Bipolar disorder: Symptoms, types and therapy

I am 20 years old college going guy. From last two years often I am experiencing extreme mood swings. Few days I feel completely depressed and lose interest in everything. I sit at home withdrawn from every social activity. But I become very active and feel excessively energetic in other days. I experience a feeling of high self-worth and then feel very low after some time. Doctor told me that I am suffering from bi polar disorder. I feel like committing suicide but control myself. Please tell me how to cope with this?

Ramu, Hyderabad.

Being diagnosed with bipolar disorder may be frightening. The future may seem terribly uncertain and initiating suicidal thoughts in you is common. But getting diagnosed is actually good because you have the chance to get treated. Often it may take many years to get diagnosed.

Treatment can make a huge difference. With a combination of good medical care, medication, talk therapy, lifestyle changes, and the support of friends and family you will feel better. Many people with this problem do well in life and even lead a normal life.

The person with this illness may feel lonely but surveys show that more than two million adults in the US are coping with bipolar disorder right now. It's important not to blame yourself for your condition. Bipolar disorder is a mental illness and not a sign of personal weakness. It's like diabetes, heart disease, or any other health condition.

What is bipolar disorder?

Bipolar disorder, which is also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out daily tasks. This disorder causes serious shifts in mood, energy, thinking, and behaviour—from the highs of mania on one extreme, to the lows of depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with your ability to function.

Bipolar disorder often appears in the late teens or early adult years. At least half of all cases start before the age of 25. Some people have their first symptoms during childhood, while others may develop symptoms late in life.

Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can perform well academically and perform well at work. They can lead full and productive lives.

Symptoms & types

Bipolar is a complex illness. There are many different symptoms and several different types of bipolar disorder. The primary symptoms of the disorder are dramatic and unpredictable mood swings. The various types of bipolar disorder range from mild to severe.

Signs and symptoms of bipolar mania:Mood changes

• Feeling overly happy or optimistic for long stretches of time
• Extreme irritability

Behavioural changes

• Talking very fast, jumping from one idea to another, having racing thoughts.
• Being unusually agitated.
• Aggressive, provocative, or intrusive.
• Being overly restless and distracted.
• Decreased need of sleep.
• Increasing activities and excessive drive to perform or achieve goals or excessive spending of money, unwise financial choices etc.
• Poor judgment, delusions or break from reality.
• Poor performance in school or work place.
• Inflated self-worth and over confidence.
• Behaving impulsively and engaging pleasurable, high risk behaviours (drugs or alcohol use, gambling).

Symptoms and signs of bipolar depression:Mood changes:

• Feeling sad or worried for long periods.
• Loss of interest in activities once enjoyed.

Behavioural changes:

• Feeling overly tired or "slowed down".
• Hopelessness and worthlessness.
• Feeling guilty.
• Withdrawal from family and friends.
• Having problem concentrating, remembering, and making decisions.
• Being restless or irritable.
• Body pains without a known reason and fatigue.
• Changing eating, sleeping, or other habits (increase or decrease).
• Thinking of death or suicide, or attempting suicide.

During a manic episode, a person might impulsively quit a job, charge up huge amounts on credit cards, or feel rested after sleeping two hours. During a depressive episode, the same person might be too tired to get out of bed, and full of self-loathing and hopelessness over being unemployed and in debt.

Symptoms in children and adolescents

Instead of clear-cut depression and mania or hypomania, the most prominent signs of bipolar disorder in children and adolescents can include explosive temper, rapid mood shifts, reckless behaviour and aggression. In some cases, these shifts occur within hours or less — for example, a child may have intense periods of giddiness and silliness, long bouts of crying and outbursts of explosive anger all in one day.

Bipolar types

There are several types of bipolar disorder; all involve episodes of depression and mania to a degree. Most common types of BPD are-

Bipolar I: This is the classic form of the illness. Bipolar I leaves no doubt as to whether someone is in a manic phase, as their behaviour quickly escalates until they are out of control. If left untreated, the person could end up in the emergency room or worse.

Bipolar II: Four times more common than Bipolar I, Bipolar II is characterised by much less severe manic symptoms. These signs are harder for people to see in themselves, and it's often up to friends or loved ones to encourage them to get help. Without proper treatment, hypomania often becomes worse, and the patient can become severely manic or depressed.

Who can get bipolar disorder?

The causes of bipolar disorder are likely to vary between individuals and the exact mechanism underlying the disorder remains unclear. Genetic influences are believed to account for 60–80% of the risk of developing the disorder indicating a strong hereditary component.

Abnormalities in the structure and/or function of certain brain circuits could underlie bipolar.

There is fairly consistent evidence from prospective studies that recent life events and interpersonal relationships contribute to the likelihood of onsets and recurrences of bipolar mood episodes. There have been repeated findings that 30–50% of adults diagnosed with bipolar disorder report traumatic/abusive experiences in childhood, which is associated on average with earlier onset, a higher rate of suicide attempts, and more co-occurring disorders such as PTSD. Hormonal imbalances also possibly cause bipolar disorder. The total number of reported stressful events in childhood is higher in those with an adult diagnosis of bipolar spectrum disorder. Other causes include brain stroke, traumatic brain injury, HIV infection and imbalance in neurotransmitters (brain chemicals) like serotonin and dopamine in brain.

There are a number of pharmacological and psychotherapeutic techniques used to treat bipolar disorder. Individuals may use self-help and pursue recovery. Different types of medications can help control symptoms of bipolar disorder. Not everyone responds to medications in the same way. You may need to try several different medications before finding ones that work best for you.

Psychotherapy

Psychotherapy is another vital part of bipolar disorder treatment. Several types of therapy may be helpful. These include:

Cognitive behavioural therapy: This is a common form of individual therapy for bipolar disorder. The focus of cognitive behavioural therapy is identifying unhealthy, negative beliefs and behaviours and replacing them with healthy, positive ones. It can help identify what triggers your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.

Psychoeducation: Counseling (psycho education) help you and your family to learn and understand about bipolar disorder. Knowing what's going on can help you get the best support and treatment, and help you and your loved ones recognise warning signs of mood swings.

Family therapy: Family therapy involves seeing a psychologist or other mental health provider along with your family members. Family therapy can help identify and reduce stress within your family. It can help your family learn how to communicate better, solve problems and resolve conflicts.

Group therapy: Group therapy provides a forum to communicate with and learn from others in a similar situation. It may also help build better relationship skills and support systems.

Lifestyle and home remedies

• Learn ways to manage your stress and be relaxed.
• Develop support systems in family and friends.
• Surround yourself with people of positive attitude.
• Exercise regularly.
• Get plenty of sleep.
• Eat Omega -3 rich food.
• Quit using drugs and alcohol.
• Keep a regular routine, such as going to sleep at the same time every night and eating meals at the same time every day.
• Learn about warning signs signaling a shift into depression or mania.
• Expect your symptoms to improve gradually, not immediately.

If you have suicidal thoughts

Suicidal thoughts and behaviour are common among people with bipolar disorder. If you experience suicidal thoughts, get help right away. Here are some steps you can take:

Contact a family member or friend.

Seek help from your doctor or psychologist.

Call a suicide help line number and talk to a trained psychologist. Few organisations like Roshni counselling center are running such helplines in our state (040-66202000)

Medication along with psychotherapy can help you manage the bipolar symptoms and smooth out the highs and lows that interfere with living a normal, productive life. Good luck!