What is bipolar disorder, and how does it affect a patient's life?

Bipolar disorder, formerly known as manic-depressive illness, is a chronic mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression)1. These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly1.

Bipolar I Disorder: Defined by manic episodes lasting at least seven days or by manic symptoms that are so severe that immediate hospital care is needed. Depressive episodes occur as well, typically lasting at least two weeks.

Bipolar II Disorder: Characterized by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes that are typical of Bipolar I1.

Cyclothymic Disorder (Cyclothymia): Periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least two years (one year in children and adolescents), but the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

I.            Manic/Hypomanic Episodes:

1.      Increased energy, activity, and restlessness

2.      Excessively high, overly good, euphoric mood

3.      Extreme irritability

4.      Racing thoughts and talking very fast

5.      Distractibility

6.      Decreased need for sleep

7.      Unrealistic beliefs in one's abilities and powers

8.      Poor judgment leading to risky behaviors

II.            Depressive Episodes:

1.      Prolonged sadness or unexplained crying spells

2.      Significant changes in appetite and sleep patterns

3.      Irritability, anger, worry, agitation, or anxiety

4.      Pessimism and indifference

5.      Loss of energy and persistent lethargy

6.      Feelings of guilt, worthlessness, and hopelessness

7.      Inability to concentrate or make decisions

8.      Thoughts of death or suicide

The exact cause of bipolar disorder is unknown, but several factors may contribute, including:

1.      Genetics: Bipolar disorder tends to run in families, suggesting a genetic component3.

2.      Biological Differences: People with bipolar disorder appear to have physical changes in their brains3.

3.       Environmental Factors: Stress, abuse, significant loss, or other traumatic experiences may trigger or exacerbate the condition.

Diagnosing bipolar disorder involves a combination of methods:

1.      Physical Exam: To rule out other medical conditions that could cause symptoms.

2.      Psychiatric Assessment: A mental health professional will discuss thoughts, feelings, and behavior patterns

3.      Mood Charting: Keeping a daily record of moods, sleep patterns, and other factors.

Bipolar disorder is a lifelong condition, but it can be managed with a combination of treatments:

1.      Medications: Mood stabilizers (e.g., lithium), antipsychotics, antidepressants, and anti-anxiety medications.

2.      Psychotherapy: Cognitive behavioral therapy (CBT), psychoeducation, and family therapy.

3.      Lifestyle Changes: Regular exercise, a healthy diet, maintaining a regular sleep schedule, and avoiding alcohol and drugs.

4.      Hospitalization: In severe cases, hospitalization may be necessary to stabilize mood and ensure safety5.

·         Approximately 2.8% of U.S. adults had bipolar disorder in the past year.

·         An estimated 4.4% of U.S. adults experience bipolar disorder at some point in their lives.

·         Bipolar disorder is associated with a high risk of suicide, with about 20% of individuals with bipolar disorder attempting suicide at least once.

As future healthcare professionals, medical students can play a vital role in managing and supporting individuals with bipolar disorder by:

·         Raising Awareness: Educating patients and communities about the symptoms and treatment options.

·         Advocating for Mental Health: Supporting policies that improve access to mental health care.

·         Engaging in Research: Contributing to the understanding of bipolar disorder through research and clinical studies.