Bipolar affective disorder 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 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 was 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.