Bipolar disorder

What is it? 

Bipolar disorder (previously known as Manic-depressive disorder) has been recognized since the time of Ancient Greeks. Hippocrates described the conditions of melancholia and mania. However, it has only been over the past 20-30 years that this condition of disturbed mood and activity has been appreciated and recognized. The lifetime incidence of bipolar disorder ranges from about 1 to 3.5% of the population. 

Symptoms

During the manic phase, symptoms may include: 

  • Extreme happiness, hopefulness, and excitement 
  • Irritability, anger, fits of rage, and hostile behaviour 
  • Restlessness and agitation 
  • Rapid speech and poor concentration 
  • Increased energy and less need for sleep 
  • Unusually high sex drive 
  • Setting unrealistic goals 
  • Paranoia 

During the depressive phase, symptoms may include: 

  • Sadness and crying 
  • Feelings of hopelessness, worthlessness, and guilt 
  • Loss of energy and interest or pleasure in everyday activities 
  • Trouble concentrating and making decisions 
  • Irritability and changes in sleep patterns 
  • Changes in appetite and weight 
  • Suicidal thoughts and attempts at suicide 

Causes 

The causes of bipolar disorder differ between individuals, and the exact mechanism is not clear. It’s often reported in families of affected individuals, suggesting a genetic component. Abnormal brain structure and function may also play a role. Other factors that may contribute include seasonal depression and certain other mental illnesses such as anxiety disorder. Risk factors include family history, stress, and drug or alcohol abuse. 

Interventions 

Intervention options include psychotherapy and medication. Medications may include mood stabilisers, antipsychotic drugs, antidepressants, and anti-anxiety drugs. Psychological therapy may involve interpersonal and social rhythm therapy, cognitive behavioural therapy, psychoeducation, and family-focused therapy. In severe cases, electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) may be used.