[I recently attended a seminar about bipolar disorder – it was very interesting and informative and I certainly learnt more about the illness. So I’ve decided to unravel bipolar disorder for you. Here’s everything you need to know about it.]
By Ilse Watson
Bipolar disorder used to be called manic-depressive disorder – that term is no longer in use.
Bipolar disorder is more than just a simple mood swing – it is rather the sudden, dramatic shift in the most extreme emotions that you experience. It is a physical illness which involves episodes of mania and depression, with periods of normal moods in between.
When does bipolar disorder start?
It normally begins in adolescence or early adulthood and it continues throughout the patient’s whole life, but it can start at any age. It can start with depression and some individuals may only experience a high or a mixed state after many years.
What causes bipolar disorder?
The exact cause is unknown but it is believed to be a combination of biochemical, genetic and psychological factors.
- Biochemical factors: Research has shown that the disorder is associated with a chemical imbalance in the brain.
- Genetic factors: The illness tends to run in families.
- Psychological factors: Mania and depression are often cyclical, occurring at particular times of the year. The illness is characterised by changes in biological rhythms, including sleep and hormone changes, seasonal changes and sometimes a stressful life event may trigger an episode of mania or depression.
There are two types of bipolar disorder – I (one) and II (two):
A person with bipolar disorder II experiences the same symptoms as a person with bipolar disorder I but the symptoms are not so severe in bipolar disorder II.
A person with bipolar disorder I experience manic symptoms. This is the most severe state to be in. The symptoms are as follows:
- The mood is abnormally elevated, euphoric and the person has grandiose delusions (e.g. he/she is the world’s best cook).
- Energy is increased, the person is over-talkative and hyperactive.
- They have racing thoughts – from one topic to the other.
- Disinhibition – they act out of character, they take risks, they go on a spending spree, they are sexually irresponsible and very aggressive.
- Psychotic – they hear voices and are out of touch with reality, have very poor insight into anything. When a person is psychotic, they normally need hospitalisation.
- These episodes are long and can last weeks or months.
- A person in a manic state feel fantastic and they are on a happy high.
A person with bipolar disorder II experiences hypomania. The symptoms are as follows:
- Hypomania is a milder form of mania and the person doesn’t experience psychotic symptoms.
- This state is less problematic – they also feel fantastic, everything is at a high speed but they are usually not reckless.
- The episode lasts for a briefer period – normally four days but psychiatrists feel that one to two days can qualify as a hypomanic episode.
- Hypomania will crash into a deep depression.
What is rapid cycling? In rapid cycling, a person with the disorder experiences four or more episodes of mania or depression in one year. It can occur at any point in the course of bipolar disorder, and can come and go over many years depending on how well the illness is treated; it is not necessarily a “permanent” or indefinite pattern of episodes.
What are mixed episodes in bipolar disorder?
Mixed episodes refer to the presence of high and low symptoms occurring at the same time, or as part of a single episode, in people experiencing an episode of mania or depression. In most forms of bipolar disorder, moods alternate between elevated and depressed over time. A person with mixed features experiences symptoms of both mood “poles” — mania and depression — simultaneously or in rapid sequence.
Interesting fact: No blood tests or other types of tests can be done to diagnose bipolar disorder. A psychiatrist or psychologist will ask questions to assess your overall mental health. Testing for bipolar disorder involves questions about symptoms, how long they’ve occurred, and how they may disrupt your life. The specialist will also ask you about certain risk factors for bipolar. This includes questions about family medical history and any history of drug abuse. They might ask your permission to ask friends and family about your behaviour. Any diagnosis will take into account other aspects of your medical history and medications you have taken.
To be exact with a diagnosis, doctors use the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM provides a technical and detailed description of bipolar disorder.
[END OF PART ONE – PART TWO FOLLOWS ON THURSDAY 8 JUNE]