Background and Symptoms
Bipolar disorder is characterised by extreme mood swings. Mood swings range from mania (highs) to depression (lows) and are severe enough to effect day-to-day life.
Bipolar is the fourth most-common mental health problem worldwide after depression, anxiety and schizophrenia. 1% to 2% of the population experience a lifetime prevalence of bipolar.
The DSM defines mania as a “distinct period of abnormally and persistently elevated, expansive, or irritable mood.” The episode must last at least a week. Common symptoms of mania include;
- Inflated self-esteem or feelings of grandiosity
- Decreased need for sleep
- Increased goal-directed activity (e.g. excessive planning, increased interested in social or sexual activities
- Improved performance
- Acting ‘out of character’
- Excessive involvement in pleasurable activities that have a high-risk consequence.
Hypomania is a milder form of mania that lasts for a few days. Common symptoms include;
- Decreased need for sleep
- Increased confidence
- Rapid speech
- Increased activity levels (e.g. more social, increased sexual energy)
- Racing thoughts/difficulty concentrating
Other symptoms of Bipolar include depression and Mixed episodes (feeling high and low at the same time)
Types of Bipolar
There are several different types of Bipolar disorder. All types involve some sort of depressive and manic/hypomanic episodes. The diagnosis of bipolar is dependent on the degree and severity to which these symptoms are experienced.
Bipolar I: at least one episode of mania is experienced which lasts longer than a week. Depressive episodes may also be prevalent although the severity of which does not alter diagnosis
Bipolar II: at least one severe depressive episode and symptoms of hypomania are prevalent
Cyclothymia: both hypomanic and depressive mood states are experienced over the course of 2 years or more, but symptoms are not severe enough to fulfil Type I or Type II Bipolar criteria.
Rapid Cycling: a person may experience four or more episodes of mania or hypomania followed by depression within a year. In this type of Bipolar it is possible to feel stable for a few weeks between episodes, or have quick mood changes within the same day or even same hour
The exact cause for Bipolar disorder is unknown (NHS choices, 2016). Some suggested causes include:
- Chemical imbalance in the brain (including neurotransmitters noradrenaline, dopamine and serotonin)
- Genetics (there is a high familial correlation, linked to genetic and environmental factors)
Symptoms of bipolar disorder may be triggered by many factors. For example, abuse (physical, sexual, emotional), bereavement, breakdown of a relationship, sleep disturbances, physical illness etc.
During the first appointment a consultant psychiatrist will initiate a detailed assessment looking at client history and diagnostic rating scales. Dr Mohamad has a particular interest in bipolar and the comorbidities attached with the condition. Based on a diagnosis, a treatment plan will be devised collaboratively. Treatments options may consider the use of of medications, which could include mood stabilisers and other licenced medications used for bipolar. Psychological approaches can also be looked at including CBT. These approaches are useful in the prevention of relapse, noticing warning signs and reducing precipitating risks for triggering the episodes.
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