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.

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What is Bipolar Disorder?

Bipolar disorder is an illness characterised by episodes of extreme mood swings. During these episodes, the patient’s mood, behaviour and activity levels are significantly disrupted. Episodes may be characterised by either an elevation of mood with increased energy and activity (i.e. mania or hypomania), or a lowering of mood with decreased energy and activity (i.e. depression).

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)
Hyperactivity
Irritable mood
Decreased need for sleep
Exaggerated, puffed-up self-esteem
Rapid or "pressured" speech
Rapid thoughts
Poor attention span
Recklessness

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

Who Gets Bipolar Disorder?

Although the local prevalence for bipolar disorder is yet unknown, global estimates suggest that 1-2% of people may suffer from bipolar disorder over their lifetime. Men and women are equally likely to get the disorder. The age of onset for bipolar disorder ranges from childhood to 50 years of age, with a mean age of approximately 21 years. 

What Causes Bipolar Disorder?

The cause of bipolar disorder is yet unknown. However, it is thought that genetics, environmental as well as social factors play a role.

When Do You Need Help?

If you or your loved one has noticed that you are suffering from severe mood swings with the symptoms associated with mania, hypomania or depression, you should seek professional assessment. If you have been diagnosed with bipolar disorder, you should be on regular follow-up with a doctor.

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.

Coping With Bipolar Disorder

Living with bipolar disorder is challenging. However, many people with bipolar disorder have successful careers, happy family lives, and satisfying relationships.
There are steps that you can take to manage the condition more effectively, such as:

  • Avoiding or learning to cope with stressful situations that may trigger an episode of mania or depression;
  • Avoiding drinking too much alcohol or taking recreational drugs, as this may interact with your medications or trigger an episode;
  • Taking your prescribed mood medications regularly and not to suddenly stop taking them just because you feel well;
  • Informing your doctor immediately if you get any side effects from the medication you are taking. He can adjust your dosage or change the type of medication that you are taking; 
  • Learning about your illness so that you can recognise the signs of an approaching episode and take the necessary steps to manage it effectively;
  • Leading a healthy lifestyle, including getting sufficient sleep.

If you have bipolar disorder, the help and support of your family and friends are important. If they know that you have the condition and understand what it is about, they can recognise when you are experiencing mood swings and advise you to seek help.

Helping Someone With Bipolar Disorder

You can help someone with bipolar disorder. The first and most important thing you can do is help him get the right diagnosis and treatment. Ensure that he sees the doctor on time. Encourage your loved one to stay in treatment. Some people stop taking the medication as soon as they feel better or because the mania feels good. Stopping medication can cause serious problems.

To help a friend or relative, you can:

  • Offer support, understanding, patience, and encouragement;
  • Learn about bipolar disorder so that you can understand what your loved one is experiencing;
  • Talk to him and listen carefully to what he has to share;
  • Listen to feelings which he expresses – be understanding about situations that may trigger bipolar symptoms;
  • Invite him out for positive distractions, such as walks, outings, and other activities;
  • Remind him that, with time and treatment, he can get better;
  • Never ignore comments about harming himself. Always inform his doctor of such comments.

Where To Get Help:

Consult a doctor if you are experiencing symptoms or wish to seek help. 
From 1 Nov 2011, the Medisave for Chronic Disease Management Programme will be extended to include Dementia and Bipolar Disorder. The scheme will allow patients with these mental illnesses to use their Medisave to pay part of their treatment bill.

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Bipolar Disorder

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