Bipolar Disorder

Mental Health

Bipolar disorder (formerly manic depression or manic-depressive disorder) is a type of mental disorder characterized by severe mood swings. One day the sufferer may be manic and have large amounts of energy and vivid emotions. The next day they go into a low or depressive phase. These periods can last up to a few hours, days, or months. Some people swing rapidly from cycle to cycle, while others remain in a cycle for long periods. Long-term care and medication may be required to manage symptoms, along with support from therapists, family, and friends. While there is no cure for bipolar disorder, with good quality care, support, and medication compliance, sufferers can live a happy and full life.

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Symptoms

One of the main symptoms of bipolar disorder is the cycling of moods or mood swings from low to high and back again. The symptoms vary by which phase the sufferer is in:

Manic episode. During manic episodes, patients may experience extreme happiness, hyperactivity, and get very little sleep. They may have racing thoughts and speech. The person may also seem very irritable. High-risk and impulsive behaviors are common, such as excessive spending, hypersexuality, and unplanned travel. Some people in a manic episode will think they can do a lot of things at one time without feeling tired. They also may have racing thoughts, a decreased need for sleep, and feel like they are incredibly important and powerful.

Depressive episode. During depressive episodes, patients may appear withdrawn, socially isolated, tired, and generally disinterested. They may also feel sad, hopeless and have suicidal thoughts and ideations. They may have trouble concentrating and feel unable to accomplish simple tasks. Other symptoms of a depressive episode are talking very slowly, sleeping too much, and a generalized lack of interest in activities.

Types

There are three major types of bipolar disorder. These include:

Bipolar I

  • Must have had at least 1 major manic episode:
    • Excessive energy
    • Inability to concentrate
    • Extreme happiness
    • High risk, impulsive behaviors
    • Difficulty sleeping
  • May or may not have had a depressive episode
  • Manic episodes may be so severe that hospitalization is required
  • A manic episode may trigger psychosis (break from reality)

Bipolar II

  • Mildly elevated moods
  • Some periods of severe depression
  • Some periods of hypomania (mild hypermania)
  • Short periods of milder depression
  • Mixed mania
  • Symptoms occur together; mania, depression, and hypomania (mild mania)
  • Insomnia
  • Despair
  • Irritable
  • Hopeless
  • Suicidal thoughts
  • Absence of a severe manic episode

Cyclothymic disorder

  • Inability to concentrate
  • Easily distracted
  • Talking more than usual
  • Poor judgment
  • Racing thoughts
  • Irritable behavior
  • Inflated self-esteem
  • Feeling sad
  • Restlessness
  • Suicidal thoughts
  • Hypomania

Rapid Cycling

  • Four or more mood swings in twelve months
  • Mood swings that occur in a single week or day
  • Severe depression
  • Suicide Attempts

Treatments

Bipolar disorder is best treated with a combination of medications and psychotherapy.

Medications include:

Mood stabilizers. Some anti-seizure medications (e.g., valproic acid and lamotrigine) can help stabilize moods. Lithium is an older mood stabilizer that has a relatively high success rate of reducing symptoms, but it can be toxic with long-term use and needs to be monitored with lab work.
Antipsychotics. Early in treatment, antipsychotics (e.g., risperidone, olanzapine, and quetiapine) may be needed to stabilize severe symptoms for a relatively short time.
Antidepressants. Some patients need to take antidepressants to help with symptoms over a longer-term period. These can help with depressive symptoms and mania.

Alternative Treatments and Home Remedies

Consult with your physician before you take or consider taking any new supplements or alternative forms of treatment.

St. John’s wort. This is a natural antidepressant. There can be drug interactions with other prescription antidepressants. In some, St. John’s wort triggers manic episodes.

Magnesium.
Magnesium can be a natural relaxant and help with manic and anxiety symptoms.

Omega-3 fatty acids.
Fish oils or Omega-3 supplements may help alleviate depression. Statistics show that there tends to be less depression in societies where fish is a large part of the diet.

Acupuncture.
Many purport that acupuncture can relieve depression and anxiety symptoms.

!!!Never stop your medications or stop going to therapy. Always talk to your doctor about your treatment plan before making any changes!!!

Lifestyle Changes

Once a diagnosis of bipolar disorder is made, a few lifestyle changes can make the disorder easier to live with. These include:

Stress. Keep life as simple as possible and learn how to manage stress.

Schedule. Write down appointments and try to keep life as routine as possible.

Exercise. Take walks, go to yoga, or swim.

Diet. Eat a nutritious diet and avoid processed and fast food.

Caffeine. Reduce your intake of caffeine. This can relieve anxiety and insomnia.

Relaxation. Learn techniques to help you relax like meditation and deep breathing.

References

Lawvere, S. & Mahoney, M.C. (2005, December 01). St. John’s Wort. American Family Physician, 72(11): 2249-2254. Retrieved from:https://www.aafp.org/afp/2005/1201/p2249.html

Mayo Clinic Staff. (2021, February 06). Bipolar disorder. Retrieved from:https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955?_ga=2.174925858.1008330994.1615395064-1112618680.1615395064

Mayo Clinic Staff. (2018, May ). Cyclothymia (cyclothymic disorder). Retrieved from:https://www.mayoclinic.org/diseases-conditions/cyclothymia/symptoms-causes/syc-20371275

National Institute of Mental Health. (2018, October). Bipolar disorder. Retrieved from:https://www.nimh.nih.gov/health/publications/bipolar-disorder/19-mh-8088_152248.pdf

National Institute of Mental Health. (2020). Bipolar disorder in children and teens. Retrieved from:https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens/index.shtml

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