Bipolar Mood Disorder
This disorder is characterized by repeated (i.e. at least two) episodes in which the patient’s mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (mania or hypomania), and on others of a lowering of mood and decreased energy and activity (depression).
Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median duration about 4 months). Depressions tend to last longer (median length about 6 months), though rarely for more than a year, except in the elderly. Episodes of both kinds often follow stressful life events or other mental trauma, but the presence of such stress is not essential for the diagnosis.
The first episode may occur at any age from childhood to old age. The frequency of episodes and the pattern of remissions and relapses are both very variable, though remissions tend to get shorter as time goes on and depressions to become commoner and longer lasting after middle age.
Features of a Manic episode
Mood is elevated out of keeping with the individual’s circumstances and may vary from carefree joviality to almost uncontrollable excitement. Elation is accompanied by increased energy, resulting in overactivity, pressure of speech, and a decreased need for sleep. Normal social inhibitions are lost, attention cannot be sustained, and there is often marked distractability.
Self-esteem is inflated, and grandiose or over-optimistic ideas are freely expressed. Perceptual disorders may occur, such as the appreciation of colours as especially vivid (and usually beautiful), a preoccupation with fine details of surfaces or textures, and subjective hyperacusis.
The individual may embark on extravagant and impractical inappropriate circumstances. In some manic episodes the mood is irritable and suspicious rather than elated. The first attack occurs most commonly between the ages of 15 and 30 years, but may occur at any age from late childhood to the seventh or eighth decade. schemes, spend money recklessly, or become aggressive, amorous, or facetious in inappropriate circumstances.
In some manic episodes the mood is irritable and suspicious rather than elated. The first attack occurs most commonly between the ages of 15 and 30 years, but may occur at any age from late childhood to the seventh or eighth decade.
Features of a Hypomanic episode
Hypomania is a lesser degree of mania. There is a persistent mild elevation of mood (for at least several days on end), increased energy and activity, and usually marked feelings of well-being and both physical and mental efficiency. Increased sociability, talkativeness, overfamiliarity, increased sexual energy, and a decreased need for sleep are often present but not to the extent that they lead to severe disruption of work or result in social rejection.
Assessment and diagnosis
Diagnosis is based on a detailed life time evaluation of psychiatric symptoms as well as cross sectional mental state evaluation. Laboratory tests and imaging have no role in making a diagnosis.a careful note of symptoms including the severity, duration and frequency is made. The patients symptoms are fully assessed using the criteria from American Psychiatric Association’s DSM V.
Mood swings and impulsive behavior may also occur in other conditions like substance abuse, borderline personality disorder, conduct disorder, impulse control disorder, developmental disorders, ADHD, Schizoaffective disorder and PTSD. Some non psychiatric illnesses like lupus, HIV, Thyroid disease or use of certain medication like steroids may have similar signs and symptoms.
A detailed assessment helps in making a definite diagnosis and treatment plan. It has immense future benefits to the client in maintaining long term records Bipolar Disorder being a chronic illness.
Treatment includes a combination of one mood stabilizer drug and/or a atypical anti psychotic with psychotherapy. Certain drugs are also used for maintenance to maintain a steady state over time.