UNDERSTANDING BIPOLAR AFFECTIVE DISORDER (BPAD), IT’S SYMPTOMS & MANAGEMENT
Bipolar Affective Disorder (BPAD): Extreme mood
swings, characterized by emotional highs (mania or hypomania) and lows
(depression), are the hallmark of bipolar illness, formerly known as manic
depression.
When someone is depressed, he or she could experience sadness or hopelessness
as well as lose interest in or enjoyment from most things. Mania or hypomania,
which is less severe than mania, can cause mood swings that include euphoria,
excessive energy, or extraordinary irritability. Sleep, energy, activity,
judgement, conduct, and the capacity for clear thought can all be impacted by
these mood changes.
It is typical for
bipolar disorder
to run in families: 80–90% of those who have the illness have a relative who
also has depression or bipolar disorder. Vulnerable individuals may experience
mood episodes brought on by environmental variables such as stress, sleep
disturbances, medications, and alcohol. It is thought that dysregulated brain
activity results from a chemical imbalance in the brain, even if the precise
causes of bipolar disease are unknown. Twenty-five is the average age of
onset.
Mood swing episodes might happen infrequently or frequently throughout the
year. Some people may not have any emotional symptoms in between bouts, but
most people will.
Even though bipolar disorder is a lifelong diagnosis, you can control other
symptoms like mood swings by adhering to a treatment plan. The majority of the
time, psychotherapy and medication are used to manage bipolar disorder.
Symptoms
Bipolar disorder and its linked disorders come in various forms. Depression
and mania or hypomania may be among them. The unpredictability of mood and
behavioural swings brought on by symptoms can cause severe discomfort and make
living challenging.
Bipolar I Disorder: The person has experienced at least one
manic episode, which may have been followed or preceded by serious depression
or hypomanic episodes. Mania can sometimes lead to psychosis or a detachment
from reality.
Bipolar II Disorder: The person has never experienced a manic
episode, but you have experienced at least one major depressive episode and
one hypomanic episode.
Cyclothymic Disorder: The person has experienced multiple
episodes of hypomania symptoms and depressed symptoms (but not as severe as
major depression) for at least two years, or one year in adolescents and
teenagers.
Other types: These comprise, for instance, bipolar illness
and associated disorders brought on by specific medicines or alcohol, or
resulting from a physical ailment like multiple sclerosis, stroke, or Cushing
s disease.
Bipolar II disorder is a distinct diagnosis rather than a less severe
variation of bipolar I illness. People with bipolar II condition may
experience prolonged periods of depression, which can significantly hinder
their lives, in contrast to the extreme and hazardous manic episodes
associated with bipolar I disorder.
While bipolar disorder can strike at any age, it is usually identified in
adolescence or the early twenties. Individual differences in symptoms as well
as changes in symptoms over time are possible.
Mania and Hypomania
Although manic and hypomanic episodes are different, they share similar
characteristics. Mania is more severe than hypomania and results in more
obvious issues with relationships, employment, school, and social activities.
Additionally, psychosis—a detachment from reality—caused by mania may
necessitate hospitalization.
An episode of manic or hypomanic behaviour involves three or more of the
following symptoms:
- Unusually Happy, Jittery, or Wired
- Increased Goal-Directed Activities
- Inflated Self-Esteem or Grandiosity
- Decreased Need for Sleep
- Overtalkitiveness or Pressure to keep talking
- Flight of Ideas or Racing Thoughts
- Distractibility
-
Making Poor Decisions, such as going on shopping binges, taking chances with
your partner, or making stupid investments
Major Depressive Episode
When symptoms of a major depressive episode are severe enough to interfere
noticeably with daily activities, such as relationships, work, school, or
social activities, it is considered a major episode. At least five of these
symptoms are present during an episode:
-
Depression, is characterized by feelings of melancholy, emptiness,
hopelessness, or tears (among kids and teenagers, depression can manifest as
impatience).
