Bipolar Disorder – What are the Causes, Symptoms and How is It Diagnosed and Treated

Bipolar disorder causes mainly three different states of mental conditions, which are manic, depressive and mixed states. Symptoms vary according to these mental states.

Here are some symptoms that patients may experience in their manic state of psychological conditions:

• Feeling elated or very high
• Being extremely short-tempered and irritable
• Talking too quickly
• Having too many thoughts in mind
• Feeling jumpy and weird
• Being unusually active
• Less requirement for sleeping
• Feeling of being a super powerful, highly intelligent person
• Engaging in risky activities in order to prove more efficiency (like excessive drinking, too much eating, etc.) 

Following are some bipolar disorder symptoms patients in their depressive episodes:

• Feeling unimportant, unsolicited, hopeless and intense sadness
• Feeling lonely or desiring isolation from others
• Feeling of saying nothing or talking at an excessively slow speed
• Forgetting necessary things
• Sleeping for longer hours
• Eating too much
• Suicidal thinking
• Almost zero interest in doing usual activities
• Inability to perform simple tasks

Here are some of the symptoms patients may experience in their mixed psychological episodes:

• Feeling of hopelessness and hollowness and being extremely energised at the same time

Apart from these, bipolar disorder patients also deal with hypomanic episodes. It happens at the juncture of manic and depressive episodes. In a hypomanic state, patients think that everything is going fine. They can even manage social interaction properly. They may realise that their behaviour has become normal and all right. However, they may show symptoms of severe depression just after this hypomanic episode.

There are no exact causes that may lead to the development of bipolar disorder. Experts believe that one may develop this due to the combined effect of several risk factors as mentioned below [5]:

• Chemicals Imbalance 

Neurotransmitters are the chemicals responsible for controlling the functions of the brain. Some of these effective neurotransmitters are serotonin, noradrenaline and dopamine. If one or more chemicals are inadequate or more than necessary, individuals can develop this bipolar disorder.

• Genetics

Bipolar disorder can also be a hereditary condition. Individuals may suffer if they have a family history of this disorder. According to a report, the chances of developing bipolar disorder become 1 in 10 in a child if one of the parents suffers from it [6]. The likelihood of getting the illness becomes 4 in 10 if both parents are patients of bipolar disorder [6].

• Triggers

Several environmental and genetic factors also act as factors triggering the bipolar disorder symptoms, as mentioned below:

• Emotional, physical and sexual abuse
• Breakdown in a relationship
• Demise of a family member or a dear one

Apart from these, sleep depravity, physical illness, and serious financial, professional or relationship problems can also act as triggers for symptoms of bipolar disorder.

Bipolar disorders are of three types, as mentioned below:

• Bipolar I Disorder

In bipolar I disorder, patients encounter one or more manic episodes. During these manic episodes, they can feel extremely energetic or irritable. Besides, they can also encounter episodes of depression that can last up to 2 weeks. So, two different extreme states of mood dictate their emotions. In bipolar I disorder, manic episodes can be very severe, causing patients to make frenzied actions that may lead to physical injuries.

• Bipolar II Disorder

Patients with bipolar II disorder deal with depressive and hypomanic mental states. They do not encounter episodes of complete manic mental states. Owing to this factor of no maniac state, they generally make frenzied movements which can be impairing for themselves. However, due to prolonged or chronic depressive state of mind, they can also become debilitated. 

• Cyclothymic Disorder

The cyclothymic disorder involves many shorter episodes of chronic mood swings that can last up to two years. The symptoms of manic and depressive episodes are milder than other types of bipolar disorders.

It is better to start the medical treatment process as soon as possible. If you are experiencing the signs or symptoms of bipolar disorder, you should contact a certified healthcare expert. You need to convey the symptoms to the doctor exactly as you experience them.

They will conduct the necessary tests and mental health evaluations to understand whether you are a patient with bipolar disorder. By timely diagnosis, you can start the medical treatment from an early stage and manage the signs and symptoms.

Individuals to be diagnosed with bipolar disorder must encounter one or more episodes of mania, hypomania or depression. The healthcare expert may suggest one or more of the below-mentioned tests for the diagnosis of bipolar disorder:

• A psychiatrist evaluates the mental health of patients with the help of questionnaires and clinical reports 
• Experts conduct necessary physical examinations
• Doctors check medical records, including lifetime health records, family history, symptoms and patient experiences
• Doctors conduct blood testing to check whether hyperthyroidism is the cause of the bipolar disorder

For the diagnosis of a particular type of bipolar disorder, doctors perform the methodical Diagnostic and Statistical Manual of Mental Disorders (DSM) test.

The prognosis of bipolar disorder may not be strong since nearly 50% of the patients need to witness a return of symptoms within 2 years of the first occurrence [9].

