Bipolar Disorder

Bipolar disorder is a chronic condition that often happens in cycles. You might have shifts in your mood that are more sustained than the usual highs and lows that can occur throughout your day. 

There are different phases of bipolar disorder and the symptoms can crossover. 

• You might have times where you experience a “high” or euphoric mood, increased energy and activity, with less need for sleep. This is known as mania, or manic episodes, and the episodes typically last for a few days to sometimes a few weeks. 
• You might have cycles of deep depression, loss of interest in activities and fatigue, lasting for at least two weeks. 
• You also may experience mild episodes of mania, called “hypomania.” 
• You might have a combination of manic and depressive symptoms at the same time. These “mixed states” can be dangerous because depression combined with increased energy can lead to impulsive and potentially violent actions.

Because there are a range of symptoms for bipolar disorder, it’s a condition that often goes unrecognized.  A misdiagnosis of major depressive disorder instead of bipolar disorder, for example, can possibly lead to the wrong type of treatment and worsening symptoms. 

Some people become concerned that they (or their children) might have bipolar disorder because they have mood swings, with a particular high mood lasting for minutes or hours, then a very sad mood lasting minutes or hours, all in the same day. While this can occur as part of bipolar symptoms, it does not necessarily mean a person has bipolar disorder.

An early, accurate diagnosis can help reduce the problems bipolar disorder might cause in your life.

Bipolar disorder affects around 2% of the population and often goes unrecognized until it causes major disruption to work, family life, and daily activity. The symptoms often can be confused with other illnesses, but an accurate diagnosis can lead to an effective treatment plan.  

A first episode of bipolar disorder can happen in the teenage years, but in many people, the condition might not be diagnosed until adulthood. Early adulthood is the time when a first experience of mania or bipolar depression is most common.

If you have been treated more than once for major depressive disorder, but antidepressant medication hasn’t worked for you, it’s possible you have bipolar disorder, not depression.

People with a pattern of unstable behaviors related to family (like divorces and remarriages), work (frequent job changes), or impulsive decisions (accidents, risky use of alcohol or drugs) might need to talk to a medical professional about the possibility of bipolar disorder.

The disorder also commonly occurs with other medical conditions, such as obesity and heart disease. In many cases, these physical complications start to appear because of the risky behaviors that are common in bipolar disorder.

A thorough evaluation and a good diagnosis are important.

Your treatment for bipolar disorder will have two main goals: 1) helping you get out of a current manic or depressive episode; and 2) preventing new manic or depressive episodes in the future. The best treatment for you will depend on which symptoms of the disorder are affecting you the most.

Medication treatments will be the centerpiece of treatment for most patients. A class of medications known as atypical antipsychotics is widely accepted as a first option for treatment of mania. 

Treating bipolar depression can be more challenging than other types of depression.

We have seen that medication treatments work best when they are combined with therapy. Psychosocial treatments—which might help you with problem solving, for example—seem to work well because they can help you cope better with stressful times that bring out your bipolar symptoms. Cognitive behavioral therapy (or “talk therapy”) and family-focused therapy are among the options we may recommend in combination with your medication.

Bipolar disorder is a complex illness, so results won’t happen overnight. Medication treatment can stabilize your mood, but you may need to stay on medication for a longer period to avoid the relapses that can set you back.

If a medication works for you early on, it likely will be our first option for longer-term treatment to keep you feeling well. If the first medication we try is not effective or has unpleasant side effects, we may consider changing the dose or switching to another medication. Some patients will need more than one medication for the best results.

Because bipolar mania or depression can resurface, we will want to monitor you for any changes in your functioning and your quality of life. We will help you monitor your symptoms for signs of a problem, so we can work together quickly to adjust your treatment.

It also will be important to educate the people closest to you, so they can help you manage the stressful times in your life that could bring back your symptoms.

If you are experiencing the kinds of ups and downs that you also notice in the people around you, it’s likely that you don’t need treatment. It’s normal to have a range of emotions.

But if you experience sustained shifts in mood, where you feel elevated with increased energy for several days, or depressed and lethargic for several weeks, you may need treatment to put you on a healthier path.

At Eappen Clinic, we can help you figure out your symptoms and the right treatments that will work best for you. Let’s work together to help you feel well again.