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Bipolar Disorder

Bipolar disorder, previously known as manic depression, is a condition that can affect your mood, making it swing from one extreme to another. If you are suffering from bipolar disorder you will have episodes of depression during which you feel low and lethargic alternating with episodes of mania during which you feel high and overactive. Symptoms of bipolar disorder depend on which mood you experience at the time. Unlike mood swings, in bipolar disorder each mood can last for several weeks with some people not often experiencing a ‘normal’ or ordinary mood.

Signs and Symptoms

Symptoms of depressed phase:

  • Sadness
  • Uncontrollable crying
  • Anxiety
  • Loss of interest or enjoyment in activities
  • Withdrawal from family and friends
  • Excessive guilt

Symptoms of manic phase:

  • Increased energy
  • Unusual talkativeness
  • Racing thoughts
  • Little need for sleep
  • Inflated self esteem
  • Spending sprees
  • Excessive excitement and happiness
  • Making grandeur and unrealistic plans.
  • Impulsive and restlessness
  • Drug and alcohol abuse

Causes

Genetic, neurochemical and environmental factors interact at many different levels to play a role in the onset and progression of bipolar disorder. The current thinking is that it is predominantly neurobiological disorder that occurs in a specific part of the brain and is due to malfunction of certain brain chemicals which are serotonin, dopamine and noradrenaline.  As a biological disorder, it may lie dormant and be activated on its own, or it may be triggered by external factors such as psychological stress and social circumstances.

 

A life event may trigger a mood episode in a person with a genetic disposition for bipolar disorder.

 

Types of Bipolar Disorder:

There are several types of bi-polar disorder, all involving periods of depression and mania to varying degrees. Bipolar 1 disorder involves periods of severe mood episodes from mania to depression. Bipolar 2 disorder is a milder form of mood elevation, involving milder episodes of hypomania(less severe than mania, where one has elevated mood and more energy than usual but it's not out of control) that alternate with periods of severe depression. Cyclothymic HYPERLINK "https://www.webmd.com/bipolar-disorder/guide/cyclothymia-cyclothymic-disorder" disorder describes brief periods of hypomaniac symptoms alternating with brief periods of depressive symptoms that are not as extensive or as long-lasting as seen in full hypomanic episodes or full depressive episodes. Mixed features refers to the occurrence of simultaneous symptoms of opposite mood polarities during manic, hypomanic or depressive episodes. It's marked by high energy, sleeplessness, and racing thoughts. At the same time, the person may feel hopeless, despairing, irritable, and suicidal. Rapid Cycling: In rapid cycling, a person with the disorder experiences four or more episodes of mania or depression in one year. It is a pattern of frequent, distinct episodes in bipolar disorder. In rapid cycling a person can experience multiple "highs" and "lows" in a single day. It feels like your mind is playing tricks on you. You are sad one minute, hyper the next, giddy and then back to sad, teary and wanting to hide.

Assessment and Diagnosis:

The diagnosis is based on a set of criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) or International Classification of Diseases (ICD-11) that a person must meet in order to be considered bipolar. An informed diagnosis would include specific tests to exclude all other causes. This may also involve a drug screen, imaging tests (CT scan, ultrasound), electroencephalogram (EEG), and a full battery of diagnostic blood tests and battery of Psychological Tests.

Treatment:

A combination of psychotherapy and medication works well in bi-polar. Along with medications, one can also opt for natural remedies and learn breathing techniques.

How Therapy Works:

A number of therapeutic modalities can be included. These are mentioned below:

  • Cognitive- Behavior Therapy: In CBT, you examine how your thoughts affect your emotions. This therapy teaches you the art and craft of choosing your thoughts consciously, eliminating distracting or depleting feelings, identifying cues of negative thinking patterns, learning to use triggers to improve patterns of thinking.
  • Inter-personal Therapy: Relationships and social support takes the patient a long way in healing and overcoming a psychological issue. So, we focus on building cooperative and healthy relationship of the client with few important people of her/his life. The client is taught social skills, conflict resolution and assertive techniques.
  • Social Rhythm Therapy: It focuses on regulating daily healthy habits like eating, sleeping and exercising.
  • Psycho-education and Family Therapy: Here the whole family along with the client is educated about the disorder and effects in daily life are explained in detail. Taking case studies of previous patients is an excellent way to build empathy for the client within the minds of the family members and friends. Family focused therapy addresses all issues within the family or marital life and focuses to restore healthy and supportive home environment.

“Except you cannot outrun insanity, anymore than you can outrun your own shadow.”