With the support of near ones, people who have bipolar disorder can live a right, effective and meaningful life. Patients can see significant improvement in terms of treating bipolar disorder with continuous medication, as suggested by doctors.

Besides referring medications, doctors also focus on forming positive habits and necessary skills within the patients to cope with their episodic mental conditions. Families also play a significant role in terms of giving proper care and emotional support.

Following are the different types of therapies that doctors may perform [10]:

• Psychoeducation

In this therapy, the doctor educates patients about their psychological health and the course of action they can take. This way, they can become more self-aware. Its main objective is to influence patients to control their own actions. For this, psychiatrists make them cognizant of their own course of episodic actions. In addition, the concerned healthcare professional instructs patients’ family members about their roles in giving the required care.

• Interpersonal and Social Rhythm Therapy or IPSRT

IPSRT is an effective therapy for people suffering from mood disorders. In this treatment process, doctors assist patients in improving their moods methodically. They first assess the social and biological rhythms of patients and then teach skills they will need to control depressive or manic episodes. The treatment process also focuses on developing tailored techniques that enable patients to take medications timely, manage stressful situations and decrease occasions of disruptive social rhythms. 

• Family-focused Therapy

This therapy considers including the patients and their caregivers in the psychoeducation sessions provided by the experts. As a result, all of them get to know about the courses of action in which the patient can get involved and how caregivers can help them. It also focuses on improving problem solving and communication skills of patients.  

• Cognitive Behavioural Therapy

The therapist trains individuals to become cognizant of their own thought processes and how they react to their emotional stimuli or triggers. Patients learn how their thoughts influence their course of action. They get to know how they can adopt and culture positive thoughts and dominate their negative impulses. 

Apart from these therapies, doctors also use medications to prevent episodes of depression and mania and treat symptoms of bipolar disorder. 

Following are some of the useful medications used as mood stabilisers[11]:

• Lithium

Lithium intake is an effective but long-term treatment procedure to curb the episodes of bipolar disorder. Doctors generally recommend using the drug for at least 6 months. If your doctor prescribes this medicine, you should continue its consumption regularly according to the doctor’s guidance. If the dosages you take are irregular or incorrect, you may experience side effects like diarrhoea. During your treatment, you also need to get an interim blood test to ensure that your body’s lithium level is in the right balance. 

• Anticonvulsant Medicines

Anticonvulsants are mood stabilisers that doctors recommend to cure the episodic manic and depressive mental state of bipolar disorder. Some of the most effective anticonvulsant medicines are valproate, lamotrigine and carbamazepine. You may need to take any of these medicines singularly or in combination with lithium on your doctor’s recommendation.

• Antipsychotic Medicines

Antipsychotic medicines like olanzapine, aripiprazole, risperidone, quetiapine, etc., help in treating mania. These also act as mood stabilisers, effective in the long term. Doctors generally prescribe these medications when the symptoms are intense. 

There is no particular technique that can help you with bipolar disorder prevention. So, if anyone from your family has a record of suffering from bipolar disorder, you should stay completely aware of the early signs of this illness. If you think that you experience those signs and symptoms, you need to communicate the issue with your family members so that they can take proper care. 

Further, you also need to refrain from taking substances that can cause a manic/hypomanic state of mind. Some of these are as mentioned below [6]:

• Recreational drugs (Cocaine, amphetamines, ecstasy, etc.)
• Caffeine

If patients do not get the required treatment from an early stage, bipolar disorder will lead to intense mood changes, which can last up to 6 months. For example, if they are in a depressive episode of the disorder, it can continue for up to that long. Additionally, patients can also experience the following complications [6]:

• Anxiety
• Abuse of narcotic and alcoholic substances
• Cardiovascular issues
• Diabetes
• Unhealthy weight gain (for example, obesity)
• Suicidal thoughts

According to a study, the average monthly cost of treatment for bipolar disorder is about Rs.770 per individual patient. Among the total cost of treatment, you may have to spend around Rs.390 for medications only. 

Bipolar disorder is a severe psychological illness that restricts an individual’s ability to react normally to different emotional stimuli. Patients experience long episodes of manic and intense depressive mental states. In manic episodes, they become very excited and unusually active, whereas, in a depressive state, they become silent and feel intense sadness and hopelessness. It is, therefore, necessary that they get the required medical attention from an early stage. 

Treatment facilities for bipolar disorder can put a substantial burden on you or your family. However, you can get yourself covered with a comprehensive health insurance policy.  You can now purchase Navi Health Insurance to cover 100% of your hospital bill for up to Rs.1 Crore. Navi has more than 10,000 network hospitals across India from where you can get cashless treatment facilities. The affordable premium starts from only Rs.234/month. Get a quote now!