What is it?
Bipolar disorder is a long-term mental condition where there are episodes of disturbance with periods of low and elevated moods. It may be described as a mood swing where at times, you feel very high and filled with energy (mania). At other times, you might feel very low (depression). But in between the two phases, you may have times when you’re in a normal, stable mood which can last for weeks, months, or even years.
There are two main types of bipolar disorder. They are called bipolar I and bipolar II.
• Bipolar I means there are periods of mania and periods of depression.
• Bipolar II also means there are periods of mania and periods of depression. But the mania is milder, and sometimes called hypomania. This type is commoner.
Why causes it?
It is not known exactly what causes bipolar disorder. However studies have shown that it may have to do with the levels of certain substances in the brain called “chemical messengers” which are responsible for carrying signals to and fro different parts of the brain. Bipolar disorder seems to have a genetic cause, although some people have it without any family history of the illness, and vice-versa.
The very first bout, or a repeat attack of the condition may be triggered by certain situations such as stress, pregnancy and use of recreational drugs.
What are the symptoms?
The core symptoms of bipolar disorder are periods of mania and depression.
Mania can make you feel good initially. You might feel very creative, energetic, happy and excited, and just want to change the world. But this subsequently, this high mood gets out of control. You may turn aggressive and do really awkward things. You may become restless, lose sleep, act impulsively, spend carelessly and want to have sex with lots of people. A bout of mania may start suddenly, and without treatment, may last for several weeks. Hypomania is usually milder and lasts for just about five to seven days.
During the phase of depression, you might feel sad, fatigued, hopeless or guilty, and may lose interest or pleasure in things you normally enjoy. Some people even develop suicidal tendencies depending on the severity. This usually lasts for at least two weeks or more.
How is bipolar disorder treated?
People with this condition usually need to take drugs every day to remain in a stable mood. There are a number of medications available and all of them can cause side-effects. You need to work closely with your doctor to arrive at the most suitable treatment regimen for you. Not all these side-effects will occur, and you must quickly report to your doctor if you start getting any. Do not stop any of these medications without your doctor’s consent, to avoid a recurrence of the symptoms.
Medicines to treat and prevent mania
There are three main types of medicine for this:
Antipsychotics are a group of medicines that calm down the activity in your brain. They include drugs like olanzapine, haloperidol and risperidone. Your doctor should be able to choose the most suitable one, and they can be used for a long time.
Tranquillisers such as clonazepam and lorazepam can be used to calm you down fast especially when you are very agitated. However, long term use may lead to an addiction.
Mood stabilisers like lithium, sodium valproate, and carbamazepine have been shown to work well. They can also be used over a long term.
Medicines to treat depression
Some of the same medicines used to treat mania can also help with depression in bipolar disorder. These include antipsychotics such as olanzapine and quetiapine, and mood stabilisers, such as lithium and sodium valproate.
Antidepressants are also sometimes used, but they are usually prescribed along with an antipsychotic, a mood stabiliser, or both. This is because taking an antidepressant alone for bipolar disorder can sometimes tip you into mania.
What will happen to me?
Long term treatment is usually required in people with bipolar disorder. This should serve well enough to help them remain stable. Low-level symptoms, or even no symptom at all, may occur between attacks of mania and depression. Relapses can also occur either because of treatment stoppage or drug failure. With appropriate management however, you may be able to have a normal or near-normal life at least.