Bipolar Disorder

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly.

Bipolar disorder is a lifelong condition, but it can be managed effectively with treatment. With proper treatment and support, many people with bipolar disorder lead full, productive lives. Early diagnosis and treatment are important for managing the condition.

Bipolar disorder involves episodes of mood changes:

Manic Episodes (highs):

• Elevated mood: Feeling extremely happy, euphoric, or irritable
• Increased energy: Very high energy levels
• Racing thoughts: Thoughts moving very fast
• Decreased need for sleep: Feeling rested after little sleep
• Grandiosity: Inflated self-esteem or sense of importance
• Risky behavior: Poor judgment, reckless decisions
• Rapid speech: Talking very fast
• Distractibility: Difficulty focusing

Depressive Episodes (lows):

• Depressed mood: Persistent sadness or emptiness
• Loss of interest: In activities once enjoyed
• Fatigue: Low energy, feeling tired
• Sleep problems: Too much or too little sleep
• Appetite changes: Weight gain or loss
• Difficulty concentrating: Trouble thinking clearly
• Feelings of worthlessness: Or excessive guilt
• Thoughts of death or suicide: In severe cases

Hypomanic Episodes (milder highs):

• Similar to manic episodes but less severe
• May not cause significant problems
• May feel productive or creative
• Still requires treatment

Call Emergency Services (112 in Sweden) if:

• Thoughts of suicide or self-harm
• Severe manic episode with dangerous behavior
• Psychotic symptoms (hallucinations, delusions)
• Inability to care for yourself
• Immediate danger to yourself or others

Managing bipolar disorder involves:

1. Take Medications as Prescribed:

   • Don't skip doses
   • Don't stop medications without doctor approval
   • Mood stabilizers are usually long-term
   • Report side effects
   • Work with doctor to find right medications

2. Recognize Warning Signs:

   • Learn your early warning signs
   • Track mood patterns
   • Notice triggers
   • Act early when symptoms appear
   • Have a plan

3. Maintain Routine:

   • Regular sleep schedule (very important)
   • Regular meal times
   • Daily routine
   • Stability helps prevent episodes

4. Sleep Hygiene:

   • Consistent sleep schedule
   • Adequate sleep (7-9 hours)
   • Good sleep habits
   • Sleep disruption can trigger episodes

5. Avoid Triggers:

   • Stress management
   • Limit alcohol (can trigger episodes)
   • Don't use drugs
   • Avoid sleep disruption
   • Manage life changes

6. Support System:

   • Family and friends
   • Support groups
   • Healthcare team
   • Don't isolate
   • Educate loved ones

7. Therapy:

   • Cognitive-behavioral therapy
   • Interpersonal therapy
   • Family-focused therapy
   • Psychoeducation
   • Regular therapy sessions

• Thoughts of suicide or self-harm
• Severe manic episode
• Psychotic symptoms
• Dangerous behavior
• Immediate danger

• Mood episodes developing
• Medications not working
• Side effects from medications
• Need to adjust treatment
• Questions about management
• Concerns about symptoms

• Regular psychiatric appointments
• Medication monitoring
• Therapy sessions
• Follow treatment plan
• Report changes

Diagnosing bipolar disorder involves:

1. Psychiatric Evaluation:

   • Detailed history
   • Symptom assessment
   • Mood patterns
   • Family history
   • Medical history

2. Mood Charting:

   • Track moods over time
   • Identify patterns
   • Recognize episodes
   • Help with diagnosis

3. Physical Examination:

   • Rule out medical causes
   • Check for other conditions
   • Assess overall health

4. Other Tests (if needed):

   • Blood tests
   • Other medical tests
   • Rule out other causes

Treatment usually involves:

1. Medications:

   • Mood stabilizers: Lithium, valproate, others
   • Antipsychotics: For manic episodes
   • Antidepressants: Used carefully (can trigger mania)
   • Combination therapy: Often needed
   • Long-term treatment usually required

2. Psychotherapy:

   • Cognitive-behavioral therapy: Change thought patterns
   • Interpersonal therapy: Improve relationships
   • Family-focused therapy: Involve family
   • Psychoeducation: Learn about condition
   • Regular therapy important

3. Lifestyle Management:

   • Regular sleep schedule
   • Stress management
   • Avoid alcohol and drugs
   • Regular exercise
   • Healthy routine

4. Hospitalization (if needed):

   • Severe episodes
   • Safety concerns
   • Medication adjustment
   • Crisis stabilization

Prevent Episodes:

• Take medications as prescribed
• Maintain regular sleep
• Manage stress
• Avoid triggers
• Recognize early warning signs
• Regular treatment
• Support system

In bipolar disorder:

1. Brain Chemistry: Imbalance in neurotransmitters
2. Mood Regulation: Brain areas that regulate mood affected
3. Episodes: Periods of mania/hypomania and depression
4. Cycles: Episodes can occur in cycles
5. Impact: Affects thinking, behavior, functioning

Causes:

• Genetics: Runs in families
• Brain structure: Differences in brain structure/function
• Environmental factors: Stress, trauma, life events
• Complex interaction: Of multiple factors

• Most commonly diagnosed in late teens/early adulthood
• Can develop at any age
• Requires ongoing treatment
• Can affect work and relationships

• May be newly diagnosed
• May have been misdiagnosed earlier
• May need different treatment approach
• Higher risk of complications

Bipolar I:

• At least one manic episode
• Usually depressive episodes too
• Manic episodes can be severe

Bipolar II:

• Hypomanic episodes (not full mania)
• Depressive episodes
• Never full manic episode

Cyclothymic Disorder:

• Milder form
• Hypomanic and depressive symptoms
• Less severe than bipolar I or II

Bipolar disorder is a lifelong condition, but it can be effectively managed with treatment. Many people with bipolar disorder live full, productive lives with proper treatment and support.

Most people with bipolar disorder need long-term medication to manage the condition. However, treatment is individualized, and some people may be able to adjust medications over time under medical supervision.

Yes. With proper treatment and planning, many people with bipolar disorder have healthy pregnancies and children. It's important to work closely with healthcare providers before and during pregnancy.

Bipolar disorder involves both depressive and manic/hypomanic episodes, while depression involves only depressive episodes. This is why accurate diagnosis is important.

Stress doesn't cause bipolar disorder, but it can trigger episodes in people who have the condition. Managing stress is an important part of treatment.