Bipolar mood disorder is a condition that affects an individual’s mood and behaviour. It is characterized by a distinct period of abnormal mood i.e. elated, expansive, or irritable mood (manic or hypomanic episodes) and depressive episodes. It is more than just feeling active or cheerful. It interferes with the daily functioning of the individual.
During a manic episode, the individual has a period of mood disturbance for most of the day, nearly every day, including the following symptoms:
Abnormally and persistently elevated, expansive or irritable mood
Abnormally and persistently increased energy and goal-directed activity
Inflated self-esteem or grandiosity
Decreased need for sleep
More talkative than usual, pressure to keep talking
Easy distraction to irrelevant or unimportant things
Excessive involvement in activities that could lead to painful consequences (e.g. rash driving, rash spending sprees, sexual indiscretion, alcohol or drug abuse or addiction, etc.).
The diagnosis of bipolar disorder is made on the basis of whether the episodes are manic or hypomanic and whether or not clinical depressive episodes occur during the course of the illness. Symptoms vary from mild to severe, and affect one’s daily functioning at work and at home, and affect one’s interpersonal relationships (American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Arlington, VA, American Psychiatric Association, 2013).
Bipolar disorder manifests in mild, moderate, or severe forms. Symptoms can vary from person to person. Subtypes of bipolar disorder include:
Bipolar I disorder: This is characterized by the presence of at least one manic episode during a lifetime lasting for at least one week. Episodes of clinical depression or hypomania may occur before or after the manic episode.
Bipolar II disorder: This is characterized by at least one hypomanic (a milder form of a manic episode, lasting for 4 days or more) and one major depressive episode.
Cyclothymic Disorder: Few hypomanic symptoms and few some depressive symptoms occur for atleast two consecutive years.
Genetics play a major role in causing bipolar disorder and it has a high rate of heritability Impaired connectivity in brain networks regulating mood and imbalances in brain chemicals called “neurotransmitters”, among other mechanisms, lead to bipolar disorder. Life stress events can act as triggers in vulnerable individuals.
Upto 4% of individuals worldwide suffer from bipolar disorders during their lifetime (Nabavi et al., 2015). Men and women are equally affected by bipolar I disorder, whereas Bipolar II disorder may be more common in women than in men. It usually begins during adolescence or early adulthood. However, it can begin during later years and sometimes in children as well.
Bipolar is a severe disorder and its outcomes become progressively worse if it is not diagnosed and treated early. It takes a heavy toll on the individual and his family. Complications of untreated bipolar include disturbed interpersonal relationships, difficulties at work, indulging in potentially damaging and dangerous activities such as spending vast amounts of money, rash driving, sexual indiscretions, aggressive behavior, alcohol abuse, or misuse (which may lead to dependence and addiction), etc. In severe cases, suicide is a real risk.
Recognizing the symptoms early and diagnosing it correctly is the first step. Treating bipolar disorder requires a combination of medication (mood stabilizers), psychotherapy, and lifestyle changes to reduce stress such as adequate rest and regular exercise. Family therapy helps family members cope with their loved one’s illness, especially with their erratic moods and behaviours which can be disturbing to the family members.
Repetitive Transcranial Magnetic Stimulation (rTMS) is the most modern form of treatment that helps some individuals with bipolar disorder. rTMS is a non-invasive, painless, and no- anesthesia procedure, with few or no side-effects and quick onset of therapeutic effects. It uses an external magnetic field to stimulate nerve cells in the brain. The rTMS device delivers a focused magnetic pulse to the brain. The sessions are held daily for 2 to 4 weeks, for 30 minutes at a time. Several individuals with bipolar disorder benefit to a great extent from this treatment.
Research has shown that individuals with bipolar disorder can be exceptionally creative, as they can be dysfunctional. Many celebrities like news channel CNN founder Ted Turner, actress Catherine Zeta-Jones and Linda Hamilton have openly talked about being bipolar. All-time great artist Picasso’s “pink” and “blue” moods are also famous, as are van Gogh’s “high” periods. during which he rose first as an evangelist and then as an artist. Although this illness leads to immense suffering, many individuals bipolar live a productive and creative life.