Having mood fluctuations and experiencing highs and lows is not uncommon. However, not all forms of mood changes are considered disorders. Bipolar disorder or manic depressive disorder is a form of a mood disorder that is often confused with having only depression. Even though they have a few similar symptoms, they are different.
Bipolar disorder is characterized by extreme mood changes in the emotional spectrum. As the name suggests, it has two phases or poles, i.e., mania or hypomania (a less extreme form of mania) and at the other pole is depression. We got in touch with Dr Santosh Bangar, Senior Consultant Psychiatrist at Global Hospital, and Dr Sonal Anand Psychiatrist at Wockhardt Hospital, Mumbai, to get a better understanding.
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While bipolar disorder can cause depression, it’s not the same as the condition called major depression or unipolar depression. Bipolar disorder can cause highs and lows within a timeframe but unipolar depression causes moods and emotions that are perpetually down. Understanding the symptoms of both mood disorders can give us a good insight into the disorders.
Symptoms of mania:
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1. Increased energy level or agitation.
2. Grandiosity or exaggerated sense of well-being and self-confidence (euphoria).
3. Decreased need for sleep.
4. Unusual talkativeness.
5. Racing thoughts or rapid speech.
6. Distractibility or inability to remain focused.
7. Poor decision-making ability. For example, speeding, going on buying sprees, taking sexual risks, or making foolish investments.
These symptoms could last a week, a few weeks, or even a few months. Hypomania is a milder form of these similar symptoms. A major depressive episode includes symptoms that are severe enough to cause a noticeable difficulty in day-to-day activities, at home or work for a period of at least two weeks. An episode includes symptoms like depressed mood, which includes feeling sad, empty, hopeless, or tearful.
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Other major signs include marked loss of interest or feeling no pleasure in almost any activities. The person suffering also can see significant weight loss or even weight gain, increased or reduced appetite. There’s a lack of sleep (insomnia) or sleeping too much. They might be restless and there could be a loss of libido as well. There’s a sense of worthlessness and hopelessness that creeps in with a decreased ability to think or concentrate. The person struggling may even think about planning or attempting suicide.
Types of Bipolar disorder:
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Bipolar disorder consists of basically two conditions – bipolar I and bipolar II. Dr Sonal explains, “Bipolar I disorder is characterized by major depression and at least one episode of mania. There may be alternate cycles or many cycles of such episodes. Whereas, Bipolar II disorder has at least one episode of major depression and hypomania. There can also be an episode of mixed features of both depression and mania. Sometimes the episodes can be complicated with psychotic features. Whereas, Cyclothymic disorder is cyclic that causes brief episodes of hypomania and depression.
Causes:
The exact cause is unknown, but usually there is a complex interplay of some of the factors, as below:
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1. Genetic: Bipolar disorder is mostly hereditary and the offsprings are at a higher risk.
2. Biological: Alterations in brain chemicals or neurotransmitters may play a role.
3. Environmental factors: Stressful life events such as significant emotional trauma or bereavement may trigger an initial episode in an ‘at-risk’ individual.
4. Drug and alcohol abuse: Excessive use of drugs or alcohol can increase the chance of bipolar in a susceptible individual.
Dr Sonal suggests, “Being aware of these differences changes treatment plans. Bipolar disorders are better treated with mood stabilizers rather than antidepressants. Making sure of not missing such vital information and to relay to the mental health professional is of utmost importance.” Being able to recognize the two spectrums by the family members also helps in early diagnosis and better management.
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