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Bipolar Disorder: The Leading Cause of Suicide

Medikoe Health Expert

Medikoe Health Expert

  Koramangala, bengaluru, karnataka, india, Bengaluru     Feb 13, 2017

   7 min     

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Overview

Bipolar disorder, earlier known as a manic disorder, is a mental disorder that causes events of depression and abnormal mood elevation, changing the person's mood, energy and ability to function. Bipolar disorder is categorized into three different conditions: Bipolar I, Bipolar II and cyclothymic disorder. 

People suffering from bipolar disorder have extreme and profound emotional states that occur at different times, called mood episodes. These events are categorized as a maniac, hypomanic or depressive. Patients do have events of normal mood as well. Bipolar disorder can be treated, and people can lead productive and unhindered lives.

Symptoms of Bipolar Disorder

Mania and depression are both explained by disruptions in normal mood, circadian rhythm, cognition and psychomotor activity. Mania can be observed in a person with varying levels of mood, ranging from euphoria to dysphoria and irritability. Mania can be present with increased self-esteem, rapid speech, superfluous thoughts, uncurbed social behaviour along with increased energy in psychomotor behaviour. 

Unlike mania, hypomania is not always associated with impaired motor functioning. 

Bipolar I: A person suffering from Bipolar I often experiences dramatic mood swings. During a manic episode, people may feel extremely elated and on top of the world, or unimaginably irritable. During a depressive episode, they may feel miserable and hopeless. 

It is diagnosed when a person is having a manic episode.

  1. Manic Episode: Manic episode is a distinct period of at least one week of extremely jovial or irritable mood. People experiencing manic episodes usually show the following behaviours: extremely verbose ( talks much and fast),  taking risky decisions, short attention span, multitasking, decreased need for sleep, racing thoughts, confusion, and increased libido ( hypersexuality). These symptoms are an impediment to patients need to socialize or work. If left untreated manic episode usually precipitate to six months. 

  2. Hypomanic Episode: Hypomanic episode is similar to manic but considered to be a bit mild. It lasts for at least four days but does not significantly hamper the individual’s ability to work, shows no probable features such as delusions or hallucinations. Hypomanic episodes rarely progress to manic episodes. Some people with a hypomanic episode show increased creativity while others are indecisive and agitated.  People with bipolar disorder, experiencing hypomanic episode forget their action on people around them, symptoms continue from a few weeks to a few months.

  1. Major Depressive Episode: A person with major depressive episode experience the symptoms for at least two weeks including persistent feelings of morose, irritability, loss of interest in activities which was previously enjoyed, redundant guilt trip, sleeping a lot or not at all, change in appetite ( increase or decrease), weight fluctuation, problem concentrating, self doubt and extreme feeling of worthlessness, thoughts of suicide. In severe cases, the person may develop symptoms of psychosis. If the symptoms left untreated may lead to suicide. Early age of onset, often misdiagnosed by major depression and treated incorrectly with antidepressants.

  1. Bipolar can disrupt a person’s life and relationships with others and cause difficulty in working and socializing. People with the disorder have other comorbidities as well, such as an anxiety disorder or psychotic disorder or attention-deficit/ hyperactivity disorder (ADHD). The risk of suicide is much higher in people with bipolar 1.

Bipolar II:  people experience at least one major depressive episode and at least one hypomanic episode. People usually return to normal function after each episode. People with bipolar ll seek treatment for depression because of severity.

People often suffer from other mental illnesses such as anxiety disorder or substance disorder. 

Cyclothymic disorder: it is a mild form of the disorder involving many mood swings, with a constant switch between hypomania and depressive symptoms that occur fairly constantly. People experience emotional ups and downs but less severe as compared to bipolar I or II.

Causes of Bipolar Disorder

The exact cause of the bipolar disorder is unknown, but there seems to be a lot of other factors which proves a significant point in association with the disorder.

  • Neurological: A person associated with other neurological conditions or injury is likely to have bipolar or a bipolar- like disorder. Conditions which are responsible include HIV infection, multiple sclerosis, temporal lobe epilepsy and traumatic brain injury.

  • Genetics: If a person has someone from their family suffering from bipolar it’s quite common to be inherited. Causative gene is still unknown.  

  • Environmental: It is quite possible that recent life events and relationships play an important role in the onset of the disorder. Adults diagnosed with the disorder have previously experienced traumatic or abusive events, which causes a higher rate of suicide attempts.

Diagnosis of Bipolar Disorder 

The diagnosis of bipolar disorder is quite complicated considering the misdiagnosis with unipolar depression. This can be simplified by identifying the symptoms and reporting them accordingly, as they are easily identified by the people around. 

The DSM-5 lists three specific sub types of bipolar and how these symptoms can be identified. 

Bipolar I Disorder: At least one manic episode should occur for the diagnosis, depressive episodes are common in the majority of cases, but are not necessary for the diagnosis of bipolar. Labels such as mild, moderate, moderate-severe, severe should be added for specificity.

Bipolar II Disorder: No manic episodes, one or more major depressive episode and one or more hypomanic episode. The hypomanic episode does not interfere with a person’s ability to function or social impairment, which makes it difficult to diagnose.

Cyclothymia: It is diagnosed by the history of hypomanic episode with intermittent events of depression that do not meet the criteria for major depression. 

Treatment of Bipolar Disorder

Bipolar I disorder: 

With the help of proper use of medicines and psychotherapy bipolar can be treated, medication is often used to mitigate the cause over time. Each person’s response towards the approach is different and so the treatment should be customised. People with the disorder should try different therapies before settling onto one. 

Mood stabilisers are the most commonly prescribed medication for bipolar.

In psychotherapy, the patient can work with a psychiatrist or mental health professional and discuss problems that may attenuate the symptoms. A psychiatrist may also prescribe medication to resolve some of the symptoms. The individual should continue the treatment as bipolar is a recurrent disorder. 

In rare cases when both the treatment doesn’t seem to work, a treatment called electroconvulsive therapy (ECT) may be used. ECT uses the application of electrical current while the patient is anaesthetised. The procedure takes about 10-15 minutes for two to three times a week for about 12 weeks.

Bipolar II Disorder: 

Treatment for bipolar II is quite similar to bipolar I, medications mostly used are mood stabilisers and antidepressants depending upon the events.

If treatment with medications doesn’t work then ECT may be used.

Cyclothymic Disorder:

This disorder can be treated with the use of medication or talk therapy. In most of the cases, talk therapy helps relieve the stress of ongoing high and low moods. Individuals may start and stop therapy accordingly. 

Rapid Cycling Bipolar Disorder:

This disorder is much more severe than any of the bipolar disorders it involves at least four episodes of major depression, hypomanic and manic episodes. This affects more women than men.

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Tags:  Mental Health,Mental Wellness,mental disorder,Bipolar Disorder

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