Bipolar Disorder: Symptoms, Diagnosis and Treatments

An individual with bipolar disorder may suffer mood, energy, and activity level fluctuations, making daily life challenging. Bipolar disorder may create significant disruption in a person's life, although the effect varies depending on the individual. Many persons with this condition may lead a full and active life with the right treatment and care. Bipolar disorder affects about 10 million people in the United States, or around 2.8% of the population, according to National Alliance for Mental Illness (NAMI). Individuals with bipolar disorder have access to various effective treatments, including medication, psychotherapy, and lifestyle adjustments. However, Bipolar disorder treatments may vary depending on the patient's symptoms and other health conditions.  

What is Bipolar disorder?

The basic signs of bipolar disorder, according to the National Institutes of Mental Health, are alternating spells of high and low mood. Changes in an individual's energy levels, sleep habits, attention, and other characteristics can significantly influence a person's behavior, job, relationships, and other parts of life. Most individuals experience mood swings at some point, but those associated with bipolar disorder are more extreme than typical mood swings, and additional symptoms may appear. Psychosis, which can involve hallucinations, delusions, and paranoia, affects certain people. In the months or years between episodes, the person's emotions may be stable, particularly if they adhere to a treatment plan. Many people with bipolar disorder may have jobs, study, and enjoy a full and productive life thanks to treatment. When treatment makes individuals feel better, they may discontinue taking their medicine. The signs may then reappear. Certain parts of bipolar disorder can be enjoyable. They may discover they are more social, talkative, and creative when in a good mood.

What are the types of Bipolar disorder?

A person may be diagnosed with one of three forms of bipolar disorder. According to NAMI, symptoms occur on a spectrum, and the difference between the kinds is rarely evident.

Bipolar I disorder -

For a bipolar 1 disorder diagnosis:

• The person must have had at least 1 manic episode.
• The individual may have already experienced a serious depressive episode.
• Other conditions, such as schizophrenic and delusional disorder, must be proven by the doctor.

Bipolar -2 disorder -

Bipolar II illness includes hypomania, though depression is usually the dominating condition. An individual must have the following symptoms to be diagnosed with bipolar-2 disorder:

• One or more instances of depression.
• At least one incident of hypomania.
• There is no alternative explanation for mood swings.
• A person suffering from hypomania may feel well and perform well, but their mood may be unstable, and depression is possible.

Many people sometimes consider bipolar II disorder to be a milder kind. Yet, it is just different. According to NAMI, persons with bipolar II disorder may have more depressive episodes than people with bipolar 1 condition.

What are the Symptoms of Bipolar disorder?

Symptoms vary from person to person, based on the International Bipolar Association. An episode might last many months or even years for some people. Some may experience "highs" and "lows" concurrently or rapidly. A person with "fast cycling" bipolar disorder will also have 4 or more episodes yearly. Hypomania or mania. Mania and hypomania are both states of increased emotion. Mania is a more extreme condition than hypomania. Among the symptoms are:

• Impaired judgment.
• Feeling wired.
• Little sleep but no sensation of fatigue.
• A sensation of distraction or weariness.
• Missed work or school.
• Underperforming at a job or school.
• Feeling as though you can achieve anything.
• Being pleasant and open, sometimes aggressively so engaged in unsafe activity.
• Increased libido.
• Feeling thrilled or euphoric.
• Speaking quickly and extensively.
• In discussion, switching from one topic to another.
• Denying or failing to recognize that something is wrong.
• Some persons with bipolar disorder may overspend, take recreational drugs, drink alcohol, and engage in risky and inappropriate behaviors.

Common Symptoms of bipolar depressive episode -  During a bipolar depressive episode, a person may experience:

• A sensation of gloom, sorrow, and hopelessness.
• Sadness to the extreme.
• Sleeplessness and sleeping issues.
• Pain or physical difficulties that do not respond to therapy.
• A sensation of guilt that could be misplaced.
• Eating more or less.
• losing or gaining weight
• Extreme weariness, lethargy, and listlessness.
• An incapacity to appreciate activities or hobbies that ordinarily generate pleasure.
• Having trouble focusing and remembering.
• Irritability.
• Sensitivity to noises and scents that others may not notice.
• In severe circumstances, the individual may contemplate suicide and act on such ideas.

How is bipolar disorder diagnosed?

There is no specific diagnostic test, such as a blood or brain scan, to definitively diagnose bipolar disorder. Instead, the diagnosis is typically based on a thorough assessment of an individual's symptoms, medical history, and other relevant factors. However, certain tests and assessments may be part of the Bipolar disorder treatments and diagnosis. Here are some commonly used components:

• Mood and Symptom Assessment - A mental health professional will conduct a detailed interview to assess the individual's mood patterns, including manic, hypomanic, and depressive episodes. They will ask about the frequency, duration, and severity of these episodes and any associated symptoms.

