BIPOLAR PERSONALITY DISORDER: How to Recognize the Signs and Symptoms.

I had a friend back in high school that had the most terrible mood swings. One moment she was happy, smiling, joking and jovial and the next moment, she was moody like someone died or she had been offended by something… Needless to say, because we were pretty close, this impacted our friendship negatively. Sometimes I would wonder if I did or said something wrong, but each time I asked, she would say it was nothing I did or said, sometimes, the sad and moody attitude dragged on for weeks, after which she would be her happy self again. After a while of this happening and being left wondering what was going on for almost a year, I got tired of the roller coaster and finally decided to stay away to protect my peace of mind. Many years later, sitting in my medical class and listening to our professor talk about bipolar disorder, my thoughts drifted back to my high school friend, and I couldn’t help but wonder if she had bipolar disorder.

WHAT IS BIPOLAR DISORDER?

Bipolar disorder, previously known as ‘manic depression’ or ‘manic-depressive illness’ is a mental disorder that causes abnormal shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. It is characterized by times of depression and times of abnormally elevated mood that last from days to weeks each. If the elevated mood is serious or associated with psychosis, it is medically called mania; if it is less severe, it is called hypomania.

WHAT ARE THE TYPES OF BIPOLAR DISORDER?

There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. These moods change from periods of very “up,” excited, irritable, or energetic behavior (known as manic episodes) to very “down,” sad, indifferent, or hopeless periods (known as depressive episodes). Less serious manic periods are called “hypomanic episodes”.

The 3 types of bipolar disorder are:

1. Bipolar I Disorder: Such a person shows excited behaviour that lasts at least 7 days, or that is so severe that the person needs immediate hospital care. Usually, sad behaviour occurs as well, lasting at least 2 weeks. Episodes of depression with mixed features (having sad moods and excited moods at the same time) are also possible.
2. Bipolar II Disorder: Such a person shows sad mood and episodes and less serious excited moods, but not the full-blown excited moods that happen in Bipolar I Disorder.
3. Cyclothymic Disorder (also called Cyclothymia): Such a person shows slightly excited moods as well as periods of sad moods lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

Sometimes a person might have symptoms of bipolar disorder that do not fit into the 3 types above.

WHAT CAUSES BIPOLAR DISORDER?

Like many other mental illnesses, there is no single cause of bipolar disorder. There are many factors that contribute to a person having this disorder and make it more likely. Some of these factors include:

1. Brain Structure and Functioning: Some studies indicate that the brains of people with bipolar disorder may differ from the brains of people who do not have bipolar disorder or any other mental disorder. Learning more about these differences may help scientists understand bipolar disorder and determine which treatments will work best. 
2. Genetics: Research suggests that people with certain genes are more likely to develop bipolar disorder. Research also shows that people who have a parent or sibling with bipolar disorder have a higher chance of having the disorder themselves. Many genes are involved, and no one gene can cause the disorder. 
3. Extreme stress
4. Overwhelming problems
5. Life-changing events; like loss of a loved one, loss of a job, divorce, etc

HOW COMMON IS BIPOLAR DISORDER?

According to the National Institute of Mental Health, Bipolar disorder is fairly common. 1 in every 100 people will be diagnosed with it at some point in their life.

Bipolar disorder can occur at any age, although it often develops between the ages of 15 and 19 and rarely develops after 40.

Men and women from all backgrounds are equally likely to develop bipolar disorder.

In Nigeria, over 1.5 million people are affected yearly. 

WHAT ARE THE SYMPTOMS OF BIPOLAR DISORDER?

People with bipolar disorder experience periods of mood changes called “episodes”. Mood episodes are very different from the moods and behaviors that are normal for the person. During an episode, the symptoms last every day for most of the day. Episodes may also last for longer periods, like several days or weeks.

People having a manic episode may feel:

• Very “up,” “high,” elated, or irritable or touchy.
• Feel “jumpy” or “wired”.
• Have a decreased need for sleep.
• Talk very fast about a lot of different things
• Experience increased appetite and weight gain.
• Feel like their thoughts are racing.
• Think they can do a lot of things at once.
• Do risky things that show poor judgment, such as eat and drink excessively, spend or give away a lot of money, or have reckless sex.
• Feel like they are unusually important, talented, or powerful.

People having a depressive episode may feel:

• Very sad, “down,” empty, worried, or hopeless.
• Feel slowed down or restless.
• Have trouble falling asleep, wake up too early, or sleep too much.
• Have a loss of appetite.

• Talk very slowly, feel like they have nothing to say, forget a lot.
• Have trouble concentrating or making decisions.
• Feel unable to do even simple things.
• Have little interest in almost all activities, a decreased or absent sex drive, or an inability to experience pleasure, medically called “anhedonia”.
• Feel hopeless or worthless, think about death or suicide.

Sometimes people experience both manic and depressive symptoms in the same episode. This kind of episode is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while, at the same, time feeling extremely energized.

A person may have bipolar disorder even if their symptoms are less extreme. 

HOW IS IT DIAGNOSED?

Proper diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking with a doctor or other licensed health care personnel is the first step. To speak with a doctor on flexicare, sign up here or gain access if you’re an existing subscriber. The doctor will do a physical exam, medical tests and a mental assessment. Bipolar disorder is usually diagnosed based on a person’s symptoms, lifetime history, experiences, and, in some cases, family history. 

 Although the symptoms may be different over time, bipolar disorder usually requires lifelong treatment.

HOW IS IT TREATED?

Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.

 Treatment consists of:

1. Medication
2. Therapy
3. Palliative care

LIVING WITH BIPOLAR DISORDER?

Without treatment, episodes tend to occur more frequently as people get older, causing increasing problems in relationships or at work. Treatment can be very effective; many of the symptoms can be reduced and in some cases stopped completely. As a result, many people with bipolar disorder are able to function completely normally and have highly successful lives.