We talk more and more about “bipolar disorder” or “manic depression.” Although this disease is sometimes difficult to diagnose, there are specific symptoms and signs to identify. Find out below more about the subject.
1. What is bipolar disorder?
Bipolar disorder is a chronic mental sickness in the mood disorder family. Formerly known as manic-depressive illness, is a long-term illness that causes mood changes. It can take various forms; in its most typical form, it alternates between periods of high mood (manic episode) and low mood (depressive episode), interspersed with free intervals (where the person is in a normal state).
2. Bipolar disorder disease types
There are three types of bipolar disorder:
- Bipolar disorder type I (the most serious): presents an alternation of frank or mixed but recurrent manic episodes and major depressive episodes.
- Bipolar disorder type II: consists of an alternation of hypomanic episodes and recurrent depressive episodes. The hypomanic episode is characterized by the same symptoms as the manic attack but less intense with a less important impact on social functioning.
- Bipolar disorder type III: presents with a change in mood (mania) following the prescription of an antidepressant, with no particular vulnerability of the patient to episodes of mania and depression.
3. Symptoms of bipolar disorder
3.1 Manic episodes
A typical manic episode lasts more than a week, and usually four to eight weeks. It often leads to offer hospitalization, to treat (or even protect) the patient.
Warning signs often precede manic episodes:
- Energy increased tenfold;
- Ease in social exchanges;
- A feeling of euphoria.
- However, at these times, some irritability is also possible.
During the manic episode, the bipolar patient has at least three of the following signs:
- Increased social activities (professional or sexual), constant need to talk, hyperactivity;
- Reckless purchases;
- Excessive feeling of power (high self-esteem);
- Tendency to go “from rooster to donkey”;
These signs can sometimes accompany other symptoms such as delirium or hallucinations.
3.2 Depressive episodes
They are characterized by a decrease in mood, energy, and activity:
The person is sad, sluggish, has no taste for anything, has great difficulty in carrying out daily activities.
She has difficulty concentrating and making decisions, withdraws socially.
She has a feeling of worthlessness, of guilt. She may have suicidal thoughts.
In both phases, the patient’s sleep can be seriously disturbed.
These mood disorders appear either for no apparent reason or as a reaction to a triggering factor such as life events, personal or professional, positive or negative (separation, professional promotion, bereavement, moving, loss of life, employment…).
Between these episodes, the person finds a more stable mental state.
These episodes can follow each other in different ways, and depressive and manic states can vary in intensity.
4. What causes bipolar disorder?
The right cause of bipolar disorder is unknown, but some factors may include:
Biological differences: People who have bipolar disorder appear to have physical changes in the brain. The meaning of these changes is still uncertain, but they may ultimately help determine the cause.
Genetic factors: Bipolar disorder is more common in people who have first-degree relatives with the disease, such as siblings or parents. Researchers are trying to find out genes that may cause bipolar disorder.
5. Bipolar disorder risk factors
Factors that can increase the risk of developing bipolar disorder or factors that may trigger a first episode include:
- If you have a first-degree relative, such as a parent or sibling, who has bipolar disorder
- Periods of severe stress, like the death of a loved one or other traumatic event
- Excessive drug or alcohol use
6. What are the consequences of bipolar disorder?
6.1 In the manic phase
The individual may adopt behaviors that are dangerous for their physical integrity (speeding, risky and unprotected sex, etc.) and socially problematic; aggression at work with a risk of job loss; compulsive spending; risky financial investments; gambling addiction …
6.2 In the depressive phase
We find all the symptoms of depressive suffering with a very marked risk of suicide. One in two patients will thus make at least one suicide attempt in their lifetime.
Finally, the disease is trying for those close to them who have to bear the mania phases during which the person refuses any moderation advice (risk of over-indebtedness, etc.). Even proves irritable or aggressive, then the depression phases which are experienced in depression and inability to act daily.
Bipolar disorder is often linked with an anxiety disorder and sometimes leads to alcohol addiction (which can mask the condition and make diagnosis more difficult).
7. How to diagnose bipolar disorder?
The diagnosis is often late (after 9 years on average), because it takes several months, or even years, before the succession of cycles is noticeable.
It is often a severe manic episode (which requires temporary hospitalization) that allows it to occur. The diagnosis is difficult when the hypomanic phases are signaled just by a slight state of euphoria. In that case, the patient may be wrongly perceived as depressed or alcoholic.
The physician who sees the patient only occasionally (and rather in a depressive phase) is not necessarily in a position to notice changes in mood. The patient himself, when he is in a euphoric phase, absolutely does not perceive himself as such he feels in great form.
It is often the entourage that sounds the alarm. Relatives must be particularly attentive to changes in the behavior of an adolescent or a young adult; withdrawal into oneself, dropping out of school, risky behavior, etc.).
8. Bipolar disorder treatment
Bipolar disorder requires lifelong psychiatric monitoring.
Treatment is usually for life.
The earlier it is started (and therefore the earlier the disease is diagnosed), the better the long-term prognosis. The course of the disease is directly linked to compliance with treatment.
The management based on drug treatment and psychotherapeutic follow-up.
Drug treatment should be monitored very precisely, and compliance should be of good quality, even when symptoms have resolved.
Depressive or manic episodes spontaneously last 6 to 8 months, but can increase with treatment.
During depressive episodes, it is the anxiolytics and antidepressants that allow the patient to recover, associated with psychotherapy.
In difficult situations, electro-convulsive therapy or seismotherapy, a treatment technique involving an electric current of varying intensity through the scalp, can be used.
In manic episodes, sedatives, neuroleptics, hypnotics, and mood stabilizers, combined with psychotherapy, lead to regressions.
9. How to live with bipolar disorder?
Bipolar disorder is a chronic disease that has effective management.
Most bipolar patients have a good socio-professional integration; between crises, the person can lead a completely normal life.
It is extremely risky for them to stop their psychiatric follow-up, even in the absence of symptoms or drug treatment, or if well-being may have eclipsed the pathological episodes.
The drug treatment must benefit from a very precise follow-up, and the adherence must be of good quality even in the presence of a disappearance of the symptoms.
Recommendations assume that patients with bipolar disease avoid weakening their mental balance by:
Avoiding stimulants (such as coffee, guarana, etc.).
Avoiding toxins (alcohol, tobacco, and other products) because of the psychic effect during intoxication and the upsurge in anxiety during withdrawal.
Avoiding sleep deprivation which can also be very destabilizing. Bedtime should be at a fixed time.
It is essential to know how to recognize its symptoms and, in particular, those related to the manic attack, which is often difficult to accept.
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Originally published on Live Positively.