Highs, lows of bipolar disorder

Annually, March 30 is designated as World Bipolar Day. The day is set aside to raise awareness and understanding of bipolar disorders to reduce stigma and promote support for those affected. The word bipolar is generally used to describe something with two extremes, often opposite.

People suffering from this condition often face conflicting changes in mood and behaviour, leading to worry and confusion.

Bipolar disorder is a mental health disorder characterised by extreme mood fluctuations, which shift from elation and high energy to a profound depression.

These mood swings may considerably affect a person’s behaviour, thoughts, energy level and sleep patterns.

The typical age of onset varies, but it typically occurs in late adolescence to early adulthood.

Bipolar disorder has several characteristics, such as manic episodes, which are periods of an abnormally elevated mood, in some cases presenting with delusions or hallucinations in its severe form.

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The condition also presents with hypomanic episodes, which are less severe than manic episodes, with the same symptoms but without delusions or hallucinations. Those with hypomania retain normal daily functioning to a large extent.

Depressive episodes can also set in and involve a low mood, hopelessness and a lack of interest in activities, which are symptoms akin to those of major depressive disorder.

The disorder is also characterised by periods of normal moods, with a majority of people with bipolar disorder experiencing intervals of steady moods between manic or depressive episodes.

There are several types of bipolar disorders, including bipolar I disorder, which typically presents with one manic episode and depressive episodes.

Bipolar II disorder is characterised by one or more major depressive episodes and one or more hypomanic episodes, while cyclothymic disorder comprises periods of hypomanic and depressive symptoms for at least two years but not meeting the diagnostic requirements for hypomanic or depressive episodes.

The other symptoms associated with manic (high mood) episodes include excitement, euphoria, more energy and restlessness, reduced need for sleep, racing thoughts with inability to focus, rapid speech, high sex drive, impulsive or reckless behaviours including overspending, excessive confidence, aggression and irritability.

Other symptoms in the depressive (low mood) phase include feeling sad, irritability or hopelessness, loss of interest in activities, low energy, fatigue and change in sleeping habits with either excessive or minimal sleep.

Furthermore, individuals may experience changes in appetite and weight, coupled with difficulty concentrating, feelings of worthlessness, guilt and suicidal thoughts and behaviours.

While the exact cause is not fully understood, several factors are known to contribute to its development and predisposition; hence, bipolar disorder is a complex condition influenced by a combination of factors like genetics, environmental, and biological factors.

Bipolar disorder is a long-standing illness that requires a multidisciplinary team to manage with medication, psychotherapy, and lifestyle changes. Properly managed, patients can lead full, productive lives.

The involvement of close family and carers plus psychoeducation to them and the patient has shown improved outcomes in reducing episodes of both manic and depressive phases.

 - The writer is a licensed psychologist/psychiatrist/clinical officer and lecturer KMTC Meru Campus