Carbonell Institute

Bipolar disorder

Bipolar disorder is a disorder in which people have mood fluctuations that alternate between periods of depression and expansive or irritable mood.

Causes of Bipolar Disorder

The exact cause is unknown, but because it occurs more frequently in relatives of people with bipolar or depressive disorders, it is believed to have a genetic basis. Bipolar disorder affects men and women equally and usually begins around age 20.

Types of Bipolar Disorder

  • People with bipolar I disorder: have had at least one full manic episode alternating with periods of depression.
  • People with bipolar II disorder: have never experienced a full manic episode. Instead, they experience periods of elevated energy and impulsivity that are not as extreme as mania (called hypomania). These periods alternate with episodes of depression.
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    Symptoms of bipolar disorder:

    Manic phase:

    A distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week. During the mood disturbance, three (or more) of the following symptoms have persisted: inflated self-esteem or grandiosity; decreased need for sleep (e.g., feeling rested after only 3 hours of sleep); increased talkativeness; flight of ideas or subjective experience of racing thoughts; distractibility; increased activity or psychomotor agitation; excessive involvement in pleasurable activities that have a high potential for serious consequences (e.g., impulsive shopping, sexual indiscretions, or reckless financial investments). In people with bipolar II disorder, the symptoms of mania are similar but less intense.

    Depressive phase:

    Presence of 5 or more of the following symptoms, including the first two: depressed mood most of the day; markedly diminished interest or pleasure in all or almost all activities; significant weight loss without dieting or weight gain; insomnia or hypersomnia nearly every day; motor agitation or retardation; fatigue or loss of energy nearly every day; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate; recurrent thoughts of death.

    Complications associated with Bipolar Disorder:

    There is an increased risk of suicide associated with bipolar disorder. Patients may abuse alcohol or other substances, which can worsen symptoms. Patients may develop gambling problems due to their impulsivity.

    Course and prognosis:

    The onset is usually abrupt and tends to become chronic. Most people with bipolar disorder experience an average of nine episodes (both manic/hypomanic and depressive) throughout their lives, although some patients, known as rapid cyclers, may have as few as four episodes per year. Medication helps control and alleviate the symptoms of bipolar disorder, especially the symptoms of manic episodes. It's important to note that the effectiveness of treatment depends on early intervention and consistent adherence to the prescribed regimen. Therefore, it's crucial to understand that even if the manic phase may seem pleasant to patients, they must continue their treatment.
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