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Bipolar Disorder

Q: What is Bipolar Disorder?

A: Bipolar Disorder is a mental disorder characterised by repeated episodes in which the patient’s mood and activity levels are significantly disturbed. These consist of some occasions where there is an elevation of mood, increased energy and activity (also known as mania or hypomania), and on other occasions where there is a lowering of mood, decreased energy and activity (depression). Each episode may last for a few weeks to a few months.

Bipolar Disorder

Q: What are the symptoms of Bipolar Disorder?

A: Depending on the type of episode he is experiencing, a patient with bipolar disorder may show the following symptoms:  

  1. Manic or hypomanic episodes

The patient experiences elevated mood along with increased energy and activity levels. He may lose his social inhibitions and display a shortened attention span and inflated self-esteem. Manic symptoms may range from carefree joviality to almost uncontrollable excitement such as talking excessively, being easily distracted, and expressing grandiose and unrealistic ideas. Mania may also manifest as heightened irritability or aggressive behaviour. Some patients may also experience delusions or hallucinations together with their mood symptoms.

Hypomania is characterised by less severe manic symptoms, and is not accompanied by delusions or hallucinations.

  1. Depressive episodes

The patient experiences a depressed mood, and has low energy and activity levels. He may feel tired and morose, and lose interest in things that he used to enjoy. He may even have ideas of self-harm or suicide. Feelings of guilt and worthlessness are common in such episodes, as is disturbed sleep, an inability to concentrate and a lack of appetite.

  1. A mixed episode

Sometimes, patients may experience symptoms of both mania and depression during the same episode. Symptoms of mania or hypomania and depressive symptoms may alternate rapidly from day to day, or even from hour to hour.

Q: What is the difference between “mood swings” and Bipolar Disorder?

A: The key differences between Bipolar Disorder and “mood swings” (transient changes in mood) in people without a mental disorder are the severity and the duration of mood changes. It is unlikely that “mood swings” that are not associated with a mental disorder would cause any significant or persistent disturbances in a person’s day to day functioning. In contrast, mood changes in bipolar disorder are severe and persistent, and significantly affect the sufferer’s ability to function in their daily life.

Q: What is the treatment for Bipolar Disorder? How can family and friends help?

A: Treatment for Bipolar Disorder involves both medication and psychosocial therapy. Mood stabiliser medications such as lithium or sodium valproate and antipsychotic medications like olanzapine are useful in the treatment of an episode of mania or hypomania. During the depressive phase of bipolar disorder, anti-depressants may be used in conjunction with a mood stabiliser under careful monitoring, as there is a risk that anti-depressants may cause patients to switch from a depressed state to a manic one. Maintenance therapy, using both medications and psychosocial interventions, is useful in preventing further episodes.

Besides medications, various forms of therapies such as cognitive-behavioural therapy can also help patients recognise early symptoms of an episode and seek treatment, reduce negative expressed emotions in relationships and implement lifestyle changes to avoid triggers that may precipitate an episode.

Support and understanding from family members and friends are equally important in the treatment of Bipolar Disorder. Caregivers should try to learn all they can about this mental disorder to provide emotional and practical support to patients. These include helping them to cope with their daily tasks during a manic or a depressive episode, and also reminding them to comply with their medications and psychological treatments.

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