Bipolar Disorder - A life between high spirits and depression
introduction
The term "bipolar disorder" seems to be familiar to many people as it has affected many celebrities such as Kurt Cobain and Carrie Fisher. However, most people do not know exactly what is behind this psychiatric illness.
Bipolar disorder is characterized by at least two episodes in which the mood of the person concerned is on the one hand raised and on the other hand has fallen sharply. It is a so-called life between mania and depression.
Also read: What are the symptoms of bipolar disorder?
Proportion of mania
The mania is accompanied by an exaggerated mood elevation or irritability. It lasts for at least a week, usually two to three months. Symptoms of mania are as follows:
- Restlessness, irritability, aggression
- excessive optimism
- excessive self-esteem, e.g. The victim thinks he is the best photographer in the world
- Cognitive disorders
- Strong distractibility: People are very active and motivated, but they cannot concentrate on their work because they are very easily distracted.
- Lack of judgment
- Flight of ideas and racing thoughts: the person concerned changes from one idea to the other.
- Significantly reduced need for sleep: The person concerned does not want to sleep and feels fit without sleep
- increased sexual drive: those affected often have changing partnerships
- Strong urge to talk: those affected talk very quickly and a lot
- senseless shopping, loss of social inhibitions: those affected spend more money than they actually could financially
- Big ideas, megalomania, e.g. The victim thinks that everyone wants an autograph from him
Read more about this at: mania
Irritated mood
About two out of three people with bipolar disease are unusually irritable during their manic phase. Conflict and aggressiveness are more common. Overall, the way of life is severely affected.
Also read:
- What are the symptoms of bipolar disorder?
- Symptoms of mania
Euphoric mood
About every third person with bipolar disorder is overly euphoric during the manic phase. Feelings of willpower and excessive optimism develop. In addition, the person concerned has an excessive self-esteem.
Further information on this topic can be found at: Symptoms of mania
Sex addiction
A very common characteristic of the manic phases is the increased sexual drive. Affected people often have changing partners or are unfaithful to their existing partner. This often causes them difficulties in everyday life.
For more information, we recommend our website to:
- What are the symptoms of bipolar disorder?
- Symptoms of mania
lying
Relatives and friends of people with bipolar disorder often have the feeling that they are not being told the truth by the person concerned. However, there is no evidence that bipolar patients lie more often. However, they often perceive their environment differently than people around them. They often feel that lies are real.
For more information, see: Symptoms of mania
Proportion of depression
The depressive phase of bipolar disorder is like normal depression. The depressive phase usually lasts for five to six months.
It is characterized by the following symptoms:
- Gloomy mood
- Loss of interests
- Reduced drive, increased need for sleep
In addition, the following complaints can occur:
- Disturbances in concentration
- decreased self-esteem
- Feelings of guilt
- Negative ideas about the future
- Suicidal thoughts and attempts
- decreased appetite
Read more on this topic at: Symptoms of depression
Gloomy mood
In the depressive phase of bipolar disorder, the disease works like normal depression. Those affected have a depressed mood, a loss of interest and are listless. Feelings of hopelessness, hopelessness and also thoughts of suicide arise.
Read more about this at: Symptoms of depression
What is the course of bipolar disorder?
A person with bipolar disorder has an average of seven to eight manic-depressive phases in life. This is significantly more common compared to normal depression, which causes around three to four relapses.
A mania usually lasts for about two to three months, while the depressive phase can last for up to six months.
It becomes particularly problematic for those affected with the phase change.
Bipolar disorder course type 1
Bipolar disorder type 1 is present when at least one pronounced manic phase and one other emotionally disordered episode is present. It can also be present if there are at least two episodes of mixed moods.
Bipolar disorder course type 2
In type 2 bipolar disorder, the depressive episode predominates. There are also weakened manias with a slight elevation in mood and somewhat increased drive.
Rapid cycling
Rapid cycling is when there are at least four phases of mania, mild mania or depression within a year.Rapid cycling occurs particularly in type 2 bipolar disorder.
