Bipolar Disorder

Overview

What is bipolar disorder?

Bipolar disorder, also known as manic depression/manic-depressive illness, is a mental disorder that causes a noticeable shift in mood that affects a person’s day-to-day activities. The mood can change from feeling extremely energized and restless (known as the manic phase) to feeling exhausted and losing interest in activities (known as the depressive phase).

What are the types of bipolar disorder?

There are several types, but the most common ones are:

  • Bipolar I 
  • Bipolar II
  • Mixed bipolar disorder
  • cyclothymia 

The common characteristics of all types consist of emotional highs and lows. However, the critical difference between them is the severity and duration of manic episodes experienced by the patient. For example, a person with bipolar I will experience a full manic episode. In contrast, a person with bipolar II will only experience a hypomanic episode (a ‘milder version’ of a manic episode).

Is bipolar disorder curable?

Bipolar disorder is a chronic condition. However, various effective treatment options are available to help manage the symptoms, such as medications and psychotherapy. Specialty Clinic of Austin offers both medication/lifestyle management and psychotherapy.

Who is at risk?

There are a few risk factors that could contribute to the increased chance of developing the disorder. Some of the risk factors are:

  • Having a direct family member with the disorder
  • Undergoing a traumatic event that leads to a high level of stress
  • Drug/alcohol abuse

 

How does it affect daily life?

It depends on what phase the patient is in at the time. If they are in a manic/hypomanic phase, they may feel exceptionally energized and hyperactive. If they are in a depressive phase, they may feel hopeless and worthless. These symptoms are most likely to interfere with daily tasks and can either impair or enhance performance.

Are there any treatment options available in Austin, TX?

You can see a provider at Specialty Clinic of Austin who specializes in the treatment of bipolar disorder.

Causes

What causes an individual to have bipolar disorder?

There seems to be no single factor that causes the development of bipolar disorder. Instead, it is most likely that many different factors come into play. They can be categorized as:

Genetics – many studies have shown the link between bipolar disorder and genetics. For example, a person with a direct family member with bipolar disorder is more likely to develop it than someone without. This finding was shown in studies done with identical twins. If one of the twins has bipolar disorder, the likelihood of the other twin developing it increases significantly.

Environmental stressors – include going through a traumatic event like losing someone you love, growing up in an unstable home, and sexual/physical abuse.

Lifestyle – Unhealthy lifestyle could also contribute to the development of bipolar disorder. It includes excessive drinking, drug/substance abuse, and lack of sleep.

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Symptoms

What are some symptoms of bipolar disorder?

Symptoms must be clustered together during the same time. Here are some examples:

 

Mania/hypomania symptoms

  • Excessive energy
  • Euphoria
  • Increased activities
  • Restless
  • Racing thoughts
  • Talking more than usual
  • Increased self-esteem
  • Making poor decisions, such as making high-risk investments, spending a lot of money, and dangerous behaviors.

 

Depressive episode symptoms

  • Feeling hopeless, sad, depressed
  • Noticeably increased or decreased amount of sleep
  • Fatigue
  • Significant weight loss
  • Suicide attempt or suicide ideation

 

Mixed episode symptoms 

  • Experiencing the symptoms of mania and depression at the same time, for example, crying uncontrollably yet feeling extremely happy.
  • The symptoms can also switch back and forth. For example, feeling ecstatic and great at one point, then feeling miserable and overwhelmed the next.

 

Diagnosis

How to diagnose bipolar disorder?

Clinicians diagnose patients with an appropriate bipolar disorder type based on the symptoms listed on DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition). Bipolar I and II may look the same due to similar symptoms but are separate diagnoses.

Bipolar disorder requires a clinical diagnosis, such as a rating scale (questionnaire) completed by the patient. No lab testing is needed. Here are some general guidelines on how to diagnose each of the common types of bipolar disorder.

Bipolar I

  • To be diagnosed with bipolar I, an individual must experience one full manic episode and one depressive episode for at least one week, almost every day.
  • The symptoms are severe enough to cause obvious impairment in daily tasks and even require hospitalization.

Bipolar II

  • Same features as bipolar I, but no full mania (aka. hypomania).

Cyclothymia

  • To be diagnosed with cyclothymia, an individual must experience a less severe form of hypomania and depressive symptoms for at least two years (1 year in children/adolescents).
  • The symptoms were presented for at least half the time during those two years (in adults) and one year (in children/adolescents).

Treatment 

What treatment options are available for bipolar disorder?

Bipolar disorder is commonly treated with mood stabilizers and/or atypical antipsychotics. Along with the use of these medications, clinicians may also help you with lifestyle modification for a healthier diet, hygiene, getting enough sleep, and exercise. Psychotherapy, also known as talk therapy, is another effective treatment option for bipolar disorder. The duration of psychotherapy can be short-term (a few sessions that deal with immediate issues that are causing emotional distress) or long-term (deals with more complicated problems, sessions can last months).

What is a mood stabilizer?

Mood stabilizers are medications that aid in treating and managing intense mood shifts. They serve as a great tool for treating the symptoms of bipolar disorder. The providers at Specialty Clinic of Austin can prescribe lithium, lamotrigine, Tegretol, and more.

What is an antipsychotic?

Antipsychotics, also known as neuroleptics, are a set of medications that treat psychotic symptoms like delusions (false belief) and hallucinations (seeing, hearing things that are not there). Although psychosis is predominantly seen in schizophrenia, patients with bipolar disorder may still experience it during intense manic episodes. Specialty Clinic of Austin can offer several antipsychotics as well, such as Abilify, Rexulti, Latuda, Seroquel, and more.

Will there be any side effects?

It is possible that some may experience side effects from these medications, just like most other medications. The symptoms can depend on what type of medication they are on.

For example, some of the side effects of mood stabilizers may be nausea, vomiting, excessive thirst, frequent urination, loss of appetite, and sedation.

Side effects of antipsychotics may include tremors, involuntary movements, weight gain, dry mouth, and sore throat.

Sources

Information

Medically reviewed by:

Charles Sweet, MD, MPH

Dr. Sweet is a native Texan and attended The University of Texas at Austin for undergraduate studies. He earned his Doctor of Medicine and Master of Public Health degrees at the University of Illinois and then did residency training at the prestigious Johns Hopkins Hospital, Dr. Sweet came back to Austin, TX for specialized training in Child and Adolescent Psychiatry and has been in practice since 2009.

Dr. Sweet believes strongly in working with, and training Physician Assistants to treat the behavioral health needs of adults, children and adolescents.

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