All people go through different moods throughout life without having to be alarmed by it, but in the case of bipolar patients those changes in their vital tone can lead to extreme situations such as giving away all their properties without any control or commit suicide.
Bipolar disease, also known as manic-depressive, consists of an alteration of the mechanisms that regulate mood, which causes in the patient episodes of euphoria, excessive mood, hyperactivity, sleep and appetite disorders, as well as phases of depression.
Strong depression that can last for several months. During these periods the patient may also suffer from delusions and hallucinations that make it necessary to be hospitalized to avoid major problems. Although there is no cure.
Symptoms of Bipolar Disorder
In our brain there is the so-called “limbic system” whose task is to regulate the mood through a kind of ‘regulator’. The function of this system is similar to that of a domestic thermostat that adapts the temperature of the heating system to the environmental changes of a house and keeps it stable.
In general, the state of mind of people tends to be regular and dependent on external environmental factors, but when a person suffers from a bipolar disorder, his ‘animosite‘ does not work properly and his mood becomes unstable and very variable, sometimes caused by an external factor and sometimes without any apparent cause.
This causes the patient to alternate during his life episodes of depression, asymptomatic phases, known as Euthymia, and episodes of euphoria.
There are different phase in Bipolar Disorder like some mention below.
The mania phase causes episodes of euphoria or excessive mood. Patients experience some of the following symptoms during this period: irritability, hyperactivity, decreased need for sleep, loquacity, increased sociability, ideas of greatness, increased sexual drive, accelerated thinking, excessive and inappropriate spending, disorderly behavior , unrealizable plans, delusions or hallucinations.
The symptoms of the depressive phase usually coincide with those that we know of a normal depression: apathy, lack of illusion, feeling of sadness or emptiness, low self-esteem, difficulty to perform the usual tasks, slowness, lack of concentration, desire to die, discomfort physical, anxiety, insomnia or excess of sleep, loss or excess of appetite, social inhibition, ideas of guilt or ruin.
The main cause is genetic, but as with other diseases such as diabetes, some people are more vulnerable than others to the onset of bipolar disorder
One of the factors that most influences this disorder is stress, but not that we usually understand by stress, because what stresses here are the changes that do not allow an adaptation of the person.
The consumption of drugs is another factor that can trigger the disease beforehand. “External factors accelerate the appearance of many psychiatric illnesses In bipolar disorder drug use can be very dangerous because it advances the appearance of the first episode, and the age at which this happens is very important for the patient”, explains the doctor.
The first episode of bipolar disorder usually appears during adolescence, although it can also occur in children or not present (or rather detected) until adulthood, which is when it reaches its peak. The most common age is around 18 years old.
Different types of bipolar disorder
About 2% of adults suffer from bipolar disorder in Europe. In adolescents, the prevalence is 1% and only 0.3% in children. In the United States the figure is somewhat higher since the statistics vary depending on where the diagnostic barrier is placed.
The Catalan psychiatrist points out that there are 1.2 women for every man, but he adds that if you admit cases of depressions with small euphoria, there are still many more women. Although it is a hereditary disease, the chances of the child of an affected person suffering from it are reduced.
1) Bipolar disorder Mania Phase
It is characterized by phases of mania, which usually require hospitalization, and intense depressions. Both stages can be accompanied by delusions and hallucinations, which can cause during the stage of mania that the patient believes himself to be gifted or a modern Messiah who must save the world and who distributes all his money among the poor.
While during depression you may become so guilty of everything that happens around you that you want suicide. For example, it could be the case of a patient who thinks he is the devil and that the Pope has died because of him, and wish to die for it.
2) Bipolar disorder Depressive Phase
Consists of depressive phases as intense as in type 1, but more moderate phases of euphoria called hypomania, which do not require hospital admission and sometimes may even go unnoticed. This type of disorder occurs in people who go through a depression and when they leave it they are too happy, but they do not realize that it is not a normal state at all.
In these cases they never get to do extreme things or put their way of life at risk, they just feel an excessive joy and some hyperactivity, accompanied by other symptoms such as: increased self-esteem, increased sociability and loquacity, sleep less than habitual, greater mental agility, greater interest in sex, spending more than usual, exaggerated optimism, lack of self-criticism or sudden mood swings.
Some of the patients define this phase as positive and consider that it is the time of their life in which they have found the best.
3) Mixed bipolar disorder or mixed phases
it consists of a mixture of depressive and manic symptoms at the same time. This type of phase is very difficult to diagnose because the patient is sad but at the same time euphoric at times, generating great confusion and great suffering for the patient and his family.
During the mixed phases the patient may experience several symptoms at the same time: bad mood, acceleration of thought, restlessness, hostility, lack of illusion, rapid changes of mood, insomnia, uncontrolled behavior, delusional or negative ideas, hallucinations or emotional fragility.
Do you know about Cyclothymia?
it is about the succession of hypomanias and mild or moderate depressive phases, and it is frequent that those who suffer from it have never requested psychiatric attention because they are not aware of the disorder and ignore that there is a treatment.
Cyclothymic people are seen by others as unstable or unpredictable. Although it is a milder type of disease, it is chronic and very long lasting, since the phases of depression and hypomania are much longer.
