Bipolar Disorder

Bipolar disorder, also known as manic-depressive disorder or simply manic depression, is a mental disorder characterised by wide mood swings from high (manic) to low (depressed) states. There are varying severities of this disorder. Mild cases may pass for normal for many years. In severe cases, the person may become agitated or psychotic.

When a bipolar patient becomes hyperactive and irritable, he is in the manic extreme of this disorder. Classically, he/she can have delusions of grandeur and go on expensive spending sprees. Patients can also be uninhibited in their expressions and sexual advances. In the depressive period, their mood is low and lethargic.

Symptoms of Bipolar Disorder

Depression and mania usually occur in episodes. Different individuals will have different symptoms. For example, one patient may be predominantly depressed and another may be predominantly manic. In between episodes, the patient is likely to be quite well and to function normally.

The manic phase is characterised by:
Delusions (false beliefs) or hallucinations (false perceptions)
Irritable mood
Decreased need for sleep
Exaggerated, puffed-up self-esteem
Rapid or "pressured" speech
Rapid thoughts
Poor attention span

During a depressive period, symptoms may include:
Appearing slow or agitated
Fatigue and loss of energy
Feelings of worthlessness or guilt
Poor concentration
Low or irritable mood
Loss of interest
Increased or decreased weight and appetite
Increased or decreased sleep
Plans of death, suicide attempts

Treatment for Bipolar Disorder

A combination of medication and psychotherapy usually produces the best outcome.

The class of medications known as mood stabilisers is the primary treatment. Lithium is widely used and is very effective for the treatment of manic episodes and for the prevention of their recurrence. Lithium levels in the blood must be checked regularly to prevent harmful levels of accumulation. It can take from a few days to a few weeks for the medications to produce the optimal effect.

Patients who are very ill may benefit from electroconvulsive therapy (ECT). General anaesthesia has allowed ECT to become a relatively safe and painless procedure.

Psychotherapy to provide education and support is important too, and helps the patient come to terms with the illness.


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