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Bipolar disorder is a mental disorder that was misunderstood and poorly diagnosed for centuries. Previously known as manic depression, bipolar disorder gained scientific awareness in the late 19th century thanks to German psychiatrist Emil Kraepelin, who analyzed the behavior of untreated bipolar patients. However, it wasn’t until the late 1970s that the types of bipolar disorder were established and this condition gained general awareness. Bipolar disorder occurs in 1-3% of the population and is characterized by extreme mood swings between depressive and manic episodes.
Bipolar disorder affects the brain, causing unusual, clear and extreme mood changes. Patients experience a sudden surge of energy or elation, causing them to be hyperactive or manic, followed by a down period when they feel sad, hopeless and depressed. In general, these two moods occur one after the other, but there are also cases when they occur at once. Bipolar disorder can range in intensity but even the mildest forms can interfere with daily tasks, affecting their social and professional life and increasing the risk of self-harm and suicide.
Doctors recognize 4 basic types of bipolar disorder:
Bipolar disorder symptoms include extreme mood changes ranging from mania to depression. Although they are referred to as “mood swings” for better understanding, it’s important to point out that these are not the normal mood swings that an average person goes through, but extreme ones that can be noticed even by strangers, but just friends and family. The symptoms of bipolar disorder fall into two categories: manic episodes (the up, elated period) and depressive episodes (the sad, down period).
Manic episode symptoms include a feeling of elation, restlessness, sudden energy surges and increased activity levels. During this episode, the patient often has trouble sleeping because they feel that their thoughts are racing, they talk very fast about many things at once and have the energy to multitask. However, the increased energy makes the irritable, agitated and could push them to do risky things that they later regret, such as get into fights or make large impulse purchases.
Depressive episode symptoms follow the manic episode and they are the complete opposite: once the surge of energy goes away, the patient feels drained of all their energy, sad, hopeless to the point of suicidal thoughts. They no longer have energy and can stay in bed for weeks, unable to sleep or sleeping too much. People who have depressive episodes have minimum productivity levels, lose their appetite, forget to do their daily tasks and experience general apathy.
In general, there is a clear distinction between the two episodes because they occur one after the other, but in some cases, the bipolar patient can have an episode with mixed features, where they feel energetic and depressed at the same time.
Symptoms of bipolar disorder in children are different from symptoms of bipolar disorder in adults, which makes diagnosis more difficult. As children and teenagers already display mood swings as a result of hormonal changes, parents and doctors have to make a distinction between these normal mood swings and the ones caused by bipolar disorder. Teenagers with bipolar disorder may display different episodes patterns and the episodes are more severe. Also, the episodes may succeed faster.
Because the signs of bipolar disorder are often mistaken for normal mood swings or confused with the symptoms of other mental disorders, bipolar disorder is one of the most misdiagnosed disorders. In 2000, people suffering from bipolar disorder lived with their condition for 10 years until getting the correct diagnosis and they had an average of 3 incorrect diagnoses before being classified as bipolar. In 2016, a connection was made between the suicide rate and people with undiagnosed bipolar disorder.
Bipolar disorder diagnosis can be hard to pinpoint when there isn’t a high rate of mental disorder awareness in the patient’s medical system or when the patient postpones seeing a healthcare professional. Blood tests cannot confirm bipolar disorder, but they may be required to exclude certain disorders that give similar symptoms, such as syphilis, thyroid problems or an infection. To diagnose bipolar disorder, specialists use rating scales and conduct a series of clinical interviews to rule out other mental disorders such as ADHD, schizophrenia and substance abuse.
The prevalence of bipolar disorder in women is the same as for men. The condition does not affect one gender more than another. However, it does affect them differently, leading many to believe that women are more at risk of developing bipolar disorder:
Because of the way in which episodes manifest in men and women, men are often misdiagnosed with schizophrenia and women with depression.
Once bipolar disorder is diagnosed, the medical professional may suggest different treatments and therapies depending on the severity of the condition. Modern bipolar treatment options include:
The causes of bipolar disorder aren’t fully understood, but several risk factors have been identified:
Following the prescribed treatment is the most effective way of keeping bipolar disorder symptoms under control and maintaining a normal, active lifestyle. Although the episodes can sometimes be severe, living with bipolar disorder is perfectly possible and the patient can function as a normal member of society. Having a pre-established action plan in case of emergencies and a list of tips to follow helps manage the condition:
Due to the media and mental health awareness campaigns, most people have heard about bipolar disorder and know at least in theory what its symptoms are. However, there are still many myths about bipolar disorder that delay appropriate treatment or prevent patients from activating in society.
Having mood swings is normal, but it does not make you bipolar. However, extreme mood swings that occur for a long period of time and prevent people from doing their job and interacting with their loved ones could be a warning sign and should be investigated by a medical professional.
As bipolar diagnosis methods have evolved and people became more aware of this condition, it became obvious that bipolar disorder is not as rare as initially thought. In the US, 5.7 million people are diagnosed with bipolar disorder every year, not including children and elderly people.
The symptoms of manic and depressive episodes are often simplified and many people imagine that patients go from agitated to depressed in a matter of minutes. The truth is that the transition from one state to another can be as long as a few months. Moreover, there is rarely a balance between depression and mania. A two-week manic episode is not automatically followed by a two-week depressive episode. On the contrary, each patient is different and one type of episode is predominant.
The fact that a bipolar patient experiences a surge of energy and alertness during a manic episode does not mean that he is happy. This episode should not be idealized because it is the one that patients often fear the most, because it makes them feel that they are losing control and could do something crazy. Oftentimes, people with bipolar disorder need the help of a loved one during this manic episode to keep them from getting in trouble.
Bipolar disorder diagnosis is a complex task that can only be carried out by a professional who has the skills, knowledge and tools for it. It may include blood tests, one-on-one interviews, long term behavioral analysis. Bipolar disorder cannot be diagnosed by an online quiz, no matter how through its questions may be.
The belief that people can only be diagnosed with bipolar disorder after the age of 18 is one of the longest standing bipolar myths. Although the disorder is harder to recognize in children because they throw tantrums and have mood swings, diagnosis is possible and finding the problem from an early age actually helps with management tremendously.
People with bipolar disorder can often feel helpless and feel that they are losing control over their own lives, especially during manic episodes. They could also feel that there’s nothing they can do apart from taking their medicine and going to therapy, but, according to researchers, establishing a daily routine can reinstate control and recognize warning signs before a new episode hits.