Bipolar Disorder
What Is Bipolar Disorder?
Bipolar disorder involves shifts between elevated mood states (mania or hypomania) and depressed mood states, impacting energy, activity, and behavior. According to the World Health Organization’s Bipolar Disorder Fact Sheet, it affects about 45 million people globally and often begins in late adolescence or early adulthood.
Signs and Symptoms
Bipolar disorder presents in two main phases:
| Phase | Symptoms |
|---|---|
| Mania | Elevated or irritable mood, increased energy, reduced need for sleep, grandiosity, impulsive behaviors (spending sprees, risky activities) |
| Hypomania | Milder mania lasting ≥4 days without severe impairment |
| Depression | Persistent low mood, fatigue, loss of interest, changes in appetite or sleep, feelings of worthlessness, thoughts of death or suicide |
Episodes may last days to weeks and vary in frequency among individuals.
Types of Bipolar Disorder
Bipolar I Disorder: At least one full manic episode, often with depressive episodes.
Bipolar II Disorder: Hypomanic episodes plus major depressive episodes.
Cyclothymic Disorder: Chronic mood fluctuations over ≥2 years not meeting full criteria for mania or depression.
What Causes Bipolar Disorder?
Bipolar disorder arises from a combination of factors:
Genetic Predisposition: Family history confers high risk (up to 80% heritability).
Neurobiological Changes: Dysregulation of neurotransmitters (dopamine, serotonin) and structural brain differences.
Psychosocial Stressors: Traumatic events, chronic stress, substance use can trigger episodes.
Circadian Rhythm Disruption: Sleep–wake cycle disturbances often precede mood shifts.
How Is Bipolar Disorder Diagnosed?
Dr. Budhwar will conduct:
Clinical Interview: Detailed history of mood episodes, triggers, and functional impact.
Mood Charts & Questionnaires: Tools such as the Mood Disorder Questionnaire (MDQ).
DSM-5 Criteria: Assessment of episode duration, symptom severity, and exclusion of other medical causes (thyroid disorders, medication effects).
Treatment Options
A multi-pronged approach yields the best outcomes:
1. Mood-Stabilizing Medications
Lithium: Gold-standard for mania prevention and suicide risk reduction.
Anticonvulsants: Valproate, lamotrigine, carbamazepine for mood stabilization.
Atypical Antipsychotics: Quetiapine, olanzapine, risperidone used for acute mania or adjunctive maintenance.
2. Psychotherapy
Cognitive Behavioral Therapy (CBT): Addresses distorted thinking and relapse prevention.
Psychoeducation: Teaches patients and families about recognizing early warning signs and medication adherence.
Family-Focused Therapy: Improves communication and support systems to reduce relapse risk.
3. Lifestyle Management
Sleep Hygiene: Regular sleep–wake schedule to stabilize mood.
Routine & Structure: Consistent daily routines for meals, activity, and social interaction.
Stress Reduction: Relaxation techniques, mindfulness, and avoidance of substance use.
Self-Help Strategies
Mood Tracking: Keep a daily record of mood, sleep, medication, and life events.
Trigger Identification: Note patterns (sleep loss, stress) that precede mood shifts.
Support Networks: Engage trusted friends, family, or peer support groups for encouragement.
Healthy Habits: Balanced diet, regular exercise, and limited caffeine or alcohol intake.
When and How to Seek Help
If you experience extreme mood swings, impaired functioning, or suicidal thoughts, consult Dr. Budhwar:
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Bipolar disorder is manageable. With early intervention, consistent treatment, and active self-management, patients can achieve mood stability, minimize relapse, and enjoy meaningful, fulfilling lives.