Bipolar disorder manifests itself in two opposing phases: mania and depression. In a manic state, a person is cheerful, energetic, very sociable, and sleeps little; in a depressed person, on the contrary, he is apathetic, drowsy, irritable, and anxious. A psychiatrist can easily notice manifestations of mental deviation in both the first and second phases, while others around him can consider the patient healthy for a long time. Treatment for bipolar disorder is selected depending on what phase the patient is in: if it is mania, then antipsychotics, sedatives, and sleeping pills are used; if depression, then antidepressants and auxiliary therapy are used. During periods of remission, maintenance therapy, including mood stabilizers, is used.
Bipolar disorder, or manic-depressive psychosis, is a common reason for visiting a psychiatrist. As the name of the disease suggests, the essence of this disorder is a combination or periodic change of two extreme polar states - depressive and manic. Bipolar disorder is inherited, so familial cases are common.
Let us dwell, first, on the nature of the manic state. To diagnose a manic state, the first and necessary criterion is an elevated mood - euphoric, expansive, or aggressive-irritable. Sometimes from the outside, to strangers, a person who is in a manic state looks like cheerful, sociable, and energetic. But people familiar with it or professionals can quite easily notice the inadequacy of this condition.
In addition to mood, typical symptoms of a manic episode are hyperactivity, decreased need for sleep, thoughts of one's own genius or grandiosity, special talents, abilities or messianic function, the ability to influence others, natural phenomena, the course of history. It often happens that a manic episode begins with mild manifestations, when a person looks cheerful, witty, he easily meets others, and successfully copes with his affairs. Such manifestations are called hypomanic. In the future, this picture can transform into an irritable and aggressive pattern of behavior, even physical aggression towards others. In these conditions, the patient lacks the ability to evaluate his behavior objectively and critically; cases of insane spending of large sums of money, increased sexual needs, up to numerous sexual contacts with different people are typical.
The manic phase is replaced by a depressive phase, which is characterized by apathy, depressed mood, emotional lability, insomnia or, conversely, drowsiness, suicidal thoughts, and inability to function normally. A person in a depressed phase may have difficulty getting out of bed in the morning, he cannot do even simple chores around the house, and he does not have the strength to work.
Thus, with bipolar disorder, the patient is in a situation of emotional swing, when his mood fluctuates sharply to two polar points - mania and depression.
To diagnose the presence of bipolar disease, there must be at least one known manic episode that the patient has experienced. Diagnosis begins with anamnesis and heteroanamnesis, during which the doctor interviews in detail both the patient himself and his relatives. In addition to a clinical interview with a psychiatrist, a consultation with a neurologist and a battery of projective tests are necessary, which will not only show any disturbances in thinking and the emotional sphere but will also help identify the causes of bipolar disorder.
There are frequent cases in which manic symptoms often appear due to the use of drugs or steroid drugs and can also be a manifestation of some other illness, including a physical illness.
Depending on the intensity of manic and depressive manifestations, different types of bipolar disorder are distinguished.
How does bipolar disorder manifest?
Bipolar disorder can begin in different ways - with depression or mania. It should be noted that the disease begins with a depressive period in almost 70% of cases, and with a manic period in the remaining 30%.
Symptoms of bipolar disorder in the first case will be as follows:
• the appearance of laziness and apathy;
• state of depression;
• drowsiness;
• physical disorders and ailments;
• anxiety;
• irritability;
• feeling of heaviness in the head;
• inability to engage in any activities or work;
• constantly in a bad mood;
• neglect of personal hygiene.
The symptoms of the disease in the manic period will be somewhat different;
• feeling of euphoria;
• impulse to creativity;
• energy;
• physical activity;
• insomnia;
• talkativeness and increased sociability;
• increased libido;
• senseless waste of money;
• need to use drugs and alcohol;
• changes in perception of the world and the environment;
• emergence of strange ideas.
Bipolar disorder is usually milder in men than in women. Typically, periods of mania and depression alternate over a long period of time. As the disease progresses, mania and depression become more pronounced, and if the patient has not received proper treatment, the disease worsens, and then treatment takes quite a long time with the help of massive pharmacotherapy and intensive psychotherapy.
