Bipolar Disorder

Bipolar disorder is a brain disorder that causes abnormal mood swings; episodes of mania or hypomania and sometimes severe depression or acute depression, bipolar disorder also known as manic-depressive illness.

There are four crucial types of bipolar disorder:

all of them include a prominent change in moods, activity levels, and energy levels. These moods vary from periods of enormously “up”, (elevated behavior that involves inflated self-esteem, decreased need for sleep, frequent different incoherent ideas, and jumbled speech, and excessive interest in pleasurable activities) to the aggrieved and hopeless period(low frame of mind, physically tired, loss of interest in fun activities for an extensive period, social isolation, feeling of worthlessness and self-loathing).

Bipolar I disorder:

Bipolar I disorder is also known as manic-depressive disorder. A person affected by bipolar I disorder has had severe manic episodes (elevated mood and high energy accompanied by abnormal behavior that upsets daily life) at least once in her/his life along with mild episodes of depression. There is a pattern of to and fro between mania and mild depression.

Case study of Bipolar I disorder:

Alia was a 17-year-old student of high school when she first began having problems. She would go days without sleeping. She began having difficulty focused in school and stopped going to classes. She started dating different men and she spent all of the money she had for the school year in a few weeks. When her parents discovered the problems, they brought her in for a check-up. Alia did not feel that anything was wrong. Her parents felt things were not the same. Her parents also noticed obvious ups and downs in her mood. She had always been a thoughtful, caring, and socially active person prior to the last several months. A scan was planned to assess the clinical situation. It uncovered marked patchy uptake throughout the cortex. Alia was diagnosed with bipolar I disorder because of the severe manic episodes along with the mild episode of depression. Lithium was very helpful for Alia and she was able to continue her studies and day to day work.

 Bipolar II Disorder:

Bipolar II disorder defined by a pattern of severe depressive episodes and hypomania episodes, but not the full-blown manic episodes that explained above

Case study of bipolar II disorder:

Kashif was a 35 year old married man who came to an outpatient mental health clinic with a long history of depression he described being depressed for a month since he began a new job. He had anxiety that his new boss and colleagues thought his work was poor and lethargic, and that he was not sociable. He had no energy or enthusiasm at home. Instead of playing with his children or talking to his wife, he has low or no libido left, he watched TV for hours overate and slept long hours. He gained six pounds in a few weeks, which made him feel even worse about himself. He also thought about suicide frequently. He also described times when he appeared excited, happy, and self-confident — “like a different person.” he would talk fast, seem full of energy and joyful, do all the daily chores and start (and often finish) new projects. He would need little sleep and still be up the next day. Kashif was diagnosed with bipolar II disorder because of severe episodes of depression and hypomania.

(Name of the clients have been changed to protect identities)

Cyclothymic disorder:

Cyclothymia or cyclothymic disorder defined by frequent periods of hypomanic symptoms as well as copious periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic criteria for a hypomanic episode and a depressive episode.

Other Specified and Unspecified Bipolar and Related Disorders:

Specified and unspecified bipolar disorders are defined by bipolar disorder symptoms that do not match the three above listed categories.

Signs and Symptoms:

When people with bipolar disorder had a manic or hypomanic episode three or more of these symptoms included:

  • Increased activity, energy, or agitation
  • Decreased need for sleep
  • bizarre talkativeness
  • Racing thoughts
  • Distractibility
  • Incoherent speech
  • Poor decision-making — for example, reckless shopping, taking sexual risks or making foolish investments
  •  An exaggerated sense of well-being and self-confidence (euphoria)
  • Abnormally buoyant, anxious, or restless

Depressive episode: An episode includes five or more these symptoms listed below:

  • Suicidal thoughts
  • Feeling tired exhausted, or physical fatigue
  • Feel very sad, down, empty, or hopeless
  • Have very little energy
  • Have decreased activity levels
  • Have trouble sleeping, they may sleep too little or too much
  • Feel like they can’t enjoy anything
  • Feel worried and empty
  • Having trouble concentrating
  • Emotionally drained
  • Forget things a lot

Diagnosis and treatment:

Bipolar disorder can disrupt a person’s life. A thorough diagnosis is important in each case to ensure that the person is getting the correct treatment. Misdiagnosis is possible. Anyone who is not responding to their treatment should discuss this with their psychotherapist. Psychotherapists or psychiatrists need to take time with the testing process, as other mental health conditions may cause similar symptoms. Monitoring and testing help ensure that the person receives the correct treatment for their condition.

Therapists will often perform a physical examination with the help of physicians when the person first visits them. This may not help with a bipolar diagnosis, but it may help rule out physical issues that can cause similar symptoms. For illustration, issues with the thyroid gland may cause similar symptoms to those of manic or depressive episodes.

On average, treatment for Bipolar Disorder involves a combination of psychotherapy and medication. Bipolar disorder is a type of mood disorder that affects all areas of life, including your mood, energy level, attention, and behaviors. While there is no cure for the disorder, but treatment with psychotherapy and medication, people with bipolar disorder can lead a healthy and normal life.

Millions of people in Pakistan are suffering from bipolar disorder. Being bipolar has not been easy for anyone in Pakistan where people do not take it as a mental illness and blame the person for their mental conditions and mood swings. In our society, we are extremely hypercritical and fault finding. If anyone around us suffering from any kind of mental illness, please don’t judge them. They need to be understood not to be stigmatized.

“We are not crazy or insane. We are just people living with a condition”


Author: Saba Naz (Psychologist)

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