What is Bipolar Affective Disorder?

Table of Contents

Preface

Mental health issues are not something that can be avoided and ignored. Mental health issues develop in different forms. Some are less severe, while others can be life-threatening (based on symptoms). Bipolar Affective Disorder is also a mental health concern that needs attention. The sad part is that a major chunk of our society is still unaware and uneducated about various psychological concerns.

In my previous blog relating to mental health, I furnished basic information on what is obsessive-compulsive disorder or OCD, its symptoms, causes, & treatment? and also shared my personal experiences living with it. Today, I will talk about Bipolar Affective Disorder (BPAD) or Manic Depression or simply Bipolar Disorder, the types of Bipolar Affective Disorder, symptoms, causes, and the treatment.

What do statistics say?

It is estimated that the lifetime prevalence of Bipolar Affective Disorder is somewhere between 0.2-2% globally. But, there is a high possibility that these numbers could be even higher. The lifetime prevalence of BPAD is estimated to be above 2% in the United States and India each. BPAD, as per the studies, is found to develop and affect people primarily of the age group between 20-30 years. However, the disorder can develop in people of any age group and at any point in life.

Note: The numbers stated here are for reference only and are based on research on the internet. The actual numbers may vary.

As the name suggests, Bipolar Affective Disorder (BPAD)/Bipolar Disorder is related to two opposite mental states: mania and depression. We can say that Bipolar Disorder is a mood disorder, but it is not that simple. It is a disorder with severe mood fluctuations. If ignored, it can hamper the normal flow of life, both personally and professionally. Also, it would not be wrong to highlight that if bipolar affective disorder is severe and left untreated, it can lead to life-threatening situations. With the right treatment, the illness can be controlled and treated, and a person with BPAD can live a normal, healthy life.

How many types of Bipolar Affective Disorder are there?

Bipolar 1 Disorder
Bipolar 2 Disorder
Cyclothymic Disorder

What are the symptoms of different types of Bipolar Affective Disorders?

Bipolar 1 Disorder

Bipolar 1 disorder is related to mania or manic episodes. For a person to have bipolar 1 disorder, he/she should have gone through at least one full cycle of the manic episode. A depressive episode also usually occurs. Hypomania is considered to be the initial stage in this type of disorder leading to a full manic phase. It is expected that in this type, the manic phase should last for at least a week.

Symptoms of Bipolar 1 Disorder

Here are some of the symptoms of the manic phase as part of Bipolar 1 Disorder. This is not a holistic list. A medical health professional should be consulted for a proper diagnosis.

High on energy than on other regular days, or euphoric
Less sleep
Easily distracted by various things around
Racing thoughts hampering the normal activities
Talking too much or blabber
Participating in reckless activities

The manic phase in the case of bipolar 1 disorder is usually the extreme manic state. If left untreated, the person having the disorder: can get out of control due to unexpected high energy, will try to do multiple activities at one go, can make rash decisions, remain distracted due to racing thoughts, can draw unnecessary conclusions about his/her personality, and can indulge in reckless activities.

The activities will seem to be excessive and strange for the people around the affected person. There can also be frequent mood fluctuations where the patient may show signs of depression at one moment and manic at the other moment. Hospitalization is often required in a full-blown manic phase considering the psychosis aspect.

Bipolar 2 Disorder

Bipolar 2 disorder is related to depression or depressive episodes. As per what is drafted, if a person has bipolar 2 disorder, he/she should have had at least one episode of major depression and at least one hypomanic (but not manic) episode.

Symptoms of Bipolar 2 Disorder

The following are some of the symptoms of the depressive phase as part of Bipolar 2 disorder. This is not a holistic list. A medical health professional should be consulted for the correct diagnosis.

Extreme sadness and feelings of being worthless
An unwanted feeling of guilt
Irritated/Agitated
Thoughts about death and suicide
Lack of interest in most of the daily activities
Socially cut-off
Lack of focus or concentration
Sleeping too much or too little

The symptoms of the hypomanic phase are similar to those in bipolar 1 disorder but of less intensity/severity.

Sometimes, bipolar 2 disorder is also called Bipolar Depression. If left untreated, the person having this type of BPAD: can go into complete isolation, can get suicidal, can feel worthless, can embrace extreme guilt about anything (e.g. may be related to the death of a close one), and will generally go through severe mood changes between hypomania and major depression leading to hopelessness. In severe cases, hospitalization is required. The death rate due to suicide is higher in this type of BPAD.

Cyclothymic Disorder

Cyclothymic Disorder lies somewhere between bipolar type 1 & type 2 disorders. It is considered to be a mild form of bipolar disorder (some mental health professionals do not consider it to be a part of bipolar disorder spectrum). The disorder relates to mood swings between hypomania (less severe than mania) and depression (less severe than major depressive disorder).

In other words, the symptoms are not as extreme or full-blown as in bipolar 1 or 2 types. The duration of symptoms as part of this type is different than the other two types of bipolar disorder. Research also shows that there is a high possibility that if this disorder is not tackled/treated in the early stages, later, it may convert into a full-blown bipolar disorder.

How Bipolar Affective Disorder impacts a person’s daily life? My experience!

