Bipolar disorder

summary of bipolar disorder

Manic-depressive disorder (or psychosis) is a psychiatric illness also known as “bipolar mood disorder” or simply “bipolar disorder”.

The symptoms of bipolar disorder are different from one individual to another as there are different types of illness known as bipolar disorder type I and type II. The diseases are differentiated according to the number and alternation of manic and depressive episodes.

In the past, patients with this disease were considered insane and admitted to asylums. Fortunately, today there are medications that can greatly reduce seizures, intensity and duration. Patients can pretty much live a normal life as long as they take their medication correctly and regularly.

When medications are ineffective, the doctor may use a combination of drugs, for example. In extreme cases, the doctor may resort to electroconvulsive therapy. Despite the great controversy surrounding this therapy, this technique was widely used when there were no drug alternatives available.

It is important to explain to the patient that he is not crazy and emphasize the importance of using the medication correctly. The drugs, in addition to reducing the frequency and intensity of crises, reduce the risk of complications, such as suicidal thoughts.

Bipolar disorder definition

Manic-depressive disorder or bipolar disorder is a psychiatric illness characterized by mood swings, which is why the illness is also known as a mood disorder. The patient goes through phases that are characteristic of mania (euphoria) and depression. There are also mixed phases at irregular intervals, where the patient is neither manic nor depressive.

There are actually two types of bipolar disorder, called I and II. These types differ in the intensity of the manic phase and its duration.

Bipolar I Disorder

Bipolar I disorder is characterized by manic or mixed phases that appear regularly. The depressive phase may or may not be present. Although the depressive phase is not necessarily present, the illness returns during the patient’s life without depression.

bipolar II disorder

In the case of bipolar II disease, the patient goes through depressive and hypomanic phases.

The manic phase lasts at least one week, with a change in social behavior, as well as the presence of at least four of the following symptoms:

– Excessive behavior, with no sense of boundaries.

– Agitation.

– Inflated self-esteem, sense of grandeur.

– Fertile ideas, a lot of creativity.

– Decreased need for sleep, rebellious insomnia.

– Ease of contact, but exaggerated.

– Distraction.

The hypomanic phase resembles the manic phase, except for the intensity. In fact, the hypomanic phase does not affect social functioning. In addition, at least 4 days are required.

The mixed phase, as its name suggests, combines the symptoms of mania and depression.

The depressive phase is characterized by a decrease in physical and mental activity, fatigue, loss of pleasure in doing daily activities. Great sadness invades the patient, who begins to have suicide desires. The depressive phase can begin insidiously and without warning, at the turn of a manic phase.

It is important to note that the patient will also, in his manic-depressive phases, have neutral phases or without any symptoms.

You can even observe the particular case of rapid cycles of bipolar disorder. Bipolar disorder is characterized by the occurrence of at least four manic episodes per year. In this case, the treatment of choice will be different. Instead, the doctor will use carbamazepine, since lithium salts are ineffective in rapidly cycling bipolar disorder.

bipolar disorder causes

The causes of bipolar disorder are not known. However, there is a genetic factor. It appears that the expression or non-expression of certain genes causes the development of bipolar disorder. This would impact on the transmission of nerve impulses by neurotransmitters as well as hormones. Doctors also research patients’ family history before making a diagnosis of manic depression.

In fact, those with a first-degree family member who suffers from bipolar disorder are 10 times more likely to develop the illness when compared to the rest of the population. The risk of suffering from bipolar disorder is around 2% in the general population. Thus, in people with a family history, the risk may increase to 20%.

Note that environmental factors are not a cause in themselves, but favor the appearance of the disease in already favorable people. These factors can be stress, lack of sleep, the consumption of stimulating and/or illegal substances, such as drugs and alcohol in excess. Difficult moments in life, such as bereavement, relationship difficulties, social or professional, emotional deprivation and sexual aggression can precipitate the appearance of the disorder in vulnerable people.

A big problem is the fact that during the depressive phase, the lack of self-esteem can lead the patient to consume more alcohol or even drugs, which causes deep depression.

There are more men than women with manic depression.

Inflammation, cause of depression

Some researchers believe that depression, and notably manic-depression, may have, in some patients, an inflammatory origin. In fact, scientists observed that 40% of psychiatric patients (including those with manic depression) had excessive levels of molecules typical of an inflammatory reaction (eg cytokines, C-reactive protein) in their blood.

That is why psychiatrists do not hesitate to prescribe non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or celecoxib to complete the treatment of psychiatric illnesses such as depression.

