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Bipolar disorder is characterized by shifts in moods that alternate between highs and lows, or manic episodes and depressive episodes
Bipolar disorder is characterized by shifts in moods that alternate between highs and lows, or manic episodes and depressive episodes. Symptoms depend on the type of bipolar disorder:
- Bipolar I: At least one manic episode and occasional depressive episodes, interspersed with periods of normal mood.
- Bipolar II: A major depressive episode and a hypomanic episode (less severe form of mania), interspersed with periods of normal mood.
- Cyclothymia: Milder form of bipolar disorder characterized by less severe manic and depressive episodes alternating for at least 2 years.
Other patterns of bipolar disorder may have associated conditions such as:
- Anxiety
- Anhedonia (loss of pleasure in most or all activities)
- Catatonia (limited or abnormal state of movement)
- Psychosis (detachment from reality that may be associated with hallucinations or delusions)
Bipolar disorder can present itself at any age, but typically, onset occurs around 25 years of age. Men with bipolar disorder may first experience a manic state, whereas women tend to first experience a depressive state.
What are the symptoms and features of manic episodes?
Manic episodes are periods of abnormally and persistently elevated mood characterized by increased target-based activity that lasts for a period of at least 1 week. Elevated mood may consist of periods of irritable mood and is present most of the day, every day. These episodes are accompanied by the following symptoms:
- Easily distracted
- Racing thoughts
- Exaggerated self-confidence and self-importance
- Reduced sleep
- Excessive talkativeness
- Reckless behavior (shopping sprees or impulsive or unprotected sex)
For an episode to be classified as mania, it must:
- Involve noticeable changes in mood and behavior
- Disrupt daily activities or require hospitalization to prevent harm to the person or people around them
- Not be the result of alcohol or drug use, medications, or another medical condition
- Be associated with psychotic symptoms
What are the symptoms and features of hypomanic episodes?
Hypomania has all the symptoms of mania but with lesser severity and shorter duration. Symptoms such as elevated mood and irritability may last for up to 4 days.
For an episode to be classified as hypomania, it must:
- Involve noticeable changes in mood and behavior
- Not be significant enough to disrupt daily activities or require hospitalization
- Not be the result of alcohol or drug use, medications, or another medical condition
- Not have any associated psychotic symptoms
What are the symptoms and features of depressive episodes?
Depressive episodes are periods of depressed mood or loss of interest or pleasure that occur every day or nearly every day, for most of the day, over 2 weeks. Other signs and symptoms may include:
- Changes in appetite (loss of appetite or binge eating)
- Weight loss or weight gain
- Insomnia or oversleeping
- Slow movements
- Restlessness
- Lethargy
- Problems with memory or concentration
- Feelings of guilt, hopelessness, and worthlessness
- Suicidal thoughts
For an episode to be classified as depression, it must:
- Disrupt daily activities and social interactions or relationships
- Not be the result of alcohol or drug use, medications, or another medical condition
What medications are used to treat bipolar disorder?
Medications can help manage symptoms of bipolar disorder, although different medications may need to be tried to determine which works best for the affected person.
Bipolar disorder is typically treated with a combination of:
- Mood stabilizers
- Second-generation (atypical) antipsychotics
- Antidepressant medications
- Medications for sleep disturbances and anxiety
If you are taking medications for bipolar disorder, you should:
- Continue taking medications as prescribed, even when you are feeling fine
- Discuss the benefits and risks of the medication with your doctor
- Tell your doctor about any other medications or supplements you are taking
- Report any side effects to your doctor immediately, who can change your dosage or try a different medication
- Avoid stopping medication without first talking to your doctor, as suddenly stopping can cause symptoms to worsen
What are other treatment options for bipolar disorder?
Along with medications, other treatment options may include:
- Psychotherapy: Psychotherapy can help patients identify and change patterns of thought, emotions, and behavior, as well as provide support and education to patients and their families. Treatment may include cognitive behavioral therapy and psychoeducation. Newer therapies have been designed specifically to treat bipolar disorder, including interpersonal and social rhythm therapy and family-focused therapy. Intensive psychotherapeutic intervention in the early stages of bipolar disorder to prevent its full-blown onset is an area still under research.
- Exercise: Regular cardio and aerobic exercises, such as jogging, brisk walking, swimming, or bicycling, can help manage symptoms of depression, anxiety, and disturbed sleep cycles. Anaerobic exercises such as weightlifting, yoga, and Pilates may be helpful as well.
- Life chart: Keeping a life chart to record daily mood symptoms, sleep patterns, and life events can help patients and their doctors track and treat bipolar disorder.