It all started a couple of years back when I had no option but to take a mental health professional’s help as I was in a total mess. I was diagnosed with Major Depressive Disorder(MDD) initially. After a thorough analysis, talk sessions, and medication responses, the psychiatrist diagnosed that I was suffering from Type 2 Bipolar Disorder. The following were some of the depression symptoms I had:

I used to be extremely sad.
I was suicidal and felt hopeless.
I felt guilty and responsible for the death of my loved ones even when they were all natural deaths.
Not a single day went without thinking about death.
I used to sleep for long hours. There were times when I used to lie on the bed for the whole day without doing anything.
There was no interest in doing any activity.
My appetite was random.
My professional life was sinking as I started avoiding going to the office.
I was socially cut-off and never felt like talking to my family or friends.

It was really bad, and I mean it. It was like, if I don’t get immediate medical help, I will take a drastic step. There was no second thought. I could not understand what was happening to me. It was all just dark and I felt worthless. I had seen low phases but I used to come out of it in a few days. That phase felt ever-lasting.

What is the cause of Bipolar Affective Disorder?

The exact cause of bipolar affective disorder is still not known. However, research has shown that a person who has a history of bipolar disorder in the family has a high chance of developing it. It can be seen as genetic. Some life events can also trigger the illness. The chemical imbalance in the brain is also one big factor in not only BPAD but also in any mental disorder.

Challenges in diagnosing Bipolar Affective Disorder?

Bipolar Disorder is not easy to be diagnosed. A thorough analysis by a mental health professional is required, and he/she should have the patient’s exact history of the symptoms. Many a time, due to lack of proper information, BPAD is not diagnosed until much later. Mostly, a person suffering from BPAD will not be able to effectively convey the symptoms to the doctor.

Specifically, it is tough to diagnose Bipolar Depression or Type 2 bipolar disorder as initially, the symptoms seem to be related to Major Depressive Disorder (MDD) or unipolar depression.

It can take some time for the mental health professional to conclude that a person is indeed suffering from bipolar disorder. The diagnosis can also involve getting the patient to go through different cycles of medication. Frequent follow-ups in the initial stage may be recommended by the doctor to confirm the illness and its severity.

What is the treatment for Bipolar Affective Disorder?

Bipolar Affective Disorder can be treated and controlled but cannot be completely cured as per the research. So, it is often considered a lifetime condition once diagnosed.

There is a high chance that Bipolar Affective Disorder symptoms will return if the treatment is stopped abruptly or if it is considered to be eliminated. It is always recommended to take mental health professional’s advice and not stop the medication without his/her consent. The condition might get worse/relapse.

Awareness

Before focusing on the treatment options, it is equally important to highlight that awareness of BPAD is very crucial. Not only BPAD, but this should apply to every other mental health issue.

Until people are not aware of the illness, they will never accept it. A dark side of our society is that some people just don’t believe in mental health illnesses. They would rather believe in superstitions or will worry about what other people in society would say rather than help a person with mental concerns. A BPAD patient needs full support and proper medical help. Half of the battle is already lost if the people around the patient will not comprehend the illness and its consequences.

Psychotherapy

Talk therapies like CBT (Cognitive Behavioural Therapy) can be helpful in BPAD. This psychotherapy is very popular and is considered effective specifically in the case of people with Major Depressive Disorder (MDD) symptoms.

In CBT, the patient and psychotherapist/psychiatrist can work together to understand the symptoms and draft a plan on how to tackle them on a step-by-step basis. The idea is to make the patient aware of the illness and to make him/her confident enough to tackle the situation as much as possible instead of surrendering to it.

Medication

In most cases, a combination of different medicines (compounds/agents) is prescribed to the person suffering from BPAD. Needless to say that the line of treatment/medication will be based on the diagnosis, symptoms, and type of BPAD.

It can’t be said that a BPAD patient will be given a fixed combination of medicines throughout the illness’s life-cycle. A regular follow-up with the psychiatrist/mental health professional is recommended. Based on the symptoms at a particular point in time, the medication could be changed/altered. The following are some of the medication options that are considered in BPAD:

Mood Stabilizers/Anticonvulsants (e.g. lamotrigine)
Antidepressants (e.g. SSRI)
Antipsychotics (e.g. olanzapine, quetiapine, etc.)

Sometimes, a single compound/agent is sufficient to control the symptoms. In other instances, a combination can be prescribed.

Note: The list cannot be treated as holistic. The medication options highlighted here are generic, stated on public forums, and popular in tackling BPAD. It is recommended NOT to use the medication without the advice and diagnosis of a psychiatrist/mental health professional. Improper use of such medicines can lead to severe consequences. Different medications and dosages can be prescribed to different people as per their symptoms. It is totally based on the diagnosis.

Conclusion

In most cases, simultaneous treatment of talk therapy and medication is recommended. Nevertheless, the patient undergoing treatment might still experience fluctuating symptoms of BPAD, and that is why regular follow-up is crucial to understand if there is a change in the mood cycle.

Considering that I am a victim of bipolar affective disorder myself, I can confidently say that BPAD is a serious mental illness and should be tackled as soon as there are visible symptoms of it.

A person suffering from BPAD might not be aware of his/her condition and actions. Thus, the people around should be aware and should immediately opt for mental health professionals’ help if they see a person with BPAD symptoms. A BPAD patient needs full support from his/her friends and family. If ignored, as stated earlier, it can even create life-threatening situations. BPAD can be controlled (if not cured) through medication and psychotherapy, and the patient can lead a normal life like others.

Lastly, please note that this blog post is in no way a holistic guide for Bipolar Affective Disorder or BPAD, its causes, symptoms, and treatment. The post’s main motive is to create awareness. People should always reach out to mental health professional’s help if they see BPAD symptoms in a person.