Today, we are going to discuss bipolar disorder and related mental health conditions, such as mania, hypomania, depression, and psychosis.

Bipolar Affective Disorder shortly referred to as BAD is a mental disorder that causes extreme mood swings ranging from depression to euphoria i.e. hypomania and mania.

History

Similar medical cases were described in the works by Hippocrates and Aretaeus. French psychiatrist Jean-Pierre Falret was the first to define BAD as a mental illness back in 1851 and attempted to introduce the expression “circular insanity” into clinical practice.

For another half of a century following this, the psychiatrists did not consider BAD to be an actual mental health disorder. In 1896, the psychiatrist Emil Kraepelin singled it out as a separate diagnosis which was called manic-depressive psychosis. This particular definition remained in use in the psychiatric field for quite some time.

Definition

The expression “Bipolar Affective Disorder” was first suggested to the medical community in the Diagnostic and Statistical Manual of Mental Disorders (DSM), 4th and 5th Edition (USA).

This definition was later officially added to the International Classification of Diseases (ICD) -10 and -11 maintained by the World Health Organization.

BAD is an affective mental disorder characterized by recurrent manic, hypomanic and depressive episodes, as well as the mixed ones.

In patients who suffer from BAD, the mood shifts from one extreme to another – either extreme fatigue or surge in energy. Unlike regular fluctuations in a healthy person’s general physical and mental state which can also improve or take a dramatic nosedive, BAD episodes are persistent and may have extremely serious implications, including suicide attempts and death.

The disorder can ruin the relationship between the patient and his or her loved ones, as well as affect the ability to study and work. Due to this, the overall quality of life gets compromised to the point that the person is no longer able to fight the disease.

Symptoms

Bipolar disorder manifests itself as a constant fluctuation in the patient’s mental state from an elevated mood which can be described as “hypo” and potential irritability to a feeling of impending doom. Such ups and downs can alternate sporadically without any “normal” moods in between. The patient feels either incredibly fatigued and depressed or ready to take the world by storm.

Behavior is affected by this in a major way. The person who had been depressed and lethargic for months on end may suddenly experience a massive burst of energy. He or she takes several assignments at once, talks a lot and is incredibly energetic, without recognizing how quickly this mood shifts to mania. The person may feel like a superhuman. In cases of severe mania, people may experience psychosis due to the inability to take a sober look at their own mental state and keep it in check. What is especially dangerous when it comes to psychosis is that the patient’s behavior spirals out of control.

Manic Episode: Signs and Symptoms

The patients may be full of energy, feeling hyperactive and restless, overly excited and even euphoric. At the same time, they may get easily annoyed and aggravated at the slightest pretext.

Patients experience “racing thoughts” and “flight of ideas”. Their speech may be too rapid and incoherent sometimes. Being in this kind of mental state, the person is unable to focus, jumping from one thing to another. When having a manic episode, patients sleep a lot less than they normally do, often becoming insomniac.

During a manic episode, patients feel unreasonably confident about their own abilities, often exaggerating them and being unable to see the situations they face adequately. There can be an increase in sex drive and sexual activity, as well as thriftlessness and overspending. The person can behave provocatively, obnoxiously or aggressively. What makes treatment particularly difficult is that the patients don’t believe that there is anything wrong with them in the first place.

So, how do you tell a manic episode from a normal amount of energy? When it comes to mania, the excitement typically goes hand in hand with three or more symptoms. This may occur almost every day and may remain for a week or longer.

Depressive Episode: Signs and Symptoms

The patients may feel down, anxious and hopeless for weeks. They often describe the feeling of guilt, worthlessness, and hopelessness. People lose interest in things they used to enjoy, like hobbies, sports, and sex.

When going through a depressive episode, the patient may feel constantly fatigued while being unable to actually rest. The response to external stimuli decreases. Patients with depression struggle to focus, retain new information and make any decisions.

Anxiety or irritability typically accompany depressive episodes. The patient has trouble sleeping: either sleeping too much or becoming insomniac. Eating habits change for the worse: the person may overeat thus gaining weight, or refuse to eat while losing weight dramatically. Change in weight can serve as a symptom of depression. BAD patients often experience pain which is not linked to the presence of any other medical condition. What makes depressive episode especially dangerous is the suicidal thoughts and actual suicide attempts.

The presence of 5+ symptoms manifesting themselves daily for two weeks or longer may suggest that we are dealing with depression.

Hypomania

Hypomania is a mental disorder that is notable for elevated mood and has the signs of mania which are, however, not so prominent. The patients feel energetic, become productive, which brings them a sense of satisfaction. More often than not, family and friends can already tell that this is a major red flag. If the person going through a hypomanic episode does not seek professional help, hypomania may escalate into mania or depression.

Psychosis

Severe mania or depression may spiral into psychosis accompanied by auditory, visual and tactile hallucinations, as well as delusion. Symptoms of psychosis in patients suffering from BAD are typically on the higher side. For example, people going through a manic episode may experience the delusion of grandeur, believing that they are immortal, have superpowers, figured out the ultimate secret of life and universe, are spiritual leaders, etc. Delusions of guilt or worthlessness can also sometimes happen during depressive episodes.

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