Duration of the phases
Those affected experience an average of seven to eight episodes of their bipolar disorder. The depression lasts for about five to six months. The manic phase usually lasts two to three months.
Non-drug treatment of bipolar disorder
Treatment of bipolar disorder must be carried out by a psychiatrist. It is made up of a non-medicinal and medicinal part.
Non-drug therapy includes:
- Psychoeducation:
In psychoeducation, the person concerned should above all be informed about their illness and acquire knowledge about it. Studies have shown that those affected who have dealt with their illness as part of psycho-education and are familiar with it have fewer relapses than those who were only treated with medication. - cognitive behavioral therapy:
Cognitive behavior therapy is also important. Here the affected person should learn that he can control certain problems himself through his own thoughts and feelings and can therefore change them. - Mood Control Therapies:
The affected person should learn through various exercises to stabilize his mood. - Family therapy and couple therapy:
Ideally, relatives should also be included in the treatment of bipolar disorder. The main thing here is teaching how to deal with the disease.
Drug treatment of bipolar disorder
Mania and depression in bipolar disorder are treated differently in principle. Therapy for bipolar disorder is more aimed at mania, because mania can become more dangerous than depression due to its increased activity. In addition, studies to date have shown that antidepressants are not effective in treating bipolar disorder.
In drug therapy for bipolar disorder, a distinction is made between acute therapy, maintenance therapy and phase prophylaxis.
In bipolar disorder, treating mania is more important than treating depression. For more information, we therefore recommend: Therapy of mania
Acute therapy
Acute therapy usually takes place with the second generation of antipsychotics, including risperidone, olanzapine and others. The first generation of antipsychotics can also be used for a short time, but these have more frequent side effects such as movement disorders. The antipsychotics work against both mania and depression.
You can find more information about antipsychotics on our website: Neuroleptics
Maintenance therapy
Maintenance therapy is continued for up to a year after acute therapy. The main concern here is to protect those affected from relapse.
Phase prophylaxis with mood stabilizers
Every bipolar disorder must be treated with a mood stabilizer to protect against new manic and depressive phases. The most popular means of phase prophylaxis is lithium. Depending on the type of bipolar disorder, however, antipsychotics may also be preferred (e.g. for bipolar disorder type 2). If the mood stabilizer is triggered, it should usually be taken for life.
Lithium for mood stabilization
Lithium is the drug of first choice for mood stabilization in bipolar disorders, especially when the manic phases predominate.
It works excellently against mania and has a proven effect of reducing suicidality. Not everyone responds well to lithium; patients with type 1 bipolar disorder benefit more from it. Lithium treatment should be attempted in all patients.
If they respond, lithium should be taken for life.
Lithium can lead to kidney failure and hypofunction of the thyroid.
Read more on this topic at: lithium
You might also be interested in: Lithium and alcohol - are they compatible?
Weight gain from medication
The second generation of antipsychotics (atypical antipsychotics) are preferred over the first generation in the treatment of bipolar disorder. This is due to the fact that atypical antipsychotics cause fewer movement disorders.
In return, however, they make more disruptions in the metabolic process. Most importantly, this includes weight gain, which many patients complain about. Nonetheless, the atypical antipsychotics have fewer side effects than the typical ones.
Read more on this topic at: Neuroleptics (antipsychotics)
How should the relatives behave?
Family members such as family members or domestic partners should ideally be included in the treatment of bipolar disorder.
The main goal is to deal with bipolar disorder and to develop an understanding of manias and depression.
This makes it easier to stand by the person concerned and to pay attention to stimulus shielding, e.g. Get enough sleep in a manic patient. If the person concerned has a critical assessment, the relatives should contact the attending physician. Talking to the patient can help during periods of depression.
What degree of disability is there in bipolar disorder?
Bipolar disorder is the fifth most common cause of disability between the ages of 14 and 45, as it can severely impair the quality of life of those affected by impaired concentration and changing emotional states.
If there is a bipolar disorder, those affected can apply to the pension office for recognition of a disability. The degree of disability is determined according to health care principles and can therefore differ individually.