In men, in particular, the mixed type of bipolar disorder is more common. The disease occurs with short periods of remission. During a period of depression, men are more likely than women to suffer from performance loss, concentration drops, and attention is distracted. Daily functioning is significantly affected. In a depressed state, men experience sleep disorders; they cannot fall asleep for a long time, or, on the contrary, they fall asleep quickly, but wake up at night and spend long hours without sleep until the morning. During a manic period, a man may lose the need for sleep, he may not sleep for several nights in a row, which leads to the depletion of physical and psychological reserves. Also, unlike women, men diagnosed with bipolar disorder experience periods of depression and mania that last about the same amount of time.
There are often cases when bipolar disorder in men occurs due to frequent alcohol consumption.
Due to the peculiarities of the hormonal background, female bipolar disorder is much brighter and more intense than in men. Women are also more susceptible to rapidly circulating bipolar disorder - this type of disease is characterized by rapid alternation between manic and depressive periods. They can replace each other several times a week and even in 1 day.
Bipolar disorder is statistically more common in women than in men. The disease progresses over time, so it is advisable to start treatment as early as possible. The main thing is to contact an experienced specialist.
It is noteworthy that often in women, instead of bipolar disorder, specialists often diagnose depression, since manic periods do not occur as often as in men, or even have short intervals of several days. Incorrect diagnosis leads to incorrectly prescribed treatment, which consists of taking antidepressants. Such treatment inevitably leads to a manic episode and hospitalization.
Unlike men, women diagnosed with bipolar disorder are more likely to commit suicide during depression. This is also an indication for hospitalization.
During a depressive episode, women suffer from insomnia - they have difficulty falling asleep, they report interrupted sleep or frequent awakenings at night.
Quite often, the first episode of bipolar disorder occurs after childbirth. Physical weakness, severe pain and general mental stress, trauma, shock experienced during labor leave an indelible mark on the female psyche and general well-being. Bipolar disorder can also develop against the background of postpartum psychosis.
Bipolar disorder in children, according to experts, develops largely due to heredity. Other reasons are:
• history of multiple sclerosis;
• diseases of the thyroid gland;
• use of a number of medications: antidepressants, corticosteroids and others;
• sleep disorders;
• caffeine abuse;
• drug and alcohol addiction.
Signs of bipolar disorder in a child/teen include erratic, illogical behavior, psychotic episodes of mania, when the child has super ideas and ideas of self-worth. Mania is usually followed by acute and severe depression when the child becomes suicidal. The character changes - the child becomes irritable, whiny, cunning, and irresponsible about his obligations. A teenager can engage in promiscuity, manipulate, and become addicted to alcohol and drugs.
Treatment for Bipolar Disorder
Treatment of manic-depressive psychosis differs significantly from treatment approaches for schizophrenia. If antipsychotic, sedative, and hypnotic drugs are often used in the active phase, then for maintenance treatment it is necessary to prescribe another group of drugs - mood stabilizers, or mood stabilizers.
The depressive phase of the disease requires treatment with antidepressants in combination with other groups of drugs to prevent a rapid change from depression to mania.
Prevention of bipolar disorder
Now, there is no specific prevention system that will help avoid the manifestations of bipolar disorder. If you have been diagnosed with this disease, all that remains is to follow the recommendations of your doctor to prevent relapses.
Chronic stress can be a trigger for the development of bipolar disorder, therefore, for inner peace and mental balance, it is recommended to resolve stressful situations and change lifestyle if stress is a constant companion in life. It is necessary to observe a sleep and rest schedule, avoid consuming the following foods and substances:
• alcohol;
• caffeine;
• psychoactive substances and drugs;
• sugar.
If you feel anxiety for no reason, sudden attacks of fear, increased negative mood or, on the contrary, a sharp rise in mood, insomnia, increased activity, you should urgently consult a psychiatrist or psychotherapist. These sensations may be warning signs of an episode of bipolar disorder. The doctor will be able not only to prevent the development of the disease in time, but also to prescribe adequate medications that will help stabilize the condition.