Bipolar Disorder
Bipolar disorder is a mental health condition characterized by extreme mood swings between emotional highs, known as mania (or hypomania) and emotional lows, usually manifested as depression. While we all have emotional mood swings, of course, the mood swings suffered by an individual with bipolar disorder are severe enough to be disruptive. They impact sleep and energy levels, activities, behaviors, judgment, and even relationships.
There are three main types of bipolar disorder. It is important to note that these are three separate diagnoses, not simply the same disorder in milder or more severe forms.
· Bipolar I disorder: Diagnosed after at least one manic episode, which may be severe enough to trigger psychosis (a break with reality). The manic episode may be preceded or followed by a major depressive episode or a hypomanic episode.
· Bipolar II disorder: Diagnosed after at least one hypomanic episode and at least one major depressive episode, even if there are period of normal function between mood swings. Diagnosis usually follows the depressive episode, which can be severe. People who are diagnosed with Bipolar II disorder may have co-occurring mental illness such as anxiety or substance use disorder.
· Cyclothymic disorder. Diagnosed after at least two years of multiple mood swings from hypomania and depression. Neither the mania nor the depression are as severe as in Bipolar I or Bipolar II disorders, but the mood swings occur more frequently and regularly. Cyclothymic disorder can be diagnosed after one year in children and teens.
Symptoms of Bipolar disorders: Mania, hypomania, and depression
A manic episode is characterized by usually high energy or extreme irritation for most of the day, for most days within a one week period. A manic episode is usually disruptive, causing noticeable problems at work, school, and social activities. In its most severe form, the manic episode can include breaks from reality (psychosis), which may require hospitalization.
A manic episode must include three or more of the following symptoms:
· Increased levels of energy, activity, or agitation
· Abnormally jumpy or upbeat
· Euphoria: an exaggerated feeling of self-confidence and well-being
· Talkativeness to an unusual level
· Disrupted sleep
· Inability to concentrate, or distractibility
· Uncontrollable racing thoughts
· Poor judgment and decision-making
A hypomanic episode is characterized by the same symptoms as a manic episode. However, the symptoms tend to be less severe. Hypomania is usually shorter in duration, and may be diagnosed after being exhibited for most of the day over a four-day span. Hypomanic episodes do not include psychosis and usually do not involve the same level of disruption to everyday living as a manic episode.
A major depressive episode is diagnosed when the symptoms of depression become severe enough to cause significant disruption to normal functioning, usually over the course of two or more weeks. A major depressive episode must involve at least five of the following symptoms, including at least one of the first two:
· Intense feelings of sadness, despair, helplessness, or worthlessness
· Noticeable lack of interest or pleasure, especially in activities that used to be enjoyable
· Feelings of excessive or inappropriate guilt
· Changes in sleep patterns: either sleeping too much or too little
· Significant changes in weight or in appetite
· Restlessness or noticeably slowed behavior, speech, or movement
· Fatigue and loss of energy
· Difficulty thinking, concentrating, or making decisions
· Frequent thoughts of suicide and death
Treatment for Bipolar Disorders
Bipolar disorder is a lifelong mental health concern. While it can be diagnosed at any age, it is most commonly diagnosed in the late teens or early 20s. As with most mental health conditions, there is no cure for bipolar disorder. However, the symptoms of bipolar disorder can be treated and effectively managed.
In most cases, bipolar disorder is treated with a combination of medication and psychotherapy (talk therapy). The manifestation of symptoms is highly individualized, and therefore each treatment plan must be individualized as well. Many people have to try different types and combinations of medications and therapy to find the approach that works for them. In most cases, treatment must be ongoing, as symptoms will reoccur once treatment stops.
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