. In some individuals, it may also be accompanied by major depressive symptoms. Symptoms vary depending on the type of disease. The symptoms of bipolar disorder that can be seen during manic and depressive periods are detailed below.

Manic or Hypomanic Episode Symptoms

• Emotional elevation, feeling very happy or extremely angry or resentful
• Feeling tense and more active than usual
• Decreased need for sleep
• Talking quickly on many different topics, experiencing flight of ideas
• Feeling like you can do many things at the same time without getting tired
• Excessive appetite for food, drink, sex, or other pleasurable activities
• Feeling unusually important, capable, or powerful

Depressive Episode Symptoms

• Feeling very sad, moody, or anxious
• Feeling restless and slowed down
• Problems falling or staying asleep, waking up too early or sleeping too much
• Speaking too slowly, having nothing to say, or forgetting many things
• Feeling like you can’t do even the simplest things
• Lack of interest in almost all activities
• Feeling hopeless and worthless or thinking about death or suicide

Bipolar Disorder Treatment

There is no treatment option yet that provides complete relief for bipolar disorder. Treatments are applied to control the symptoms of the disease. Primary treatments for bipolar disorder include medication and psychological counseling (psychotherapy) to control symptoms. Additionally, participation in education and support groups can also positively contribute to treatment. Treatment is determined by the patient’s needs and may include:

• Medications: Medication is often started to prevent exaggerated ups and downs in the patient’s mood. Drug treatment is continued not only during attack periods but also during asymptomatic periods. Treatment often continues for life.
• Preventing substance abuse: In order to control bipolar disorder, problems related to alcohol and substance use, if any, must be treated.
• Hospitalization: Patients who engage in dangerous behavior, are suicidal, or have psychotic symptoms that are detached from reality may require hospitalization and treatment.
• Psychotherapy: Psychotherapy, that is, talking treatment, is an important building block of bipolar disorder treatment. It can be applied individually or in family or group settings.
• ECT (Electroconvulsive therapy) ECT, also known as electroshock therapy; It can be applied especially when symptoms are severe, there is suicidal tendencies, are accompanied by psychotic symptoms, or medications appear to be ineffective. ECT is a short-term treatment that can be used for severe manic or depressive episodes and provides effective results in approximately 75% of patients.

If you observe problems similar to bipolar disorder, you can apply to a health institution and undergo a psychiatrist examination.