How many times have you come across people using psychological disorders as insults? We often tend to label people who do not behave in accordance with our own perceptions of ‘normal’ as someone suffering from some mental illness or the other. Let’s say if a colleague is expressing a range of emotions, often forgetting what they said, they are labelled as being ‘bipolar’. Add to that, the media has mostly highlighted the negative aspects of bipolar disorder, which further adds to the stigma that one attaches with mental illnesses.
However, bipolar disorder is a very real, and serious form of mental illness, which causes extreme mood swings. According to Ms Mehezabin Dordi, clinical psychologist, rehabilitation and sports medicine department, Sir HN Reliance Foundation Hospital, Mumbai, 'There are emotional highs (mania or hypomania) and lows (depression). Mood swings might happen once a year or several times a year, depending on the person. While the majority of people will have some emotional symptoms in between bouts, some will not.'
Types
There are three main types of bipolar disorder. Ms Dordi lists them out as:
1. Bipolar I Disorder: It is characterised by highly unpredictable behaviour, with manic phases lasting at least a week or severe enough to necessitate medical attention. Extreme periods, usually lasting at least two weeks, are also common.
2. Bipolar II Disorder: Here, there are highs and lows, but the symptoms aren’t as severe as in Bipolar I Disorder.
3. Cyclothymic Disorder: It is characterised by episodes of manic and depressive behaviour lasting at least two years in adults and one year in children and teenagers. The symptoms aren't as severe as they are in bipolar disorder I or II.
Signs And Symptoms
When it comes to spotting the signs of bipolar disorder in a person, Ms Dordi explains that individual indications and symptoms are likely to differ. An episode might last months or even years for some people. Others may experience the 'highs' and 'lows' simultaneously, or at a faster rate. However, some common signs to look out for are:
1. Mania Or Hypomania
Mania and hypomania are two different types of episodes with similar symptoms. Mania is more severe than hypomania, and it results in more obvious problems at work, school, and social activities, as well as relationship problems.
Three or more of these signs are present in both a manic and hypomanic episode:
• Exaggerated sense of well-being and self-confidence (euphoria)
• Reduced need for sleep
• Unusual talkativeness
• Racing thoughts
• Distractibility
• Poor decision-making — for example, indulging in impulsive needs such as taking risks, or going on sprees
2. Major Depressive Episode
A major depressive episode is defined as a set of symptoms that are severe enough to impair daily activities such as job, school, social activities, or relationships. Five or more of the following symptoms are present during an episode:
• A depressed mood, such as sadness, emptiness, hopelessness, or tears (in children and teens, depressed mood can appear as irritability)
• Significant loss of interest or enjoyment in all — or nearly all — activities
• Significant weight loss, weight gain, or a decrease or increase in appetite when not dieting (in children, failure to gain weight as expected can be a sign of depression)
• Insomnia or excessive sleeping
• Restlessness or sluggish behaviour
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Reduced capacity to thought or focus, or indecisiveness
Symptoms In Children And Teens
Bipolar illness symptoms in children and teenagers can be difficult to spot. It might be difficult to identify whether these are normal mood swings, the effect of stress or trauma, or symptoms of a mental health disease other than bipolar disorder. 'Children and teenagers may experience different significant depressive, manic, or hypomanic episodes, although their patterns may differ from those experienced by adults with bipolar disorder. Moods might also fluctuate quickly during episodes. Between bouts, some children may experience periods with no mood problems. Severe mood swings that are distinct from their regular mood swings are one of the most noticeable indications of bipolar illness in children and teenagers,' Ms Dordi elucidates.
Diagnosis
A psychiatrist or a certified mental health professional can diagnose bipolar disorder. Ms Dordi adds, 'Despite their mood swings, persons with bipolar disorder frequently fail to understand how much their emotional instability interferes with their life and the lives of their loved ones, and hence do not receive the therapy they require. Consult your doctor or a mental health expert if you are experiencing signs of depression or mania.'
Bipolar disorder does not improve by itself. Getting treatment from a mental health expert who has dealt with bipolar disorder before can help you manage your symptoms.
Treatment Options
There are several treatments available to assist in managing a person's bipolar condition. Medication, counselling, and lifestyle modifications are among them.
For medication, Ms Dordi mentions the use of mood stabilisers, antipsychotics, antidepressant-antipsychotics, benzodiazepines, and other drugs may be prescribed.
In therapy, cognitive behavioural therapy (CBT), supportive therapy, psycho-education, interpersonal counselling, and other psychotherapy therapies may be recommended. 'Electroconvulsive therapy (ECT), sleep medicines, nutritional supplements, and lifestyle modification and alterations as per the person’s health profile are some of the other therapeutic possibilities,' she signs off.