Bipolar disorder risk groups

People at risk of developing manic depression include those who have a family member already suffering from the condition, as there is a genetic factor involved in the development of the disorder.

Other risk factors include social, professional and family. That is, the person’s life story. What she went through (death, rape), stressful situations (overload at work), etc. All of these events will trigger the illness in people who are genetically predisposed to bipolar disorder. Note that these factors are not the causes of the disease, but triggers.

It is important to note that the patient’s denial of the disease delays care, further aggravating the disease. Rapid establishment of treatment with medication and counseling significantly reduces the duration and intensity of both manic and depressive episodes. As a result, there is an improvement in the person’s quality of life, as well as the quality of life for their family. In addition, it prevents comorbidities (alcohol abuse, drug abuse) and complications of the disease, such as the risk of suicide, among others. So, before judging a person, make sure he doesn’t suffer from bipolar disorder, for example.

bipolar disorder symptoms

During bipolar disorder, the patient goes through different manic and depressive episodes. The patient experiences neutral periods as well. These neutral episodes are free intervals in which the patient is neither manic nor depressive.

Manic phases last at least a week and may include the following symptoms:

– Decreased need for sleep; insomnia.

– Agitation.

– Ideas of grandeur, inflated self-esteem.

– Ease of contact, social disruption.

– Fertile ideas, great creativity.

– Distraction.

– Excessive loss of boundaries of social behavior.

– Hallucinations, delusions.

Excessive behavior can result in an intense state of euphoria (pure happiness) or another form of irritability.

Hypomania lasts more than 4 days. Hallucinations begin to disappear.

Depressive phases are characterized by the following symptoms:

— Great and growing inexplicable sorrow.

– Despair, sadness.

– Continuous self-deprecation; exaggerated self-blame.

– Difficulty moving, to move forward (motor retardation).

– Difficulty finding new ideas (creative retardation).

– Difficulty falling asleep and waking up early.

– Difficulty and little desire to eat.

– Difficulty speaking, expressing oneself, being understood.

– Lack of dynamism.

– Suicidal ideation.

In bipolar I disorder, the patient experiences recurrent manic episodes with or without depressive episodes.

In the case of bipolar II disorder, the patient experiences hypomania with depressive episodes.

If the manic episodes cause deep emotional pain, the patient may have suicidal thoughts. Suicide attempts can be spontaneous as well as previously thought out. It is also possible that patients commit homicide trying to save their loved ones and then commit suicide. This is the idea of ​​saving your families.

bipolar disorder diagnosis

The diagnosis of bipolar disorder involves collecting the symptoms presented by the patient. The physician reviews the patient’s complaints and first tries to determine alternatives for intellectual, somatic, or psychotic disorders.

Clearly, the doctor will try to see the different possible causes for the symptoms.

After studying the patient’s symptoms, the doctor will be able to rule out the possibility of other illnesses and ensure the diagnosis of bipolar disorder.

With regard to the symptoms of manic-depressive disorder, there are many characteristic mood swings from one extreme to another, from mania to severe depression. As these episodes usually occur one after the other, at irregular intervals, the physician must be vigilant and alert to these signs. In addition to symptoms of mania and depression , the doctor will also consider addictions (alcohol, drugs), eating disorders, insomnia and digestive disorders such as constipation and others.

The doctor will also take into account the family history, since manic depression can be hereditary, although it is not yet fully explained scientifically. It is important that the doctor looks at the history of illnesses, as well as other signs such as anorexia, and attempted suicide, behavioral disorders, OCD (Obsessive Compulsive Disorder) or eating disorders.

bipolar disorder complications

In the case of bipolar disorder, the social function of the patient is the main affected part. Do not neglect physiological aspects such as sleep quality, food or the menstrual cycle in women.

The main complication of manic depression is the suicidal desire and the risk of homicide of relatives in the patient’s idea of ​​saving the environment from himself. Homicide is usually followed by the patient’s suicide. Suicide can be carefully premeditated or occur spontaneously.

Added to this, there are some associated comorbidities. People suffering from manic-depressive psychosis may consume alcohol, stimulants and other illicit drugs, aggravating cases of deep depression, euphoria, hallucinations, etc.

The patient often feels distressed. This causes him to become a hypochondriac (always afraid of being sick, catching all the viruses and bacteria in the world). This deep anxiety can worsen and lead to a state of hallucinatory delirium.

In the depressive phase, the patient may become malnourished because of his rejection of the diet and, as a result, lose weight. Anemia can occur due to lack of nutrient intake. It is possible that the patient becomes anorexic. Urinary disorders can also occur due to dehydration. This, of course, is related to the eating disorder.

