Stuck on a Mood Rollercoaster? Learn How Bipolar Disorder Affects You

Bipolar disorder offers ups and downs and highs and lows when one expects them the least. This widely occurring mental health issue affects 1 in every 150 individuals worldwide and is fairly common among teens and adults. Moreover, bipolar disorder affects 6.7% of the population in India.

Though there are many myths and social stigmas attached to it, with celebrities like Kanye West and Demi Lovato openly accepting their diagnosis, awareness about the condition is slowly increasing.

Bipolar disorder, which is also referred to as bipolar affective disorder and was formerly known as manic-depressive illness or manic depression, is a long-term condition characterised by unpredictable mood fluctuations that impact activities, energy levels, and the ability to concentrate. There are sudden highs, extreme happiness (mania), then irritation and anger, followed by episodes of depression.

Bipolar disorder is of three types:

• Bipolar I disorder: This includes ‘manic’ episodes that last for about seven days and are so severe that those affected may need immediate medical help. This follows depressive episodes lasting at least two weeks. Often, both episodes overlap. If four or more mania or depression occurrences happen in a year, it's called ‘rapid cycling’.
• Bipolar II disorder: The second type usually includes depressive and hypomania episodes and is less severe.
• Subthreshold bipolar disorder: This is when a person experiences mood swings with ups (mild highs) and downs (mild lows). However, these mood changes aren't as extreme or long-lasting as those in full hypomanic or depressive episodes.

The precise origins of bipolar disorder remain unclear, but it is believed to arise from a mix of genetic, chemical, and environmental influences. Together, these impact the onset and the trajectory of the mental illness.

Genetics
Research shows that genetics play a strong role, along with changes in brain chemicals and how they work — proteins that help brain cells grow and stay healthy, like brain-derived neurotrophic factor (BDNF). This suggests that bipolar disorder may affect how the brain adapts and changes over time.

Chemical factors
The process of energy production in cells, stress-related damage, and immune system imbalances further aggravate the condition. Brain scans have shown physical changes in the brains of bipolar disorder cases, like the loss of tiny structures in a part of the brain that helps control decision-making and emotions.

Social or environmental factors
These are the risk factors or triggers for bipolar disorder. Experiences like losing a loved one, trauma, violence, or going through a breakup can trigger the issue. Moreover, the consumption of alcohol or drugs can contribute to the onset and advancement of the disorder.

Bipolar disorder symptoms can be divided into mania and depressive episodes.

Mania: Feeling unusually happy, energetic, and high with great appetite, good sex drive, overenthusiastic about activities, racing thoughts — brimming with ideas, having difficulty containing thoughts, and feeling no need to rest.

Depressive episodes: It is crucial to highlight the widespread nature of the sad mood or its intensity to emphasise the significance of this clinical condition and prevent confusion with sadness linked to specific life events, such as the death of a loved one, where deep sadness may occur but is not indicative of a depressive disorder.

Poor sleep patterns or sleeping way too little or more, inability to think correctly or perform tasks, and forgetfulness may be related to feeling hopeless and suicidal tendencies.

Distinguishing bipolar disorder and depression is often tricky. A thorough history must be recorded from the patient, their family, and all those in close connection. The investigative history-taking must include if there have been any distinct episodes of mania and depression, how long they lasted, and how the patient reacted in each case.

One of the biggest misconceptions regarding bipolar disorder is that it lacks distinct types. Similarly, some think that mania and depression occur in cycles; much to the contrary, both cases can happen together at the same time. 

Unlike popular belief, there is no set of tests and exams to definitively diagnose bipolar disorder. Contrary to what most think, WHO says that working can be difficult for those with bipolar disorder, but it can also be beneficial. Working in supportive workplaces can help people recover. Having good employment can enable them to function better, reduce symptoms, enhance their quality of life, and boost their self-esteem.

Yes, the depressive episodes of bipolar disorder can instigate suicidal thoughts. The treating physician and the family must keep an eye out for suicidal and self-harm risks in bipolar disorder patients with acute depressive episodes. Most suicide deaths occur during this phase, so hospitalisation is a must.

During manic episodes, individuals experience heightened self-esteem and chattiness and undertake excess activity, though they are easily distracted and rarely productive. Depressive episodes, on the other hand, bring intense sadness, hopelessness, fatigue, and loss of interest, along with either weight gain or loss and reduced or increased sleep. Though a genetic predisposition has been proposed, risk factors such as stressful life events, childhood abuse or neglect, and harmful substance abuse are noted as triggers.  

With early recognition and management using mood-stabilising medications and psychotherapy, more severe consequences, such as disrupted relationships and suicidal risk, can be avoided. Identifying symptoms and notifying family and friends to reach out to mental health resources, developing coping strategies for stress management, regularising sleep, and avoiding alcohol and recreational drugs can help oneself and those around us to lead balanced, fulfilling lives.

It is vital to accept bipolar disorder as just another mental health issue that is manageable by closely working with doctors and loved ones, especially family. The need to change affirmations from ‘I suffer from bipolar disorder’ to ‘I am bipolar’ can make a huge difference.

The main causes of bipolar disorder are a combination of genetic and chemical predispositions and social triggers.

A bipolar person will have episodes of either severe highs and elated moments (mania) or low moments called depression or both together.

It is important to consult a doctor with family to help rightly diagnose bipolar disorder.

The basic symptoms of bipolar disorder are extreme ecstasy, hyperactive moments, overactivity or low moments of despair, sloppy behaviour, and irritated sleep.

While there is little evidence for a definitive cure for bipolar disorder, one can manage it effectively.

Bipolar disorder starts in youth and in the working age groups.

Advanced bipolar disorder can lead to suicide or comorbidities related to the side effects of the chronic intake of medicines.

Bipolar disorder is a constant state of mood swings; thus, related hormones are epinephrine, serotonin, etc.