-
Marked Disinterest in or Lack of Enjoyment from all or nearly all activities
-
Not gaining weight, losing weight while not dieting, or experiencing an
increase or reduction in appetite (in youngsters, not gaining weight as
planned can indicate depression)
- Insomnia or Hypersomnia
- Psychomotor Agitation or Retardation
- Fatigue or Loss of Energy
-
Feelings of Worthlessness or Excessive or Inappropriate Guilt
-
Diminished Ability to Think or Concentrate or Indecisiveness
-
Recurrent Thoughts of Death or Suicidal Ideations
Cyclothymic Disorder
Cyclothymic disorder is a milder variation of bipolar illness that has a lot
of "mood swings," including frequent episodes of hypomania and depression.
Emotional ups and downs are a feature of cyclothymia, but the symptoms are not
as severe as those of bipolar I or II illness.
The following are some symptoms of cyclothymic disorder:
-
Numerous episodes of hypomanic and depressive symptoms spanning at least two
years, however, the symptoms don t fit the description of a hypomanic or
depressive episode.
-
The symptoms (mood swings) have persisted for at least half of the two-year
period and have never stopped for longer than two months.
Other features of bipolar disorder
Bipolar I and II illnesses might present with other signs and symptoms, such
as anxiety, sadness, psychosis, or other conditions. When symptoms first
appear, they may be diagnosed with mixed or rapid cycling, among other
classifications. Moreover, bipolar symptoms might fluctuate with the seasons
or manifest during pregnancy.
Symptoms in children and teens
Bipolar illness symptoms in children and teenagers might be challenging to
recognize. It might be challenging to determine whether these are symptoms of
stress or trauma, typical ups and downs, or any mental health issue other than
bipolar disorder.
While major depressive, manic, or hypomanic episodes can occur in children and
teens, the pattern of these episodes may differ from that of adults with
bipolar disorder. And throughout episodes, feelings can change quickly.
Between bouts, certain youngsters may experience periods free of mood
disorders.
Severe mood fluctuations that differ significantly from the patient s typical
mood swings may be one of the most noticeable symptoms of bipolar illness in
children and teenagers.
When to seek therapy
Even though bipolar disease causes dramatic mood swings, many sufferers are
unaware of how much their emotional instability affects them and their loved
ones, and they frequently go untreated.
Additionally, if someone has bipolar disorder, they might find that the cycles
of increased productivity and exhilaration are enjoyable. But this
exhilaration is invariably followed by an emotional collapse that can leave
them exhausted, unhappy, and possibly in problems with the law, money, or
relationships.
Visit a physician or a mental health professional if you have any signs of
mania or depression. Bipolar disorder does not improve by itself. If suffering
from Bipolar Disorder, they can manage their symptoms by seeking treatment
from a mental health specialist who specializes in treating bipolar illness.
Treatment and Management
Treatment usually makes bipolar illness symptoms better. Bipolar disorder
treatment primarily consists of medication, though many patients find that
talk therapy, also known as psychotherapy, helps them understand their
condition and take their meds as prescribed, which helps to prevent more
episodes of moodiness.
Medications referred to as "mood stabilizers," such as lithium, are
the kind most frequently used for bipolar disorder. It is thought that these
drugs balance out abnormal brain signals. As bipolar disorder is a chronic
condition with recurrent mood episodes, it is advised to receive preventive
treatment continuously. Treatment for bipolar disorder is personalized, and
patients may need to try a variety of drugs before settling on one that is
most effective for them.
Psychosocial treatment does not eliminate the need for medication. Long-acting
injectable antipsychotics are now available and may offer benefits to those
who take them: early detection of medication nonadherence, no daily medication
intake, and reduced rates of relapse and rehospitalization. However, these
drugs (such as aripiprazole, olanzapine, paliperidone and risperidone) are
indicated for schizophrenia.
Electroconvulsive therapy (ECT) is a useful therapeutic option that
may be utilized in some situations when medicine and psychotherapy have failed
to provide the desired results. ECT causes a brief, controlled seizure by
applying a brief electrical current to the patient s head multiple times while
they are unconscious. Seizures brought on by ECT are thought to alter brain
signalling networks.
