It is normal for anyone to have good days and bad days or to occasionally be angry, nervous, sad, or even extremely happy. Emotions are natural and can change often based on relationships, jobs, daily interactions, health, and many other factors both within and out of our control.  But when emotional mood shifts are extreme, often without a clear cause, and sometimes lasting for several days or even weeks, then you may be suffering from an illness called bipolar disorder.

Understanding Bipolar Disorder

Bipolar disorder, also known as manic-depressive disorder, is a brain disorder that causes unusual mood shifts, ranging from manic episodes to extreme depression. Bipolar disorder can affect someone’s performance at work or at school, personal relationships, sleep patterns, and daily activity. Bipolar disorder can often lead to financial problems, frequent absences from work or school, relationship issues, or feelings of isolation. Therefore, it is very important to know the signs and symptoms of this illness, as the disorder can worsen over time if it is not treated. And luckily, it can often be controlled with proper treatment.

 

 

Symptoms of Bipolar Disorder

A major symptom of bipolar disorder is a mood episode – a period during which a person is in an unusually intense and extreme emotional state. A mood episode can be described as “manic” or as “depressive.” During a manic episode, a person may be extremely confident, happy, and overexcited; but during a depressive episode that same person may become sad, hopeless, anxious, and overwhelmed. Affected people can very quickly shift from a manic state to a depressive state, and occasionally may be in a mixed state where both manic and depressive emotions are experienced.

Symptoms of bipolar disorder depend on whether you are in a manic state or a depressive state. There are also varying degrees of each state, resulting in episodes and symptoms that can range from mild to moderate to extreme.

Symptoms during Manic Episodes

• Euphoric feeling; extreme happiness

• Inflated self-esteem or feeling of self-importance

• Overexcitement

• Extreme feelings of optimism

• Increased physical activity

• Decreased need for sleep

• Increased focus on specific goals or activities (socially, at work, sexually)

• Feeling extremely irritable or angry

• Talking too much and too fast

• Restlessness

• Being easily distracted

• Shifting quickly from one idea or thought to another

• Inability to concentrate

• Taking part in pleasurable activities that have serious consequences; some examples of risky behaviors may include impulsive sex, taking drugs, impulse buying or spending sprees, excessive drinking, gambling, and risky business investments

Symptoms during Depressive Episodes

• Feeling hopeless, empty, or extremely sad

• Feeling guilty

• Feeling anxious and worried

• Reduced interest in activities that once were enjoyable

• Difficulty concentrating and making decisions

• Fatigue

• Forgetfulness

• Irritation and restlessness

• Change in appetite, sleep patterns, activity levels

• Thoughts of death or suicide; an attempt at suicide

Symptoms during Mixed Episodes

• Difficulty sleeping

• Feeling anxious or agitated

• Being easily distracted

• Racing thoughts

• Major change in appetite

• Feeling depressed, sad, and hopeless; yet still feeling energized

• Thoughts of suicide

The exact cause of bipolar disorder is unknown, but several factors are thought to trigger bipolar episodes and to increase the risk of becoming bipolar. It is thought that many of these factors often work together to produce the illness.

Age: Half of all people with bipolar disorder develop this condition before the age of 25, usually between the ages of 15 and 25. If someone has not developed this condition by age 25, it is less likely that they will develop it later in life, although it is still possible.

Genetics: Bipolar disorder is more common in people who have a blood relative with the condition; especially a close relative like a parent or sibling. However, studies have shown that having a relative with bipolar disorder does not necessarily mean you will develop the condition.

Physical Differences in the Brain: People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.

Chemical Imbalances: An imbalance in the naturally occurring neurotransmitters – brain chemicals that transmit signals – might play a large role in causing bipolar disorder and other mood disorders.  These imbalances disturb the mood regulating area of the brain, which can result in extreme mood swings.

Hormone Imbalances: Changes in hormones, including changes that happen during puberty or in people with thyroid conditions, are thought to contribute to causing bipolar disorder. Also, hormonal fluctuations that come during a menstrual cycle are thought to sometimes trigger an episode in women suffering from the condition.

Environmental Factors: Stress, abuse, death of a loved one, the loss of a job, the end of a relationship, or other traumatic experiences may play a role in triggering a bipolar mood episode.

 

Diagnosing someone with bipolar disorder is not easy. Things like blood tests or a brain scan will not diagnose the condition, but may help rule out other possible health issues. Doctors will often perform a thorough physical exam, may ask that a patient keep a diary of their moods over a period of time to review with the doctor at a later date, may interview friends or family members that have observed mood episodes, or may partner with a mental health provider to assess the patient’s psychological state and study behavior patterns, thoughts, and feelings. 

