pathoscribe

Written by Simran Ahluwalia | Art by Simran Ahluwalia

Once known as manic-depressive illness or manic depression, bipolar disorder is a mental illness that causes unusual and random shifts in a person’s mood, energy, concentration, and more. During bipolar episodes, patients can find it very difficult to carry out everyday tasks and do their daily activities like going to school or work and maintaining relationships. Bipolar disorder affects millions of people in the US. In the past year, an estimated 2.8% of U.S. adults have suffered from this mental illness. An estimated 4.4% of US adults have had bipolar disorder at some time in their lives. With much disinformation and stigma surrounding bipolar disorder, we must work to educate ourselves.

Patients with bipolar disorder often experience manic and depressive episodes. Manic episodes can include intense feelings of euphoria, excitement, or happiness; appearing abnormally jumpy or full of energy; insomnia or restlessness; and speaking fast or being unusually talkative. Manic episodes also include racing or jumbled thoughts, easily distracted, inflated self-esteem, highly impulsive decisions, increased agitation and irritability, and hypomania. In contrast, depressive episodes include feelings of sadness, worry, worthlessness, anxiety, guilt, hopelessness, lack of interest, low energy, forgetfulness, and indecisiveness. Patients who go through depressive episodes may also experience difficulty concentrating, changes in sleep, changes in appetite, and suicidal thoughts. Patients may also experience mixed episodes. This refers to the presence of both manic and depressive symptoms; in other words, they will experience both the highs and lows of these two types of episodes. The patient’s moods will switch from elevated to depressed rapidly and simultaneously over time.

There are three types of bipolar disorder. First is Bipolar I Disorder, defined by manic episodes that last for at least seven days or manic symptoms so severe causing the patient to need immediate medical care. Depressive episodes occur as well, usually lasting up to two weeks. Additionally, mixed manic and depressive episodes can also occur. Patients with type I can also undergo rapid cycling of episodes in which they experience four or more episodes of mania or depression within one year. Bipolar II Disorder is defined by a pattern of hypomanic and depressive episodes. The hypomanic episodes of type II are distinctly less severe than the manic episodes of type I. The last type of bipolar disorder is cyclothymic disorder, also called cyclothymia. Patients diagnosed with cyclothymia have recurring hypomanic and depressive episodes that are not intense or long-lasting enough to be classified as depressive or manic episodes.

Often, patients are diagnosed with bipolar disorder during late adolescence or early adult years. Medical professionals and researchers believe that certain physical, medical, and environmental conditions make some people more susceptible to bipolar disorder. Experts believe that severe childhood trauma can lead to the development of this disorder, as intense childhood distress can affect a person’s ability to regulate emotions. This childhood trauma can include sexual, physical, or emotional abuse, neglect, traumatic events, or the loss of a loved one like a parent or guardian. Brain structure and functioning are also examined when determining risk factors for bipolar disorder. Studies show that the brains of people with bipolar disorder have conspicuous differences from the brains of people with no mental disorders. Understanding these differences can help medical professionals develop better methods of treatment specific to each patient. Genetics can also be a significant risk factor when looking at bipolar disorder diagnosis. Research suggests that people with certain genes and those with a family history of bipolar disorder are more at risk of developing this mental illness. Still, no single gene has been linked with causing the disorder.

While bipolar disorder is chronic, there are treatments to alleviate the symptoms and make living with this disorder easier. Several medications are used to treat bipolar disorder. These include mood stabilizers for manic and hypomanic episodes, antipsychotics for persistent depression and mania, antidepressants, antidepressant-antipsychotics for both mood stabilizing and depression treatment, and anti-anxiety medications. Additionally, several types of psychotherapies can help manage bipolar disorder. Interpersonal and social rhythm therapy (IPSRT) can create stabilized and consistent daily routines for sleep, eating, and waking, allowing for better mood management. Cognitive behavioral therapy (CBT) focuses on identifying unhealthy, negative beliefs and behaviors to replace them with healthy, positive ones, allowing for the identification of triggers of bipolar episodes. Psychoeducation helps patients learn about bipolar disorder to help them understand their condition to help them receive the best support, identify issues, and prevent relapses. Family-focused therapy helps patients stick with their treatment plans and helps them and their loved ones recognize signs and manage mood swings. Continued treatment is crucial for patients with bipolar disorder, as skipping maintenance treatment can pose risks of relapse or lead to minimal mood changes that entail full-blown mania or depression.

While bipolar disorder may have much stigma surrounding it, we must be educated about its impact and the effects it has on people’s lives. By spreading this awareness, we can work toward better solutions for bipolar disorder and support people who suffer from this disorder to lead healthier and happier lives as a whole.

Works Cited:
“Bipolar Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 13 Dec. 2022, http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961.
“Bipolar Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 13 Dec. 2022, http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955.
“Bipolar Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, http://www.nimh.nih.gov/health/topics/bipolar-disorder. Accessed 30 Mar. 2024.
“Bipolar Disorder.” SAMHSA, Substance Abuse and Mental Health Services Administration, http://www.samhsa.gov/mental-health/bipolar. Accessed 30 Mar. 2024.
“Causes of Bipolar Disorder.” Mind, Fundraising Regulator, http://www.mind.org.uk/information-support/types-of-mental-health-problems/bipolar-disorder/causes-of-bipolar/#:~:text=What%20causes%20bipolar%20disorder%3F,physical%2C%20environmental%20and%20social%20conditions. Accessed 30 Mar. 2024.
“Mixed Bipolar Disorder Symptoms, Causes, and Treatments.” WebMD, WebMD, http://www.webmd.com/bipolar-disorder/mixed-bipolar-disorder. Accessed 30 Mar. 2024.