Bipolar Disorder

 Definition

          The recurrent episode of mania or depression symptoms are referred as unipolar disorder.

          In other word the episodes of unusual shift in mood from one end of behavioural continuum to another.

          It’s a kind of expression of alternating intense emotional behaviour.

 

Introduction

          The bipolar disorder, a psychological disorder, also known as Manic-depressive disorder. In this mental condition the          unusual shift of mood occurs from depressive to manic or vice versa within short period of time.                                     The alternative mood swings seriously affect psychophysiological functions. Along with mood the energy & activity level also change.                                 It is typically accompanied by    serious impairment in work and social functioning.

 

Types of BPD

BPD is mainly of three types

(i)       Bipolar I (appearance of at least one manic episode)

(ii)      Bipolar II (At least one major depressive episode at least for two weeks. They also have at least one hypomanic episode that lasts about 4 days)

(iii)     Cyclothymia (The episodes of hypomania and depression are shorter and less severe than the mania and depression caused by bipolar I or bipolar II disorder).

 

Diagnostic Criterion

Manic Episodes

(i)       A span of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week and present most of the day, nearly every day.

(ii)      During the period of mood disturbance three (or more) of the following symptoms should be present: -

Ø  Inflated self-esteem or grandiosity.

Ø  Decreased need for sleep.

Ø  More talkative than usual.

Ø  Flight of ideas or racing thoughts.

Ø  Distractibility.

Ø  Excessive involvement in activities

Ø  that have a high potential for painful consequences

Ø  The mood disturbance is sufficiently severe to cause marked impairment in daily life.

Diagnostic Criterion

Depressive Episodes

          Five (or more) of the following symptoms have been present during the same 2-week period (most of the day, nearly every day): -

Ø  Depressed mood (e.g., feels sad, empty, or hopeless).

Ø  Diminished interest or pleasure in almost all activities.

Ø  Significant weight loss or weight gain (e.g., a change of more than 5% of body weight in a month).

Ø  Insomnia or hypersomnia nearly every day.

Ø  Fatigue or loss of energy nearly every day.

Ø  Feelings of worthlessness or excessive or inappropriate guilt.

Ø  Diminished ability to think or concentrate, or indecisiveness.

Ø  Recurrent thoughts of death and recurrent suicidal ideation.

Characteristics of BPD

(i)       The mean age at which BPD shows its symptoms is 25 years.

(ii)      The depressive episodes last for at least for 2 weeks.

(iii)     The mania (due to BPD) also lasts for days together and can go up to several weeks.

(iv)     Disbalance of psychophysiological energy.

(v)      Mood swing is common thread of BPD.

(vi)     Noticeable departure from normal behaviour.

(vii)    Genetics, environmental factors (stress & traumatic experience) and some disturbance in brain structure are major causes.

 

Functional Consequences of BPD

          BPD ensues following psycho-physical consequences in the patient.

(i)       It impairs the individual's capacity to do things quickly and efficiently.

(ii)      The mood swings lead to difficulty in concentrating, sleep, decision making, judgment and rational thought process.

(iii)     Leads to psychological fatigue due to excessive use of cognitive resources in mood swings.

(iv)     Engaging in a behaviour that may lead to negative consequences (drug use, too much spending).

Management of BPD

          The appropriate Medication and Behavioural therapy jointly can cure this mental illness.

(i)       Cognitive Behaviour Therapy (modification of maladaptive cognitions).

(ii)      Medications (Such as antidepressants).

(iii)     Yoga (NYU Grossman School of Medicine).

(iv)     Relaxation techniques (breathing exercises, relaxation strategies, and meditation practice).

(v)      Combination of Psychotherapy, medications, and relaxation techniques.

 

References:

1.       Coleman, C. J. (1988). Abnormal psychology and modern life. Bombay, India: D. B. Taraporevala Sons & Co.

2.       Generalized anxiety and generalized anxiety disorder: description and reconceptualization. (1986). American Journal of Psychiatry, 143(1), 40–44. doi:10.1176/ajp.143.1.40

3.       NCERT. (XII). Psychology Book.

4.       DSM V Manual. Published by APA.

5.       https://www.nimh.nih.gov/health/topics/ bipolar-disorder/index.shtml.

 

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