Because there are often many steps taken to confirm a case of bipolar disorder, it might be months or years before there is a clear diagnosis.  Some symptoms of bipolar disorder – like anxiety, drug abuse, thyroid issues, heart issues, or weight gain – look like symptoms of other illnesses. It might even be diagnosed wrongly as depression or schizophrenia.

It is important to work with your doctor and mental health professional to diagnose bipolar disorder, because when the condition goes undiagnosed, it tends to worsen. Left untreated, a patient may end up in a psychiatric hospital or a residential treatment center. But if it is diagnosed early, it can be treated and controlled using various methods.

Bipolar disorder unfortunately cannot be cured, but can be treated and controlled once diagnosed. Treatment procedures are mostly focused on controlling behavioral changes and mood swings. Doctors may use medications or alternate therapies to help control the condition.

The first step to controlling bipolar disorder is for the patient and his or her doctor to understand any triggers and symptoms, as well as severity and frequency of episodes. To help facilitate this, it is recommended that patients keep a diary to track mood episodes and the behavior, feelings, sleeping patterns, and eating habits during these episodes. It is also important to keep track of all prescription medications and to track the effects of these medications on moods and any side effects. This will help the doctor to decide whether to continue the same medicines, to switch, or add medication. It will also help the doctor determine if psychotherapy or other treatments would be helpful.

Medications

Prescribing medicine for a patient with bipolar disorder depends on the patient’s condition and severity of the disease. Different people react differently to medications, and doctors may have to prescribe many different medicines to determine which combination is best.

Some medications doctors may prescribe are:

• Mood Stabilizers: used to control moods and avoid mood episodes; lithium is a common mood stabilizer used to treat mania and known to prevent the recurrence of both manic and depressive episodes

• Antidepressants: used to help minimize the feeling of depression

• Sleeping Pills: used as temporary relief for people suffering from disrupted sleep patterns during mood episodes

Each of these medications has possible side effects. Some are mild such as acne, nausea, or drowsiness; but others can be quite serious such as increased lipid or glucose levels, decreased thyroid function, or suicidal thoughts. To avoid serious complications, note side effects in a diary, consult with a doctor, and follow the doctor’s and pharmacist’s instructions for taking all medication.

Never stop taking a medication unless instructed to do so by a doctor. Even if you feel like your mood is stabilized, always continue your medication unless told otherwise by your physician.

Therapy

Doctors may recommend psychotherapy in place or in conjunction with medication. Some types of psychotherapy are:

• Cognitive Behavioral Therapy: individual therapy used to help patients identify unhealthy behaviors, lifestyle patterns, and thought patterns

• Family Therapy: therapy that involves family members and that focuses on family-coping strategies, family communication, and ways family members can identify episodes before they happen as well as help the patient cope with these episodes

• Group Therapy: therapy done in a group setting with other people that are suffering from similar conditions; this type of therapy often focuses on relationship skills and coping methods

• Educational Therapy, or Psychoeducation: counseling to help you or your friends and family learn more about bipolar disorder and its symptoms

Occasionally, bipolar episodes cannot be controlled, even with medicine and therapy.  In these cases, a doctor may try something called electroconvulsive therapy (ECT), also known as shock treatment. ECT involves passing electrical currents through the patient’s brain, which sometimes will improve a person’s mood by changing their brain chemistry. This option is mainly offered to people who are severely depressed, who are having suicidal thoughts, or who are not seeing any effects from drugs or therapy.

While your doctor is developing and monitoring your treatment plan, you can help both yourself and your doctor by communicating with your doctor, by being open and honest, and by following your doctor’s instructions. Here are some tips to help your treatment be successful.

• Keep a diary of medications, side effects, mood changes, and treatments

• Take your medicines regularl

• Continue taking medications, even if your mood improves, unless told otherwise by your doctor

• Stick to a somewhat consistent eating and sleeping schedule

• Get enough sleep

• Avoid stress 

• Learn to recognize your mood swings

• Ask family and friends for support

• Practice relaxation techniques such as meditation, yoga, and deep breathing

Living with Bipolar Disorder

Even before a formal diagnosis is made, a bipolar patient may suffer from severe mood swings. These mood swings might affect their behavior, their personal relationships, or their professional life. Bipolar disorder might even leave you feeling like you are not in control of your emotions or your life.  But you can manage this condition.  If you consult your doctor early on, you can learn how to manage or even prevent these episodes through the use of drugs, therapy, or a combination of both. With the proper treatment, you and your doctor can control bipolar disorder.