Bipolar Disorder

Cause

Heredity plays an important role in the development of a bipolar disorder. The condition is more common in some families. Other risk factors include:

• Cannabis use.
• Loneliness.
• Traumatic childhood experiences, such as maltreatment, incest or neglect.
• Living in a big city.

Symptoms

Almost all people with bipolar disorder have manic and depressive episodes.
Signs and symptoms of a manic episode are:

• Excited and excessive self-confidence. Megalomania.
• Getting angry quickly.
• Feeling physically very good and needing little sleep.
• More talkative than in other episodes.
• Thoughts are difficult to control and easily distracted.
• Dedicated to activities, which you know will cause harm in the long term.
• Social and relationship problems.
• Delusions and hallucinations (psychoses).

Signs and symptoms of a depressive episode are:

• At least two weeks of continuing depressed mood and loss of interest in the environment and daily activities.
• Less appetite, resulting in weight loss.
• Trouble sleeping.
• Restlessness or just feeling inhibited.
• Concentration problems, delayed thinking and indecision.
• Feelings of worthlessness and recurring thoughts of death or suicide.

A manic episode lasts at least one week, a depressive episode at least two weeks. Some people have periods when they simultaneously have a mania and a depression (mixed episode). In most people, manic episodes and depressive episodes alternate. There are also periods in which one feels normal.

Diagnosis

Bipolar disorder is difficult to recognize, not only for the person himself but also for the doctor. On average, it takes six years before the diagnosis is made. During a crisis, it is often ultimately clear that it’s a bipolar disorder. This is determined by a psychiatrist, based on a number of symptoms and with the aid of various questionnaires. In any case, a physical examination and blood tests are always performed, in order to establish that the symptoms are not caused by medication, drugs or any other condition. In addition, the story of the partner or immediate family completes the picture.

Treatment

Bipolar disorder can be treated by psychotherapy and medication. Which form of therapy or medication the patient receives, will depend on the personal situation. Psychotherapy usually includes talking with a psychotherapist. This doesn’t solve problems, but helps patients to see things differently and to tackle problems themselves. There are several forms of psychotherapy:

• Cognitive behavioral therapy. In a number of sessions, people learn how they can influence the disease themselves. Thus, a patient can learn to recognize a manic or depressive episode and how to deal with it.
• Interpersonal and social rhythm therapy. In this form of therapy, patients try to create a regular daily structure for themselves. They also learn to see what circumstances in daily life affect the mood swings.
• Family-based therapy. This form of therapy is not only focused on the patient, but also on the rest of the family.

Drugs that can be used to treat bipolar disorder are lithium, antidepressants, antipsychotics and valproic acid.

Prognosis

Bipolar disorder cannot be cured, but medications and therapies may reduce the symptoms or help prevent a new episode. Whether a patient recovers, depends on what has happened. Often, relationships are ended or the patient is permanently disabled. Anyone who gets the disease at an early age, has less favorable prospects.

Considerations

For someone with bipolar disorder, stability is very important:

• Try to lead a regular life. That means: sufficient sleep at regular times, adequate and healthy diet and drink and relaxing regularly. It’s best not to deviate too much from this fixed daily rhythm.
• Beware that stress doesn’t increase too much and act in time when this is likely to happen. Set limits in here and make these clear to others.
• Be careful with alcohol and drugs. These can bring the patient out of the so important balance.

Facts

• The term ‘bipolar’, which emphasizes the bipolarity of the disease, was used for the first time in 1953 by the German psychiatrist Karl Kleist.
• Bipolar disorder was formerly called manic depression.
• The prevalence of bipolar disorder is 3%.
• Men and women are equally likely to have this disorder.