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According to the World Health Organization (WHO), approximately 40 million people live with bipolar disorder all around the world. However, mental health issues such as bipolar disorder are often shrouded in mystery and misunderstanding. This blog details bipolar disorder's meaning and manifestations to demystify a mental health issue that impacts the relationships, work, and well-being of so many worldwide.
What is Bipolar Disorder?
Bipolar disorder disease was previously known as manic depression. It is a mental health condition that severely impacts mood. According to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), “It is a group of brain disorders that causes extreme fluctuations in mood, energy, and ability to function.”
Bipolar disorder has two states; mania and depression. To understand what bipolar disorder is, one has to fully comprehend these two states.
Bipolar Disorder - Mania/Hypomania Symptoms
Mania and hypomania both refer to the emotional “high” of bipolar disorder disease. Hypomania is the less severe of the two. These states are characterized by elevated mood, irritability, and impulsiveness. Patients are often very talkative, impulsive, with inflated self-esteem, and prone to risky behavior.
Bipolar Depression Disorder Symptoms
The other side of bipolar disorder disease symptoms is the depressive state. It is characterized by a consistently low mood, lack of enjoyment in any activity, lethargy, sleep issues, altered appetite, weight fluctuations, difficulty in focusing, and feelings of guilt and worthlessness.
Individuals suffering from bipolar disorder symptoms fluctuate between these two states. These “mood changes” may happen once a year or more, lasting many days each time. Bipolar disorder is often a debilitating condition that has a significant impact on an individual's daily life and relationships. However, it is manageable with care options that combine medicine and psychological therapy.
Bipolar Disorder Symptoms
Bipolar disorder symptoms constitute extreme mood swings. What people around someone with bipolar disorder fail to understand is that these symptoms are clinical and there is no way that the patient can alleviate them without seeking professional help and guidance.
Understanding bipolar disorder involves recognizing the impact of this mental health condition on daily life and activities. There are three main types of bipolar disorder disease:
Bipolar 1 Disorder
People suffering from this form of bipolar disorder have experienced one or more manic episodes with depressive episodes in between. Eventually, the incidence of depressive episodes exceeds the manic ones.
Bipolar 2 Disorder
In bipolar disorder 2, patients have suffered from one or more hypomanic episodes (less severe symptoms) and one depressive episode. However, there were no manic episodes.
Cyclothymic Bipolar Disorder
A less severe form that includes cyclic episodes of mania and depression.
What Causes Bipolar Disorder?
Exploring the meaning of bipolar disorder, or understanding the answer to the question ‘What is bipolar disorder?’, is the first step toward meaningful change for both patients and the people around them.
Bipolar Disorder Disease - Risk Factors
Factors that may worsen or trigger an episode of bipolar disorder symptoms include:
Genetics - Having a family member with bipolar disorder (First-degree relative)
Periods of extreme stress
Biological differences (still being researched)
Drug use
Alcohol addiction/abuse
Bipolar Disorder Disease - Pathophysiology
The pathophysiology of bipolar disorder disease is characterized by poorly understood interaction between biological and genetic factors and the brain’s structure and chemistry.
Neurotransmitters
Our brains produce chemicals called neurotransmitters to affect other cells and elicit a response. One of the major problems in bipolar disorder is the abnormal regulation of these chemicals, especially mood regulators such as dopamine, serotonin, and norepinephrine.
This neurotransmitter dysregulation is responsible for both bipolar depression disorder symptoms and manic/hypomanic symptoms.
Genetic Factors
Bipolar disorder disease has a genetic preponderance. Meaning that it runs in families. Factors like inflammation, oxidative damage, and abnormal mitochondrial function may play a role in the manifestation of bipolar disorder.
Abnormal Structure And Function of the Brain
Susceptible changes in the brain’s structure and working in areas such as the prefrontal cortex, amygdala, and hippocampus (regions concerned with emotions, decision-making, and memory) may predispose to bipolar disorder.
How Bipolar Disorder is Diagnosed?
The diagnosis of bipolar disorder is based on evaluations after a thorough physical examination, tracking mood changes, and a detailed mental health check-up by a professional psychiatrist.
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), the criteria for diagnosis of bipolar disorder is:
Minimum one episode of mania/hypomania
For mania – Elevated/irritable mood changes lasting for a week (present all day, every day)
For hypomania – Mood changes lasting four days in a row (present all day, every day)
For depression – Five or more depressive symptoms experienced in 2 weeks
Bipolar disorder is different from normal changes in mood or feeling down. The mood changes experienced due to bipolar disorder have no apparent cause or trigger most of the time, fluctuate abnormally, and are difficult to recover from simply by changing the surroundings or any other feel-good measures. The mood fluctuations of bipolar disorder disease also last longer and are more intense.
Treatment for Bipolar Disorder
The treatment of bipolar disorder symptoms is possible and requires a combination of medicine and psychological intervention. The treatment is ongoing and lifelong.
Medications
The medications for bipolar disorder disease include medicines that address mood changes, depression, and antipsychotics. The combination is individual-specific and depends on the intensity and frequency of bipolar disorder symptoms.
Psychological Treatment
Psychotherapy for bipolar disorder focuses on factors such as:
Psychological education
CBT - Cognitive Behavioral Therapy
Learning coping mechanisms
Knowing and recognizing the triggers
Learning to balance emotions
Supportive measures like lifestyle changes, mood tracking, and regular follow-ups also play an important role in the treatment of bipolar disorder.
Bipolar Disorder Test
There is no particular lab test or investigation that will give a conclusive bipolar disorder diagnosis. The diagnosis is usually made based on various factors that include:
Evaluation by a mental health professional like a qualified psychiatrist
Behavioral examination
Mood tracking or charting
Quantifying questionnaire scales (MDQ, YMRS)
Lab tests (to rule out other medical conditions)
Imaging (in rare cases to evaluate the structure of the brain like CT, MRI)
