Bipolar disorder or manic depression is a mental disorder characterized by serious mood swings. It causes unusual shifts in mood, energy, activity levels, and the ability to carry out daily tasks. It's an oscillation between periods of elevated mood and periods of depression.
During the elevated mood, also known as mania or hypomania, the person feels extremely happy, energetic or irritated. They make silly decisions with no worry about the consequences. And usually there is no need for sleep.
Periods of depression are signified by crying, poor eye contact with others, and a negative outlook on life. The risk of suicide among those with the disorder is very high. Other mental health issues such as anxiety disorder and drug misuse are commonly associated.
The causes of bipolar disorder varies between individuals and it's hard to pin point the exact reason.
About 60%–80% of the risk of developing the disorder is due to genetic influence thereby indicating a strong hereditary component. The risk of the disorder is almost ten-fold higher in first degree-relatives of bipolar patients than the general population. The risk of major depressive disorder is three times higher in relatives than the general population.
Bipolar disorder can also be due to abnormalities in the structure and/or function of certain brain circuits. An increase in the volume of the lateral ventricles, globus pallidus and increase in the rates of deep white matter hyperintensities are reported in the meta-analyses of structural MRI studies in bipolar disorder.
Environmental factors play a very significant role in the development and course of bipolar disorder. It's found that almost half of the adults diagnosed with bipolar disorder report traumatic/abusive experiences in childhood. This leads to a higher rate of suicide attempts, and more co-occurring disorders such as PTSD.
As a result of neurological conditions, such as stroke, traumatic brain injury, HIV infection, multiple sclerosis, porphyria, and rarely temporal lobe epilepsy bipolar, a person can get bipolar disorder.
The disorder will be recognized only after 5-10 years of having it; i.e. during early childhood or during adolescence. The self-reported experiences of the symptomatic individual, behavior abnormalities reported by family members, friends or co-workers helps in confirming the disease.
Treatments are done both psychosocially and through medication. Therapy caters to the lessening of core symptoms like recognizing episode triggers, reducing negative expressed emotion in relationships, recognizing prodromal symptoms before full-blown recurrence, and, practicing the factors that lead to maintenance of remission. To develop a therapeutic alliance in support of the recovery, some clinicians emphasize the need to talk with individuals experiencing mania.
The medication with the maximum efficacy is lithium, which is effective in treating acute manic episodes and preventing relapses. It is also good for bipolar depression. Lithium reduces suicide risk, self-harm, and death in people with bipolar disorder. Anticonvulgents like valproic acid, Lamotrigine, gabapentin, topiramate, and oxcarbazepine are also used as mood stabilizers. Yoga is a good meditative therapy for bipolar depression.