It affects at least one in a hundred people and can present with a wide variety of manifestations. It is an important pathology, not to be overlooked, but with targeted treatments it can be managed effectively.
Everyone can have mood swings, but sometimes the alternation between euphoric phases and moments of depression is so marked as to connote a real psychic illness: bipolar disorder.
In those who suffer from it, periods of excitement or moderate excitement (manic or hypomanic phase) and periods of depression (depressive phase) alternate. Although a family predisposition to get sick is evident, the disorder is not inherited. The risk of developing it is favored by bad lifestyle habits, especially with regard to sleep, and by substance abuse (drugs, alcohol, etc.).
Alarm bells
Bipolar disorder often manifests itself as early as adolescence, only in many cases it is not recognized or mistaken for other conditions, from depression to schizophrenia.
Before real manic episodes occur (it can take years), you can have anxiety disorders, sleep disorders and depressive episodes.
The symptoms of dipolar disorder are related to mood fluctuations and can be very varied. In general, depressive phases last longer over time, while manic or hypomanic phases last less (from a week to just over a month).
The transition between these two phases can be relatively long, allowing the patient a period of well-being, or very sudden.
Manic symptoms | Depressive symptoms |
---|---|
Increased vital and creative energy | Depressed mood most of the time |
Inability to restrain one’s impulses (overspending, substance abuse, etc.) | Loss of interest in everyday activities |
Sexual promiscuity | Tendency to isolation |
Increased sociability | Feelings of guilt |
Reduced need for sleep | Alterations in sleep and appetite |
Thoughts of death/suicide |
What to do
Bipolar disorder can be easily recognized especially in the manic phase, as it is very well defined and has peculiar characteristics that persist for at least a week.
If, on the contrary, the patient comes to the specialist in the depressive phase (which is more likely) it can take many years before clearly recognizing the disorder. In fact, it may happen that some patients have only depressive episodes for years without showing manic or hypomanic phase. These patients are therefore diagnosed as depressed until the appearance, perhaps many years later, of a first manic phase. Hence the importance of a very detailed clinical evaluation of symptoms and family history that could lead to the correct diagnosis.
Treatment
The treatment of bipolar disorder is based on the use of drugs, which aim to stabilize mood and improve sleep, and on the other hand on a psychoeducational approach, which aims to teach the patient and family members to recognize the signs of an upcoming manic or depressive relapse. The problem, especially in adolescents, is adherence to therapy and lifestyle indications, especially in manic phases.
The most used drugs are lithium salts, although second-generation antipsychotics have been available for some years, which have proved particularly useful in some forms of the disorder.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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