Bipolar Disorder: Causes, Symptoms, Treatments

This mood disorder is characterized by alternating episodes of depression and manic episodes (periods of euphoria, high energy). Usually, the manic period occurs just before or right after the depressive period. These periods can last a week or more.

Between these two phases, the mood is "normal" for more or less time, up to ten years. In other cases, the manic or mild manic episodes (hypomania) and depression follow one another more quickly.

If a person goes through four or more episodes in a year, these are called rapid cycles. These may be contiguous episodes (a constant alternation of depression and mania/hypomania) or isolated episodes with a symptom-free interval. Episodes can last for days (sometimes) or weeks (usually). In some cases, the mood may change on the same day.

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Bipolarity can take three forms.

• Bipolar disorder type 1. Characterized by manic, depressive, and mixed periods.

• Bipolar disorder type 2. At least 1 hypomanic episode in addition to sadness.

• Cyclothymic disorder. A series of mild manic (hypomanic) episodes occur, interrupted by episodes of milder depression and phases of exhaustion.

How Common is Bipolar Disorder?

Bipolar disorder occurs in about 1 to 2% of the population (other sources speak of 5 to 6%) and as often in men as in women. The risk increases markedly with a family history.

The disease almost always begins between the ages of 15 and 35, but it can also start later. It persists throughout existence.

What are the Causes?

The exact cause of the bipolar disorder is not yet known. We know that it is based on a combination of several factors, probably with a genetic predisposition. Psychological, biological, and social elements can trigger it.

• Genetic Predisposition

There is a family hereditary predisposition or vulnerability to the development of the bipolar disorder. More than two-thirds of patients have at least one close family member with a mood disorder. People with a first-degree relative (father, mother, brother, sister) who have bipolar disorder are more at risk of developing it in turn.

The risk that children of a parent with bipolar disorder would suffer from it would be around 20%. If both father and mother have bipolar disorder, the chance of the children developing the disorder can be as high as 50%. In monozygotic twins, this risk can reach 70%. The link to the disease in second-degree relatives is not clear.

Different genes seem to play a role independently of each other. A DNA test is, therefore, unnecessary at this stage. Much research is underway on this subject.

• Physiological or Biochemical Factors

In bipolar patients, changes in some parts of the brain have been shown. The balance of chemicals responsible for signal transfer in the brain, such as dopamine, norepinephrine, and serotonin, is disturbed. Another day-night rhythm has also been observed in people with bipolar disorder.

Physical disorders can sometimes also play a role, such as a thyroid disease, an accident, a brain injury.

• Psychological Factors

Personality and character determine the management of stress, loss, or traumatic experiences. These factors include difficulty solving problems, a lack of self-confidence, and a tendency towards perfectionism. The risk of developing bipolar disorder is also higher in people with recurrent depression, and women who have experienced postpartum depression.

According to psychoanalytic theories, during the child's upbringing, a love-hate relationship can develop between the child and the mother/father when the child becomes independent. The child is asked to obey, even if it comes to the detriment of his needs and desires. The child wants to meet his parents' expectations, but at the same time, he is angry with their demands. Bipolar disorder could refer to the disturbing development of the ego.

• Social Factors

Events can cause depression or mania in certain sensitive people: divorce, financial difficulties, the birth of a child, death of a loved one, problems at work, intense love, neglect, or abuse during childhood. ..

What are the Symptoms?

The presentation of bipolar illness can vary greatly from person to person. A typical symptom is the alternation and recurrence of mood episodes. Between these phases, there are usually periods without symptoms, during which everything seems normal.

Bipolar disorder, depending on the severity and duration of the episodes, affects many areas of life. Severe episodes can cause temporary or long-term breaks with school or work. The entourage, parents, spouse, friends ..., can be under pressure because of the disorder. The disease's variable nature often makes it difficult to know how to approach a person with bipolar disorder. External help must be requested. During stable periods, find the

What Treatment?

Bipolar disorder is a serious mental illness, and professional help from a psychiatrist is essential. Treatment should address both manic and depressive episodes, as well as mixed episodes with rapid mood changes. It is also important that new episodes are avoided.

There is no cure for bipolar disorder, but most patients can hope to control their mood swings and related symptoms.

The treatment of bipolar disorder consists of 3 phases.

• Phase 1

At first, the drugs are aimed at alleviating manic and depressive symptoms. Temporary admission to a hospital is often required. This first phase of treatment lasts a few weeks.

• Phase 2

It consists of allowing people to continue living as normally as possible.

• Phase 3

It is the maintenance treatment to ensure that the mood remains stable and to prevent relapses. This treatment usually lasts several years or even lifelong.

The most effective treatment for bipolar disorder is a combination of medication, psychotherapy, and psychoeducation.

Medication

Usually, several drugs are combined. With drugs such as lithium, regular blood tests are needed.

• Mood stabilizers are used to prevent episodes. Lithium is the most commonly used agent. Other agents may also be prescribed.

• Antipsychotics are used for the cure of mania.

• Antidepressants are used to treat depression. But there is a risk of hypomania.

• In addition to these substances, anxiolytics, and sedatives are also used.

Psychotherapy

She learns to deal with emotions and conflicts, tackling additional aspects, such as anxiety and drug addiction.

Psychoeducation

It is essential that the patient and family members better understand the disease, the risk factors that trigger a mood, the first signs of a new episode, and learn to deal with it.