TYPES OF BIPOLAR DISORDERS
There are three basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. Symptoms can cause unpredictable changes in mood, thought process and behaviour, resulting in significant distress and difficulty in life.
- Bipolar I Disorder
You’ve had at least one MANIC episode that may be preceded or followed by a major depressive episode. Episodes of mood disturbance with mixed features (having depression and manic symptoms at the same time) are also possible. In some cases, mania may trigger a break from reality (psychosis).
- Bipolar II Disorder
You’ve had at least one major depressive episode and at least one HYPOMANIC episode, but not a full blown manic episode.
- Cyclothymic Disorder
You’ve had at least two years – or one year in children and teenagers – of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression
MANIA AND HYPOMANIA
Mania and hypomania have similar symptoms yet they are two distinct types of episodes. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
Both a manic and a hypomanic episode include three or more of these symptoms:
- Abnormally elevated mood
- Exaggerated sense of importance (Grandiosity)
- Decreased need for sleep
- Increased levels of energy
- Racing thoughts
- Unusual talkativeness
- Poor decision-making and judgement
- Excessive participation in pleasurable activities
MAJOR DEPRESSIVE EPISODE
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships.
An episode includes five or more of these symptoms:
- Depressed mood, or irritability
- Loss of interest or feeling no pleasure in all or almost all activities
- Changes in appetite leading to significant weight loss or weight gain
- Changes in sleeping patterns
- Restlessness or motor retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Difficulties with concentration and decision making
- Thinking about, planning or attempting suicide
CAUSES OF BIPOLAR DISORDER
The exact cause of bipolar disorder is unknown. Research suggests that there is a combination of factors that contribute to bipolar disorder.
Bipolar Disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers have found that a number of genes are involved.
People with Bipolar Disorder appear to have physical changes in their brains. Researchers are still trying to ascertain the significance of these changes..
RISK FACTORS FOR BIPOLAR DISORDER
Factors that may increase the risk of developing Bipolar Disorder or act as a trigger for the first episode include:
- Family history of Bipolar Disorder
- Periods of high stress
- Drug or alcohol abuse
COMPLICATIONS OF BIPOLAR DISORDER
If left untreated, Bipolar Disorder can result in serious problems:
- Drug and alcohol abuse
- Suicide or suicide attempts
- Legal or financial problems
- Relationship difficulties
- Poor work or school performance
CO-MORBIDITIES OF BIPOLAR DISORDER
Bipolar Disorder can also coexist with other conditions:
- Anxiety disorders
- Eating disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Alcohol or drug use disorders
TREATMENT OF BIPOLAR DISORDER
There is no curative treatment for Bipolar Disorder. Treatment is aimed at preventing and minimising recurring episodes of mania or depression.
Successful treatment is individualised and relies on a combination of:
- Support groups
- Electroconvulsive Therapy (ECT)
- Lifestyle modifications
- In some cases, admission to psychiatric hospital may be necessary.
Certain medications can help control the symptoms of Bipolar Disorder. We may need to try several different medications and work together to find the medication that works best for you.
Mood stabilizers and atypical antipsychotics are the medication classes of choice in the treatment of Bipolar Disorder. Additional medications can be added to the mood stabilizers as part of a treatment plan to help treat anxiety and sleep difficulties.
Psychotherapy offers support, education, and coping strategies to people with Bipolar Disorder and their families.
ECT is a procedure that delivers electrical stimulation to the brain and can help give relief from severe symptoms of Bipolar Disorder. ECT is usually considered only if the symptoms have not improved after a trial of other treatments, or in severe cases (like suicide risk and catatonia).