Bipolar disorder is a chronic mental disorder that causes abnormal shifts in persons, sleep pattern, activities, energy, thinking pattern, and behaviour. These changes disturb to carry on a person’s day to day life. Mood swing may occur several times within one year. This is a lifelong disease that can be managed by the treatments. Depression episode tends to show often more than the manic episode in most patients and some patients have mixed episode of mania and depression.
Though generally, this disease identified during late adolescence or early adulthood some times in children also. After a baby delivery, mother face to large hormone changes and it may a cause for starting mental illness within some women. So some times bipolar disorder firstly appear in some women in their pregnancy or after the delivery.
Bipolar disease is a disease that should take medications life long treatments under a psychiatrist. If patients take treatments according to doctors advice with good followup care, can manage their symptoms and improve their quality of life.
“Bipolar Disorder, Manic Depression, Bipolar Affective Disorder (BAD)” all of these synonyms use to call this disease.
There are four types of bipolar disorder (or mainly there are three types). The mood, energy, and activity levels are changed in all of these four types. These mood changes come extremely higher or extremely down. When those moods come up or irritable called a manic episode and when become down called depression. Minor severity of the manic episode named a hypomanic episode. Here are the types of bipolar disorder.
Bipolar I Disorder
This is also known as a manic depressive disorder. In bipolar I disorder, the patient has experienced manic episode lasts at least one week with severe features that need immediate hospitalization and the major depressive episode lasts at least two weeks with both manic and depressive mixture features. In this, the patient may have manic episodes with any depressive symptoms or depressive episodes with any manic symptoms.
Bipolar II Disorder
In this, recurring episodes of major depression and hypomanic episodes. The patient may have experienced at least one episode of minor mania and major depression in his/her lifetime.
Cyclothymia is the milder form of bipolar disorder which consists of cyclical mood swings. Normally this starts in adolescents. The symptoms are not severe adequate to identify as either mania or major depression. Because of the less of the severity of the symptoms, people with the disease live in a society without treatments. That is a rick to increase the disease condition.
Other Bipolar Related Disorders
There are some bipolar disorder symptoms, not include to above three. These patients have abnormal alternative mood changes for two or more years.
Risk Factors of Bipolar disorder
Heredity – Genes are not only the main reason for the disease, but it takes an important place. A child who has a parent diagnosed with bipolar disorder have a 15-30% chance of developing the disease and a child with two bipolar parents have a 50- to 75% risk. But genes are not the only risk factor for the disease.
Brain Structure – There are some brain structure abnormalities can be seen in a bipolar patient. Those changes appear in brain areas responsible for the regulation of emotions, inhibitions, and motivation.
Environment – When increasing the various type of physical, psychological and emotional trauma, they have a risk for bipolar disease. Substance misuse likewise habits also affect to increase risk.
The episode which increases happy, energy and activity. In this episode, patients are irritable, confuse, confident, joyful and more prone to cope with activities. Mania is a character of multiple mental diseases such as bipolar disorder, schizoaffective disorder and medical condition like multiple sclerosis. Some drugs are caused to mania like prednisolone and substance like caffeine and cocaine.
As reported by DSM-5 manic episode divided into three parts according to its severity. The three stages of the mania are hypomania(stage I), acute mania (stage II) and delirious mania – delirium (stage III).
Symptoms in Manic Episode
- Lots of energy
- Decrease sleeping (insomnia)
- Over talkative
- Racing thoughts
- Increased sexual desire
- Restlessness and agitation
- Increase emotional sensitivity
- Lack of concentration
- Grandeur delusion
- Try doing dangerous activities
The episode which decreases the patient’s energy and interesting. In this period, the patient stays in a depressed or sad mood.
Symptoms in Depressive Episode
- Prolong period of sadness without reason
- Loss of motivation
- Hopelessness and guilty feeling
- Extreme fatigue or loss of energy
- Poor concentrating
- Poor or excessive sleeping
- Generalized anxiety
- Social isolation
- Feel worried and empty
- Forget things a lot
- Poor or excessive food intake
- Suicidal ideas and thoughts
Treatments of Bipolar Disorder
Most effective treatment method is a combination of medication and psychotherapy. Bipolar disorder is a lifelong illness, so manic and depression episodes typically come back over time. Between episodes, some patients are free of mood changes and some patients have lingering symptoms. However, long term proper treatment can control symptoms.
Medications for Bipolar Disorder
Usually use mood stabilizers (lithium, carbamazepine, lamotrigine, valproate), antidepressants (amitriptyline, clomipramine, imipramine), and atypical antipsychotics (clozapine, olanzapine, quetiapine, risperidone) drugs. These drugs can help control symptoms of bipolar disorder.
Psychotherapy for bipolar disease (Talk Therapy)
In this method, talks with the patient regarding their feelings, thoughts, and behaviours that cause problems to him. Talk therapy helps to understand the problems of the person and improve a positive self-image.
Family members, caregivers and individual therapy are included for this. Here are the type of psychotherapies;
- Cognitive behavioural therapy (CBT)
- Family-focused therapy
- Interpersonal and social rhythm therapy
Other Treatments of Bipolar Disease
Training in life skills and symptom management is one of the solution-oriented treatment of bipolar. Holistic healing techniques such as meditation, massage therapy, acupuncture, yoga help to emotional stability. Electroconvulsive Therapy is used to treat severe bipolar patients who can’t recover with another treatment.
How to cope with a Bipolar patient?
Live with a bipolar patient is a challenge for relations and they have to bear all his/her abnormal behaviours. So it is better to know how to cope with the patient and how to help him to make it easier.
The first thing is to understand the patient and the disease condition. Normally your psychiatrist and the psychiatric nurse give you knowledge about those things. There is more time to recover. It is not an easy or simple thing. The patient should take medication and can’t miss even one dose. So always a relation has to stay with the patient to care for him.
Take all medications under a psychiatrist according to his order. Do not change or stop the drugs though the patient change in a good manner.
Help the patient to do his works and allow to sleep taking meals at the same time every day as a habit. They want proper sleep.
Identify their signs of severe situations of the disease. ( mood changes, poor sleep, behavioural changes)
Understand the patient and always help him. Be patient to cure the patient. It takes more time to control the symptoms. This is a lifelong illness. But with treatments patient can spend a normal life. He needs the support of others.
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