His difficulty falling asleep and waking up drives the patient into an even deeper depression. Insomnia is a clue for the doctor to make the diagnosis . Sleep improvement is also a marker to assess improvement in the patient’s condition.

In women, there are complications in the menstrual cycle, and amenorrhea (absence of menstruation) is common.

In men, as well as in women, a decrease in libido may occur.

bipolar disorder treatments

Treatment consists of:

– Treat the manic-depressive phases of the disease.

– Prevent relapse of manic and depressive episodes.

– Prevent complications, such as the risk of suicide.

The medication significantly shortens the period of mania. The latter from 6 months to 6 weeks in general.

Depending on the severity of the manic and depressive episodes, the doctor will use various medications, called psychotics. When the intensity of the manic phase is too strong, it can become a medical emergency and require hospitalization. When drug treatment is ineffective, the doctor may use other drugs or make combinations of them. When even this fails, electroconvulsive therapy.

Bipolar disorder medications

There are several medications against manic-depressive disorder:

– Mood stabilizing drugs such as lithium salts, sodium valproate, carbamazepine and lamotrigine.

– Atypical antipsychotics such as olanzapine, aripiprazole, risperidone or asenapine.

Note that sodium valproate, carbamazepine and lamotrigine are used in epilepsy.

The first choice in treatment is lithium salts, instead of carbamazepine, for example. However, when the bipolar disorder is rapidly cycling, the physician will prescribe carbamazepine as the first line, as lithium salts are ineffective.

These drugs have some serious side effects, which is why different monitoring will be offered to the patient to avoid toxicity, liver attack for example.

The depressive phase is treated, but an antidepressant is never used alone, so as not to exacerbate the manic phases.

electroconvulsive therapy

Electroconvulsive therapy is performed in the hospital under general anesthesia. It takes about 1 month to 1 month and a half, with three sessions per week. The treatment involves the application of an electric current (well known with the name electroshock). These electrical discharges are used to calm patients during manic episodes. This treatment was already widespread in the past, as doctors had few drugs.

Treatment of depression based on anti-inflammatory drugs

As indicated under causes, manic-depression can have an inflammatory origin in about 40% of patients. Only those who have an abnormal amount of inflammatory molecules (cytokines, C-reactive protein) in their blood can benefit from the anti-inflammatory effect of some medications. In other words, in patients who do not have excess inflammatory molecules in their blood, an anti-inflammatory treatment is ineffective.

The treatments used to treat manic-depression, in individuals with an inflammatory profile, are based on non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and celecoxib. In some cases, doctors have observed that after a few days of treatment with NSAIDs, depressive symptoms significantly reduce. NSAIDs can be combined with conventional treatments such as lithium.

bipolar disorder tips

During manic depression, whether you are in the manic or depressive phase, it is important to accept your illness and take your medication correctly. This is as important as the treatment itself and is aimed at improving the patient’s quality of life, as well as preventing the onset of mania or deep depression and allowing him to lead a normal life.

It is also important that the patient and his social circle understand the disease and its different stages (mania, hypomania, depression , interval without symptoms), in order to support and encourage.

The person with bipolar disorder is not crazy. Although the causes of the disease are not yet well defined, it is important to accept your condition and take your medication. Adherence to treatment is a key success factor.

Furthermore, if a treatment does not seem to suit him, because of poor efficiency or too many side effects, it is absolutely essential to talk to his psychiatrist about changing medication. There is no need for side effects, and they usually go away with time. The proper dosage of the drug should be discussed and established between the patient and the physician.

bipolar disorder prevention

It is not possible to avoid bipolar disorder, because the causes of the disease are not yet fully understood. However, genetic factors can be one of the causes of bipolar disorder. Thus, if a family member suffers or has suffered from bipolar disorder, it is important to notice and quickly recognize the symptoms of the illness so that the patient can be quickly treated.

In order not to increase the patient’s suffering time, it is essential that the people around the patient understand the disease and help him. A quick treatment, whether medical or psychological, is a key factor to prevent the occurrence of crises and reduce their intensity. The person can then lead a normal life.

Adequate medication intake quickly improves the patient’s condition, reducing the manic and/or depressive phases to a few instead of months. Treatment also prevents complications of the disease, such as anorexia or suicide risk.

In addition to drug treatment, it is highly advisable to undergo psychotherapy and properly educate the patient and his family so that everyone understands the disease and its consequences.

Thus, good management of the sick person and good education will also prevent comorbidities (alcohol abuse, illicit drugs) and prevent the patient from falling even further into his bipolar disorder. Medication and information go hand in hand in managing a manic-depressive person.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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