11 - 17 December 2015 #786

In two states of mind

Anjana Rajbhandary


Bipolar disorder is a mental illness in which there is an unusual shift in mood, energy, and ability to function. The extreme shifts in mood range from a manic to depressive state. To improve the accuracy of diagnosis, the primary criteria for manic and hypomanic episodes highlight changes in activity and energy, not just mood.

A person in manic state will feel impulsive, euphoric and full of energy, possibly engaging in risky, unhealthy behaviour. The depressive state causes a loss of energy and interest in activities once enjoyed by the individual, accompanied by extreme sadness and hopelessness. This deep depression may cause thoughts or attempts of suicide.

The management of personal relationships, school, work, and other aspects of everyday life may be troublesome. Bipolar disorder is a long-lasting illness that would benefit from support and supervision throughout the individual’s life. According to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), there are five types of bipolar disorder.

Bipolar disorder I: Characterised by the following three episodes.

Manic episode: when an individual is impulsive, euphoric and full of energy with the likelihood of engaging in risky and unhealthy behaviour for at least a week.

Hypomanic episode: similar to manic episode for at least four consecutive days. Major depressive episode: when an individual feels extreme hopelessness, sadness, suffers from insomnia, lacks energy and has suicide ideation for a two-week period.

Bipolar disorder II: When an individual has both conditions of hypomanic episode (previous or current) and major depressive episode. Cyclothymic disorder: When an individual has experienced symptoms of hypomania and depression in the last two years for at least half the time and has not been symptom-free for more than two months at a time.

Substance/medication induced bipolar and related disorder: When an individual uses substances or medication that causes symptoms similar to bipolar disorder, in which shifts between manic and depressive episodes within a month of substance abuse or use of medication.

Bipolar and related disorder due to another medical condition: When an individual experiences symptoms of hypomanic and depressive episode due to a medical condition such as Cushing’s disease, multiple sclerosis or stroke.

Due to the mood swings of extreme euphoria to the depths of despair, daily life is difficult for the individual and associated loved ones. Depending on the severity of bipolar disorder, an inpatient treatment could be the best environment towards the road to recovery. Certified psychiatrists and medical professionals can work with the individuals and make customised plans to fit their specific needs with the right medications and therapies. An inpatient treatment for bipolar disorder is one of the safest and most guaranteed roads to full recovery. The combination of monitored medication and evidence-based customised therapies at an inpatient treatment can help stabilise and reduce both manic and depressive episodes for the long-term, under the proper care and supervision of qualified professionals.

Some probable causes of bipolar disorder are genetic factors, stress, changes in brain activity, problems with brain structure, prenatal and perinatal factors, and environmental and lifestyle of family. Bipolar disorder is a chronic mental illness. Unpredictable mood swings are the most common indication of the disorder. The symptoms vary between the two states of the manic and depressive episodes.

With effective and proper treatments, most people with bipolar disorder live happy and healthy lives. Bipolar disorder is a long-term, recurring illness, but the right combination of medications and psychosocial treatment can help manage the disorder by stabilising mood swings and other related symptoms. It is recommended that bipolar disorder is treated consistently over time, with no breaks, in order to maintain the well-being of the individual. Other treatments for bipolar disorder include electroconvulsive therapy (for extreme cases), and natural supplements, although little is known about natural supplement’s effects on the disorder. Under the monitoring and supervision of a qualified medical professional, and use of right medication in conjunction with psychosocial therapy, bipolar disorder can be well-managed by the individual.

Read also:

Overcoming depression, Anjana Rajbhandary

The silent scream, Anjana Rajbhandary

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