Sudden change in mood and Bipolar disorder- A health issue
Maybe
you’ve heard the term “bipolar” used to describe someone who’s moody, or who
has mood swings, but this colloquial use of the term is really different from
bipolar disorder.
Bipolar disorder, which used to be called manic depression, is a serious mental illness that causes a person to have dramatic shifts in emotions, mood, and energy levels: moving from extreme lows to extreme highs. But these shifts don’t happen from moment to moment, they usually happen over several days or weeks. There are a few different types of bipolar disorders, but there are some common features. First, the low moods are identical to those in a related disorder - major depressive disorder, also known as unipolar depression. Individuals with this can feel hopeless and discouraged, lack energy and mental focus, and can have physical symptoms like eating and sleeping too much or too little. But along with these lows, the thing that sets bipolar disorders apart from unipolar depression is that individuals can have periods of high moods, which are called manic episodes or hypomanic episodes, depending on their level of severity. In a manic state, people can feel energetic, overly happy, or optimistic, even euphoric with really high self-esteem. And on the surface, these might seem like very positive characteristics, but when an individual is in a full manic episode, these symptoms can reach a dangerous extreme. A person experiencing mania might invest all of their money in a risky business venture or behave recklessly. Individuals might talk pressured speech, where they talk constantly at a rapid-fire pace, or they might have racing thoughts and might feel ‘wired,’ as if they don’t need sleep. Manic episodes can also include delusions of grandeur, for example, they might believe that they are on a personal mission from god, or that they have supernatural power. And they might make poor decisions without any regard for later consequences.
One way to understand
these swings is by charting them on a graph. So let’s say the y-axis is a mood, with
mania and depression being on the far ends of the axis, and the x-axis is time.
The average healthy individual might have normal ups and downs throughout their
life, and they might even have some pretty serious lows once-in-awhile, maybe
after losing a job or moving to a new place and feeling lonely. An individual
with unipolar depression though might have the normal highs, but they might have
some crushing lows that last for a long period of time and may not have an
obvious trigger. Now, for the bipolar disorders, the first one is called
Bipolar 1, and these are people that have some major lows that last at least 2
weeks, and some major highs that last at least a week or require
hospitalization. That said, untreated manic episodes can last as long as 3-6
months. Depression is seen in most cases but is not required for a diagnosis. The
second one is called Bipolar-2, and this is when a person experiences similar
lows and has additional highs called “hypomania”, which are less severe manic
episodes than we see in Bipolar 1.To qualify for a diagnosis, these hypomanic states
need to last at least four days. Once again though, these symptoms generally last
a few weeks to a few months. Alright the third one is called cyclothymia, or
sometimes cyclothymic disorder, and these individuals have milder lows as well
as the milder highs or “hypomania” like you see in Bipolar-2, and they cycle
back and forth between these two over a period lasting at least 2 years. Sometimes,
people with Bipolar disorder can show other, less common symptoms as well, for
example having what is referred to as mixed episodes—experiencing symptoms of both
depression and mania at the same time. Another symptom they might have is rapid
cycling, which describes a situation where a person has 4 or more episodes of
depression or mania within a given year. Like most mental health conditions,
the exact underlying cause of the bipolar disorder isn’t known, and there is no
single “bipolar gene” identified, but it’s thought that there are genetic and
environmental factors that play a part. For example, one interesting clue is
that people with family members who have bipolar disorder are 10 times more
likely to have it themselves. Another clue is that some drugs and medications can
trigger manic episodes, like selective serotonin reuptake inhibitors (or
SSRIs). It’s also worth mentioning that people with bipolar disorder often have
other disorders like anxiety disorders, substance use disorders, ADHD, and
personality disorders as well, making diagnosis and treatment a real challenge.
Even though there’s no cure for bipolar disorder, identifying and treating
individuals is really important, since there’s a real danger that the person
could harm themselves or commit suicide. One of the oldest treatments is also
one of the most effective treatments, and that’s lithium salts. Lithium acts as
a mood stabilizer—smoothing out the highs and lows they experience. That said,
it is much better at treating manic rather than depressive episodes, and so
individuals who take it often have to take other medications as well, which can
be problematic since some antidepressants (like the SSRIs) can trigger manic
episodes in individuals who are predisposed to them. Other treatment options
include antipsychotics, anticonvulsants, and benzodiazepines, but many of
these—including lithium—have side effects that can be severe and lead to
non-adherence which can be dangerous for an individual. Now, unlike certain
disorders like unipolar depression, psychological interventions, like talk
therapy, or cognitive-behavioral therapy are not particularly effective in
treating the manic episodes of bipolar disorder. Having said that, they can
still be very helpful tools to help individuals with bipolar disorder in
general—especially after a manic episode has ended. They can also help an
individual handle stressful situations that might otherwise lead a manic episode,
thereby helping to prevent a potential manic episode in the first place.
Conclusion:
Alright,
so super fast recap: bipolar disorder is a mental disorder characterized by
depression, periods of lowered mood, as well as mania, periods of heightened
mood.
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