Bipolar Disorder

Bipolar disorder is a mental illness which causes extreme mood swings from highly energetic to low, sad mood. The extreme mood swings bring changes in sleep, energy levels, and the ability to think clearly. This illness can affect a person at any stage of life, teen or early adulthood. The extreme high’s are called mania and extreme low’s refer to depression.

Mania, or a manic episode, is defined when a person shows the mentioned symptoms over a period of at least 7 days. Signs of a manic episode are:

•         High energy and acute activity
•         Excessively good mood
•         Irritability for impatience
•         Erratic talking
•         Inability to concentrate
•         Little need for sleep
•         Feelings of power

•         Poor judgment
•         Inattentive
•         Heavy careless spending
•         High sex drive
•         Alcohol or drug abuse
•         Aggression

Depression refers to when a person experiences persistent sad mood, lack of energy in the body and interest in the activities which were considered pleasurable. If the mentioned symptoms are observed in a person for a period of 2 weeks or more then its important to consult the doctor.

• Sadness, anxiety, or a feeling of emptiness
• Feelings of guilt, feeling worthless or feeling helpless
• The trouble with concentration or memory
• Thoughts of death, or suicidal thoughts or attempts
• Pain or other physical symptoms not explained by an illness or injury

• Hopelessness
• Low energy
• Changes in appetite or weight
• Disturbances in sleep. need for less sleep or no sleep
• Lack of interest in activities that were once enjoyable, such as sex

• Genetics
• Heredity
• Environment factors
• Personality
• Traumatic experiences
• Physical illness
• Extreme stress

Bipolar disorder is a serious mental illness. A person during the illness may not know that he/she is has a mood-related disorder. But the changes in the person’s mood, behaviour and thoughts can be observed by the others. Due to illness disturbances in routine, relationships and workplace are often observed.

For the management of the symptoms, hospitalisation is recommended. Also as there are risks to self and others, inpatient treatment helps manage it better.

Having bipolar disorder does not mean you are broken, it means you are strong and brave for confronting your condition

Mr Ranjeet, a 46-year-old married male, currently separated from his wife was brought for hospitalization by his family.

They gave a history for the last 4 months where Ranjeet was restless, overtalkative, felt a decreased need for sleep. He was also suspicious, over-religious and showed aggressive behaviour. A detailed clinical assessment was done which revealed that there have been similar episodes in the past. With reference to his past and current psychiatric history, he was diagnosed with Bipolar affective disorder currently manic episode with psychotic symptoms.

In the ward, Ranjeet revealed auditory hallucinations (where he would hear voices), and persecutory delusions (he believed that “some people are trying to conspire against me and kill me. They are constantly following me”).

For these symptoms, mood stabilisers and antipsychotic medications were started and reduction in irritability, aggression and suspiciousness was noted in 1 month. During the active treatment phase, education about the illness was given that brought about awareness and understanding. Interpersonal and social rhythm therapy was given with the aim to improve treatment and drug compliance. Ranjeet was also taught how to manage stress while at the same time working towards relapse prevention.

During the end of the second month, a significant reduction was observed in the manic-psychosis symptoms. Interpersonal disturbances due to illness and related aggression were addressed through family intervention. Patient attained complete recovery by the end of treatment and resumed his job. He is currently coming for follow-ups since the past 5 months and drug compliance is good.