Bipolar disorder

Other names: Manic-depressive illness

DEFINITION

Bipolar disorder, formerly called manic Depression, causes extreme mood swings that include emotional highs (mania or hypomania) and lows (Depression). When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may occur only a few times a year or as often as several times a week. Although Bipolar disorder is a disruptive, long-term condition, you can keep your moods in check by following a treatment plan. In most cases, Bipolar disorder can be controlled with medications and psychological counseling (psychotherapy).

SYMPTOMS

There are several types of bipolar and related disorders. For each type, the exact symptoms of Bipolar disorder can vary from person to person. Bipolar I and bipolar II disorders also have additional specific features that can be added to the diagnosis based on your particular signs and symptoms.

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Criteria for Bipolar disorder The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for diagnosing bipolar and related disorders. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Diagnostic criteria for bipolar and related disorders are based on the specific type of disorder:

• Bipolar I disorder.
• Bipolar II disorder.
• Cyclothymic disorder.
• Other types.

Bipolar II disorder is not a milder form of bipolar I disorder but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.

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Criteria for a manic or hypomanic episode The DSM-5 has specific criteria for the diagnosis of manic and hypomanic episodes:

• A manic episode
• A hypomanic episode

For both a manic and a hypomanic episode, during the period of disturbed mood and increased energy, three or more of the following symptoms must be present:

• Inflated self-esteem or grandiosity
• Decreased need for sleep
• Unusual talkativeness
• Racing thoughts
• Distractibility
• Increased goal-directed activity or agitation
• Doing things that have a high potential for painful consequences

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Criteria for a major depressive episode The DSM-5 also lists criteria for the diagnosis of a major depressive episode:

Signs and symptoms include:

• Depressed mood most of the day
• Markedly reduced interest or feeling no pleasure in activities
• Significant weight loss or gain
• Insomnia or sleeping excessively
• Restlessness or slowed behavior
• Fatigue or loss of energy
• Feelings of worthlessness or excessive guilt
• Decreased ability to think or concentrate
• Recurrent thoughts of death or suicide

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Other signs and symptoms of Bipolar disorder Signs and symptoms may include additional features such as anxious distress, mixed features, melancholic features, atypical features, catatonia, peripartum onset, seasonal pattern, rapid cycling, and psychosis.

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Symptoms in children and teens Children with Bipolar disorder may have distinct major depressive, manic, or hypomanic episodes that differ from their usual mood swings.

When to see a doctor If you have any symptoms of Depression or mania, see your doctor or mental health provider. Many people with Bipolar disorder don't get the treatment they need despite the disruptive nature of the condition.

CAUSES

The exact cause of Bipolar disorder is unknown but biological differences, neurotransmitter imbalances, and inherited traits may play a role.

RISK FACTORS

Factors that may increase the risk of developing Bipolar disorder include having a family history of the condition, periods of high stress, drug/alcohol abuse, and major life changes.

QUESTIONS

1. What are the main criteria used to diagnose Bipolar I disorder?

The presence of at least one manic episode.

2. What distinguishes Bipolar II disorder from Bipolar I disorder?

Individuals with Bipolar II experience longer periods of depression rather than severe manic episodes.

3. How does the DSM-5 define a major depressive episode?

Five or more symptoms over a two-week period involving depressed mood or loss of interest/pleasure.

4. What are some risk factors for developing Bipolar disorder?

Having a first-degree relative with the condition.

5. How can one differentiate between a manic episode and a hypomanic episode?

The severity of symptoms and their impact on daily functioning.

6. What should someone do if they suspect they have symptoms of Depression or mania?

See a doctor or mental health provider for evaluation.

7. Why is it essential to seek treatment for Bipolar disorder?

Left untreated, it can lead to serious complications like suicide attempts or substance abuse problems.

8. What are some lifestyle recommendations for managing Bipolar disorder?

Pay attention to warning signs and avoid drugs/alcohol.

9. How is medication management typically approached in treating Bipolar disorder?

It often involves mood stabilizers alongside other medications like antipsychotics or antidepressants based on individual symptoms.

10. Are there alternative medicine options available for treating Bipolar disorder?

Yes, but their effectiveness is not well-established compared to conventional treatments like medications and psychotherapy.