Bipolar disorder is also known as manic depressive illness or manic depression. This is a disorder where the person is unable to regulate their emotions. This causes mood shifts such as periods of depression and times of abnormally elevated moods that can last several days or even weeks. It also affects the person's energy, activity levels, concentration, and motivation to follow regular day-to-day tasks. This can be such as brushing their teeth, taking a shower, or going to work. There are three types of this disorder, Bipolar I, Bipolar II and Cyclothymic. Each of them is different but share a common ground.
The two extreme mood changes that occur are known as manic and depressive. A manic episode is known to be an emotional high. The common symptoms are elevated high mood, decreased need for sleep, loss of appetite, talking fast, thoughts racing, multitasking, impulsive decisions, and feeling powerful. Several people can experience psychosis during this state of mind. The other state has the opposite effect compared to mania. The impact of this state of mind is feeling hopeless, suicidal ideation, indecisiveness, trouble falling asleep or sleeping too much. Some people experience manic and depressive effects in one episode; it's called an episode with mixed features.
Bipolar I is considered to be the more severe one compared to the other ones. This is more severe due to full blown mania that the different types do not experience. According to the DSM-5, there needs to be at least one manic or mixed episode of mania and depression to be diagnosed with this. There are also hypomanic episodes that are not as severe as full-blown mania episodes but still raise concerns. These focus episodes can be so severe that some experts describe them as "Raging Bipolar" and can last from a few days to weeks. If the person going through these episodes experiences psychotic features, they call it Bipolar Disorder I with psychotic features. They believe the cause of this disorder has three factors that play a role: The first one being genetics; this is why if someone’s diagnosed with Bipolar, they are asked if there’s a family history for mental illnesses. According to the American Psychiatric Association, 80% to 90% of people with bipolar disorder have a relative with depression or bipolar disorder. The second reason is due to chemical imbalances in the brain. Serotonin and dopamine are two neurotransmitters that affect the levels in the brain that control the emotional and overall well-being of a person. Serotonin is the emotional processing, and dopamine is how you experience activities that give you pleasure. The third factor is when an event is causing stress or triggering a prior predisposition. To treat bipolar I, they often use mood stabilisers such as lithium or Divalproex. For patients who experience psychotic features, it is usually recommended to use antipsychotics as a treatment option. Often, they have to try different medications to find the perfect dose or amount for that person because everyone reacts differently.
Bipolar II is not as severe as bipolar I but still has similar symptoms. In this type, the episodes never reach full blown mania but suffer more from episodes of depression. This often leads to more extended periods of depressive episodes. The elevated moods or episodes in bipolar II are known as hypomania or hypomanic episodes. Depressive symptoms often happen soon after hypomanic symptoms fade away. These hypomanic symptoms can occur for weeks or even months. Because hypomania is not as disrupting everyday life as full blown mania, it is often missed and untreated.
In some cases, hypomania can be disrupted because of how random it often comes to those who experience it. If it is euphoric, some people find it disrupting to be around. Bipolar II, because of the not as severe episodes, there are fewer hospitalisations than bipolar I. The medications used to treat can prevent episodes of depression and lessen the effects of hypomania. Given that bipolar II consists of recurrent episodes, medication is recommended to avoid relapse. Antipsychotics are rarely used for bipolar II. Usually, there are no psychotic features.
Cyclothymic disorder or Cyclothymia is a mild mood disorder that has similar symptoms to bipolar II. Low moods with periods of hypomania define this disorder. This disorder, compared to Bipolar I and II, are that the symptoms have to last at least two years before a diagnosis is made. The mood swings are not as intense as those in bipolar disorder I and II. If it goes untreated, it can develop into bipolar. Since this does not come off as a problem because it is mild, many people do not seek help. It is a chronic condition that requires lifelong treatment. The medicines are the same for Cyclothymia as for bipolar. The two types of therapy that have been proven to help are cognitive behavioural therapy and well-being therapy. Well-being therapy is known to focus on the overall being instead of the psychological symptoms.
Cyclothymia, Bipolar I and II have similarities but can be manageable with the proper medication and treatment. Other mental illnesses that may be present can make the diagnosing part of bipolar hard to diagnose. There are several main factors they use, such as manic or depressive symptoms. Another factor is the use of substances such as drugs or alcohol. This is why being informed about a person's well-being and genetics is vital to early prevention. Having a support system and communicating with the doctors is essential to getting positive results.
Written by Sienna Ponce
Edited by Hrudhai Chand