• Diagnostic Criteria - The mental health professional will refer to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Bipolar disorder has specific criteria that must be met for a formal diagnosis. These criteria include the presence of manic or hypomanic episodes and depressive episodes.

• Screening Tools - Various screening questionnaires and rating scales may be used to gather additional information and assess the severity of symptoms. Examples include the Mood Disorder Questionnaire (MDQ) and the Bipolar Spectrum Diagnostic Scale (BSDS).

• Medical Evaluation - The mental health professional may request medical tests or consult with a physician to rule out any underlying medical conditions that could be contributing to the symptoms or causing similar symptoms. This evaluation may include blood tests and a physical examination.

• Family History - Bipolar disorder has a genetic component, so the mental health professional may inquire about a family history of bipolar disorder or other mental health conditions.

• Collaborative Information - Input from family members or close friends who have observed the individual's behavior and mood changes can provide additional information for the diagnosis.

Remember, a thorough assessment by a qualified mental health professional is crucial for an accurate diagnosis of bipolar disorder.  

What are the Treatment options for bipolar disorder?

The goal of Bipolar disorder treatments is to stabilize the person's mood and lessen the intensity of symptoms. The purpose is to assist the individual in functioning properly in daily life. A mix of therapy is used in treatment, including:

1. Medication
2. Psychotherapy
3. Physical intervention
4. Lifestyle changes 

Because people react differently and symptoms vary greatly, it might take time to establish a precise diagnosis and find an appropriate therapy.

Treatment with drugs

Medications can assist in regulating mood and controlling symptoms. A doctor will frequently recommend a combination of the following:

• Lithium, for example, is a mood stabilizer.
• Antidepressants.
• Antipsychotics of the second generation (SGAs).
• Anticonvulsants are used to treat mania.
• Medication to aid sleep or anxiety.

The drug may need to be adjusted by the doctor over time. Certain medications have adverse effects, and they affect people differently. If people worry about drug therapy, they should consult their doctor. A person must follow,

• Inform your physician about any other medications you take to lessen the chance of interactions and side effects.
• Follow the doctor's medication and treatment directions.
• Discuss any concerns regarding side effects and whether they believe the medication is effective.
• Continue taking your medicine until the doctor says it's safe to stop.
• Keep in mind that the medications may take some time to set in.

If the person stops taking their medication, their symptoms may worsen.

Counseling and psychotherapy

Psychotherapy can assist in alleviating symptoms and prepare an individual to deal with bipolar disorder. Individuals can learn: through cognitive-behavioral therapy (CBT) and other approaches:

• Recognize and respond to important stimuli, such as stress.
• Early indicators of an episode must be identified and managed.
• Work on things that will keep your mood consistent for as long as feasible.
• Enlist the assistance of family members, instructors, and coworkers.
• These methods can assist a person in maintaining great connections both at home and at work. A doctor may prescribe family therapy for children and teenagers with bipolar disorder.

Hospital treatment 

Some persons may require hospitalization if they are in danger of hurting themselves or others. If prior therapies are ineffective, a doctor may recommend electroconvulsive therapy (ECT). Electrical currents are transmitted into the brain during electroconvulsive treatment (ECT), causing a short seizure. ECT appears to alter brain chemistry, which can cure the effects of certain mental conditions.  If you are unable to improve with drugs, are unable to take antidepressants due to medical reasons such as pregnancy, or are at high risk for suicide, ECT could be an alternative for bipolar treatment. Transcranial magnetic stimulation (TMS) is being researched as a treatment option for individuals who have not responded to antidepressants.

Changes in Lifestyle 

Certain lifestyle changes can aid in the maintenance of a stable mood and the management of symptoms. They are as follows:

• Keeping a regular schedule.
• Following a nutritious and diverse diet.
• Developing a consistent sleep schedule and taking precautions to prevent sleep disruption.
• Doing regular exercise.

Some individuals take supplements, but it is critical to consult a doctor first. Several alternative treatments may interact with bipolar disorder medications. These may aggravate symptoms.

Conclusion -

Bipolar disorder is a moderately common but significant mental health condition characterized by mood, energy, and concentration swings, among other symptoms. It can significantly impact a person's life, although therapy can significantly improve the outlook. Therapy may not completely eradicate mood swings, but working closely with a therapist may make the symptoms more bearable and improve the quality of life.