Fortunately, patients with bipolar disorder do not spend their entire lives from one phase to another. After overcoming a crisis of any kind, there are periods in which the state of mind is normalized and the symptoms of the disease disappear almost completely.
These phases are called ‘eutimia‘ or ‘correct mood’, considers that the duration of each phase depends very much on the way of being of each patient, although the latest studies show that the time that serious patients spend sick is approximately between one third and 40% of their life if they are properly medicated.
Bipolar Disorder Diagnose Phase and Treatment
Under normal conditions a depressive phase usually lasts between 6 and 9 months and the manic phase between 2 and 4 months, if a pharmacological treatment is followed the duration can be shortened considerably.
Depending on when the treatment is started, the manic phase can be reduced to a quarter, while the depressive phase is shortened by 30%, that is, we are more effective at treating the manic phases than the depressive ones. that during the episode of mania patients are not so aware that they are sick and do not usually go by themselves in search of help
In the opinion of the experts consulted, bipolar disorder is one of the psychiatric illnesses that has greater resources for its treatment, since medication is available that stops the euphoria phases and helps to overcome depression, as well as reducing the frequency of relapses and their intensity.
Effective drugs in both prevention and treatment
Among the stabilizers, lithium is the most widely used, although there are also very effective antipsychotics, and there is a lot of research going on. What’s important in this disease is that you have to take lifelong medication to keep it under control. If you had any other chronic problem, what you should not do is put a blindfold on your eyes and do not assume what happens to you.
According to a 10-year follow-up study conducted with patients on lithium salt therapy, people who had forgotten when taking the pills fell two to four times more than those who took the medication correctly. These results demonstrate the importance of correctly following the treatment.
It is essential for us to be aware of the disease and correct medication in order to lead a more or less normal life and be more stabilized. It is also very important to know oneself well in order to know which things make you nervous or that can accelerate you. Recognize symptoms early and go to the doctor as soon as possible.
Associations affected by this disease do a great job organizing self-help groups that are very useful for the patient and their families. We recommends try to escape destructive processes or social marginalization. You have to give skills to the sick person so that they can socialize again.
The treatment does not only consist of medication, More than a therapy is a ‘training’, because we considers that the disease “is like a wild horse that you have to learn to tame, and for that you have to learn to ride horses first.
Recognize the symptoms of relapse in time for them to go to the psychiatrist before the crisis overcomes them. We also teach them the management of stress, which is achieved by following certain routines.
For example it is very important that they get enough sleep and that they do not alter the schedules of sleep People who work shifts have more problems because it alters the biology of the ‘animostato’.
Late diagnosis Problem
The great problem of bipolar disorder is that it still takes a long time to diagnose: an average of seven years in Europe and ten in countries like the United States, which greatly harms the sick, since experts say that 80% of the damage and Complications that the disease causes occurs during the first five years.
There are social aspects that are not understood when the disease begins, usually coincides with the person’s study years or when he or she begins to work, it is also a time when sentimental relationships are usually initiated and a late diagnosis can leave them out of control.
In addition to the social part, we must take into account the biological part of the disease, because at first the appearance of the episodes is more related to external factors, but with the passage of time becomes independent and spontaneous, and therefore less controllable and predictable.
The first years are decisive to prevent the disease from becoming malignant and go on its own regardless of whether the patient’s situation is stressful or not, says the psychiatrist.
What is the reason for the delay in the diagnosis?
On the one hand this psychiatrist attributes it to the ignorance of the disease among the general practitioners, who often confuse the symptoms with a depression, and limit themselves to prescribe antidepressants.
This only helps the patient to get manic again, antidepressants can be used, but you should always prescribe a stabilizer first.” Another reason for late diagnosis is that patients are not so aware that they are ill during the manic stage and do not go to the psychiatrist, because they always find alternative explanations for the unusual things they do.
Consequences of a bipolar disorder
The consequences of a bipolar disorder without treatment can be very serious. The worst is suicide, which usually occurs during the phase of deep depression. There are about 10% of completed suicides, although remember that this figure could be reduced a lot if the patients were treated.
Drug abuse and family problems (broken couples, separations and conflicts) are also common consequences of this disease. In addition, serious cases can mean the loss of a job, since euphoria can lead to excessive risks and spend more than you have, while the depression leads to labor losses and an evident drop in productivity.
The family plays a fundamental role in the development of the disease, since it can become a great help or a detriment, if it is a stress or for the patient.
In general, psychiatrists observe two types of errors in family members: over protection, especially when the patient is young, or a negation of the disease, more common among the spouses. For them there are also psychoeducation programs that try to correct specific aspects of the relationship between patient and family.
The family has a better depressive phase than the manic one: In the depressive you are more controlled, although you suffer more, in the maniacal you can do a lot of nonsense, but you do not have as much awareness of the illness and that is why the first thing that the patient does is leave the medication, because many times he has the feeling of feeling better than ever.
Bipolar disorder can not be cured, but medication allows it to be compensated so that a reasonable percentage of patients lead a normal life. According to a European study, coordinated by Vieta and carried out among more than 3,500 patients, one third of bipolars can not work because they are disabled, another third are working but below their means or in precarious conditions because of the disorder, and another third leads a practically normal life.