Prognosis and healing of bipolar disorder
Bipolar disorder can seriously impair the quality of life of those affected. It can be treated well with good medication control, but it cannot be cured.
The prognosis differs depending on the present form or the type of bipolar disorder. With rapid cycling or mixed types, the prognosis is often worse than with type 1 or type 2 disorders. This is related, among other things, to the simultaneous occurrence of depressive moods and manic, increased drive. Relapses and suicide attempts are more common.
Overall, life expectancy with bipolar disorder can be reduced by up to 9 years - mostly as a result of suicide. Two out of three people affected can no longer participate in working life. Nevertheless, the prognosis must be viewed individually and can take different forms.
Can you drink alcohol if you have bipolar disorder?
Alcohol is not prohibited in the presence of bipolar disorder, but it often makes the disease worse. The risk of alcohol dependence is increased by a factor of five to twelve with bipolarity, so doctors often advise against alcohol.
Also read: Lithium in bipolar disorder and alcohol - are they compatible?
Diagnostic criteria for bipolar disorder
To make a diagnosis of bipolar disorder, the diagnostic criteria of depression and mania must be met.
If depression is already known, this diagnosis must be changed to bipolar disorder the first time a manic phase occurs.
Diagnostic criteria for mania
The diagnosis of mania is made when the main symptom and at least three additional symptoms last more than a week and other psychological causes have been excluded.
Main symptom:
- a situation-inappropriate, abnormally elated mood (euphoria) or irritable mood
Additional symptoms:
- increased drive
- lack of need for sleep
- Distractibility
- excessive optimism
- increased self-esteem
- increased talkativeness, urge to talk
- constant changing of ideas, many different ideas (flight of ideas)
- senseless spending of money
- Loss of social inhibitions, reckless behavior
- increased sexual drive
- increased appetite
Other symptoms can be megalomania and hallucinations: e.g. The person concerned thinks that everyone in the world would envy him for his success.
Read more about this topic on our main page: mania
Diagnostic criteria for depression
Main Symptoms: These symptoms must have been present for at least two weeks to diagnose depression:
-
depressed mood, loss of interest, listlessness
Read more on this topic at: Symptoms of depression
Are there bipolar disorders already in children?
Children of parents with bipolar disorder can inherit the condition. However, it is difficult to make a diagnosis in childhood, as the symptoms are often unspecific at first and therefore misdiagnoses such as ADHD (attention deficit hyperactivity syndrome) or schizophrenia can often initially arise.
Early symptoms can include mood swings, irritability, outbursts of anger, impaired attention, sleep disorders, and more. From the age of ten, the manic-depressive symptoms can come to light better. However, the diagnosis of bipolar disorder is usually only made in adolescence and adulthood.
Diagnosing bipolar disorder in childhood is rather uncommon. If there are abnormalities in your child's behavior, other possible diagnoses should therefore be considered. We recommend our site to: Symptoms of ADD or Schizophrenia in children
Can you recognize bipolar disorder yourself?
The presence of a bipolar disorder can mainly be suspected if the disease occurs in the family and the clinical picture is therefore already known. Nevertheless, the diagnosis cannot be made independently. Affected people often do not notice the bipolarity and do not show any insight when they are made aware of it by those around them.
Also read: What are the symptoms of bipolar disorder?
What self-tests are there for bipolar disorder?
Bipolar disorder cannot be diagnosed using self-tests.
The specialist makes the diagnosis by talking to the patient and after excluding other mental illnesses such as the schizophrenia. However, relatives or those affected can carry out numerous self-tests for an initial assessment of the presence of bipolarity on the Internet.
You might also be interested in: What are the symptoms of bipolar disorder?
How safe are the self-tests?
The self-tests are not enough to detect bipolarity. We do not recommend them because they are often not serious.
Causes of Bipolar Disorder - How Common is Heredity?
There is a clear genetic component in bipolar disorder.
If one of the parents has bipolar disorder, the probability that this condition is inherited is around 25%. If both parents are affected, the probability increases to 50%.
No other causes of bipolar disorder are known, but studies have shown that stress and environmental factors also have an influence.