Family members of someone with bipolar disorder may find it helpful to access
professional resources, especially mental health advocacy and support groups,
as the illness can seriously disrupt a person s daily routine and stress out
the family. Families can get information about coping mechanisms, active
treatment participation, and finding support from various sites.
Psycho-Social Treatment Modalities for Bipolar Affective Disorder (BPAD)
Cognitive Behaviour Therapy (CBT):
Cognitive behavioural therapy, which involves changing your thinking patterns,
is effective in treating bipolar disorder, according to the American
Psychological Association. Strategies used in CBT include role-playing to
prepare for interactions that may be problematic, rather than avoiding facing
fears directly, and learning techniques to calm and relax the mind and body.
Interpersonal and Social Rhythm Therapy (PSRT): IPSRT, an adjunctive
treatment for people with mood disorders, describes methods that help improve
medication adherence, manage stressful life events, and reduce disruptions in
social rhythms. Through this form of treatment, patients learn skills to help
them protect themselves from future episodes. IPSRT focuses on managing the
patient and their symptoms and improving interpersonal relationships.
Family-Focused Therapy (FFT): Family-focused therapy (FFT) involves
both the BD patient and their parents, spouse, or other family members. FFT
usually takes about 12 sessions (depending on the needs of the family) given
by a single therapist. Early sessions focus on education about the disease:
its symptoms and their cycle over time, its causes, recognizing the early
warning signs of new episodes, and what to do as a family to prevent episodes
from getting worse. Later sessions focus on communication and problem-solving
skills, especially for resolving family conflicts. In several randomized
trials conducted by my labs at the University of Colorado and UCLA, we found
that BD patients who received FFT and medication after an episode had fewer
mood symptoms and better functioning over 1-2 years than those who received
medicine and a shorter time. . treatment or case management.
Dialectical behaviour therapy (DBT): Dialectical behaviour therapy is
a skills-based approach that includes both individual and group therapy. It
teaches mindfulness and acceptance skills, such as the ability to experience
moment-to-moment thoughts, feelings, and associated physical sensations from
the attitude of an observer without negative judgment. It also teaches anxiety
tolerance, emotional regulation and interpersonal effectiveness.
Conclusion:
Bipolar disorder is a chronic mental health condition that causes extreme mood
swings, from mania to depression. Mania is a period of high energy,
irritability, and reduced need for sleep. Depression is a period of low
energy, sadness, and loss of interest in activities.
There is no cure for bipolar disorder, but it can be managed effectively with
medication and therapy. Medications called mood stabilizers are the first line
of treatment. They help to level out mood swings and prevent episodes of mania
and depression. Other medications, such as antipsychotics and antidepressants,
may also be used.
Therapy can also help people with bipolar disorder manage their symptoms.
Cognitive-behaviour therapy (CBT)
is a type of therapy that helps people identify and change negative thoughts
and behaviours. Psychoeducation is another type of therapy that teaches people
about bipolar disorder and how to manage it.
The goal of bipolar disorder management is to achieve and maintain euthymia,
which is a state of normal mood and functioning. This can be achieved through
a combination of medication and therapy.
In addition to medication and therapy, there are a number of lifestyle changes
that people with bipolar disorder can make to help manage their condition.
These include:
- Getting regular sleep
- Eating a healthy diet
- Exercising regularly
- Avoiding alcohol and drugs
- Managing stress
- Having a strong support system
Bipolar disorder is a serious mental health condition, but it can be managed
effectively with medication and therapy. People with bipolar disorder can live
full and productive lives with the right support.
Here are some additional tips for managing bipolar disorder:
-
Keep a mood journal to track your mood swings and identify triggers.
-
Develop a crisis plan for what to do if you start to experience a manic or
depressive episode.
-
Talk to your doctor about any side effects you are experiencing from your
medication.
-
Be patient with yourself and don t give up on your treatment plan.
-
With the right support, people with bipolar disorder can live full and
healthy lives.
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