APA refers Bipolar disorder as a serious mental illness in which common emotions become intensely and often unpredictably magnified. Individuals with bipolar disorder can quickly swing from extremes of happiness, energy, and clarity to sadness, fatigue, and confusion.
The key identifying feature of bipolar disorder is the tendency of manic episodes to alternate with major depressive episodes in an unending roller-coaster ride from the peaks of elation to the depths of despair. Beyond that, bipolar disorder are parallel in many ways to depressive disorders. For example, a manic episode might occur only once or repeatedly.
Bipolar l disorder, in which the individual fluctuates between episodes of mania or hypomania and major depressive episodes or experiences a mix of these
The criteria for bipolar I disorder are the same, except the individual experiences a full manic episode. As in the criteria set for major depressive disorder, for the manic episodes to be considered separate, there must be a symptom-free period of at least 2 months between them. Otherwise, one episode is seen as a continuation of the last.
During manic or hypomanic phases, patients often deny they have a problem. Even after spending inordinate amounts of money or making foolish business decisions, these individuals, particularly if they are in the midst of a full manic episode, are so wrapped up in their enthusiasm and expansiveness that their behavior seems reasonable to them. The high during a manic state is so pleasurable that people may stop taking their medication during periods of distress or discouragement in an attempt to bring on a manic state again; this is a serious challenge to professionals.
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Diagnostic criteria for bipolar l disorder.
A. A person must have experienced at least one episode of mania or hypomania.
B. To be considered mania, the elevated, expansive, or irritable mood must last for at least one week and be present most of the day, nearly every day.
C. To be considered hypomania, the mood must last at least four consecutive days and be present most of the day, almost every day.
D. The depressive side of bipolar disorder is characterized by a major depressive episode resulting in depressed mood or loss of interest or pleasure in life.
E. Person must experience five or more of the following symptoms in two weeks to be diagnosed with a major depressive episode:
- Depressed mood most of the day, nearly every day
- Loss of interest or pleasure in all, or almost all, activities
- Significant weight loss or decrease or increase in appetite
- Engaging in purposeless movements, such as pacing the room
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Diminished ability to think or concentrate, or indecisiveness
- Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt.
Symptoms.
- feeling sad, hopeless or irritable most of the time.
- lacking energy.
- difficulty concentrating and remembering things.
- loss of interest in everyday activities.
- feelings of emptiness or worthlessness.
- feelings of guilt and despair.
- feeling pessimistic about everything.
- self-doubt.
Causes of Bipolar l Disorder.
The exact cause of bipolar disorder is still unknown. It is observed that bipolar disorder usually starts during teenage or adolescence. Due to lack of knowledge about the disorder, most people with bipolar disorder suffer for a long time before seeking help.
Possible risk factors could be hormonal imbalance, genetics, extreme trauma due to tragic incident, drugs or substance abuse. Bipolar disorder can co-exist with other illnesses such as acute depression with psychosis or schizophrenia.
Bipolar disorder seems to often run in families and there appears to be a genetic part to this mood disorder. There is also growing evidence that environment and lifestyle issues have an effect on the disorder’s severity. Stressful life events — or alcohol or drug abuse — can make bipolar disorder more difficult to treat.
Treatment.
Bipolar disorder, like diabetes or heart disease, is a long-term condition and needs to be managed through a person’s lifetime. Proper diagnosis and treatment can help a person lead a healthy and productive life. Treatment can make an enormous difference by reducing the frequency and severity of episodes. A combination of medication, therapy and counseling (cognitive behavior therapy) can be very effective in treating bipolar disorder. Treatment may vary depending on the age, medical history, severity of the condition, or the person’s tolerance to medication.
Not getting treatment, or discontinuing the existing treatment or medication can actually worsen the condition or cause a relapse. In some cases, the symptoms may get triggered unexpectedly and the person may not even be aware of it or be able to control it.
Treatment is directed at managing symptoms. Depending on your needs, treatment may include:
- Medications. Often, you’ll need to start taking medications to balance your moods right away.
- Continued treatment. Bipolar disorder requires lifelong treatment with medications, even during periods when you feel better. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression.
- Day treatment programs. Your doctor may recommend a day treatment program. These programs provide the support and counseling you need while you get symptoms under control.
- Substance abuse treatment. If you have problems with alcohol or drugs, you’ll also need substance abuse treatment. Otherwise, it can be very difficult to manage bipolar disorder.
- Hospitalization. Your doctor may recommend hospitalization if you’re behaving dangerously, you feel suicidal or you become detached from reality (psychotic). Getting psychiatric treatment at a hospital can help keep you calm and safe and stabilize your mood, whether you’re having a manic or major depressive episode.
Reference,
David H. Barlow, V. Mark Durand. Abnormal Psychology, An Integrative Approach. (7th ed).