By: Bhavya Appannagaari
What is bipolar disorder?
Bipolar disorder is a mental health condition that includes emotional highs and lows, such as abnormal changes in happiness or depression. These emotional fluctuations can affect sleep, energy, and physical activity, these mood swings may appear rarely or multiple times a year (Mayo Clinic, 2022). Bipolar disorder has genetic predispositions; the majority of individuals with bipolar disorder have relatives with those conditions. Lack of sleep, stress, and drugs may trigger bipolar episodes. It is believed that discrepancies in brain chemicals lead to dysregulated brain activity. The average age of onset of bipolar disorder is 25 years old (American Psychiatric Association, 2021).
What is required according to the DSM V for someone to be diagnosed with bipolar disorder?
In order to be diagnosed with bipolar disorder, the DSM V states that at least one episode of hypomania or mania must take place. The individual may also experience a depressive episode. Mania is characterized by an irritable and elevated mood and must last at least a week for the majority of days. Hypomania is characterized by the same mood but must last at least four consecutive days, for the majority of the day.
A mood is characterized by three or more symptoms characterized by a significant change from an individual’s usual behavior:
Symptoms of mania are:
- Abnormally high self-esteem
- Decreased need for sleep
- Over talking
- Rapid thoughts
- Easily distracted
- Increase in goal-directed activity or psychomotor agitation
- Engaging in activities that hold the potential for painful consequences
Symptoms of a depressive episode are:
- Depressed mood most of the day
- Loss of interest in activities
- Significant weight loss or little to no appetite
- Feeling worthless
- Diminished ability to concentrate
How is bipolar disorder diagnosed?
In order to diagnose bipolar disorder, a doctor performs a physical exam, conducts blood tests, and asks about symptoms to rule out other diseases. If no other diseases are found, then a psychological evaluation is performed to determine if the individual has bipolar disorder or not (Langone Health, n.d.).
A psychological evaluation may include:
- Physical exam: a physician performs an exam to identify any medical problems present
- Psychiatric assessment: the physician will do an assessment and have the individual fill out a psychological self-assessment or questionnaire
- Mood charting: keeping daily records of mood and sleep patterns
- Criteria for bipolar disorder: compare symptoms in the DSM-V to see if the symptoms an individual is experiencing meets the criteria for a diagnosis of bipolar disorder.
(Mayo Clinic, 2022)
How can bipolar disorder affect someone with epilepsy?
People with mood disorders such as bipolar disorder are more likely to experience seizures. According to the article, Bipolar disorder and epilepsy: a bidirectional relation? Neurobiological underpinnings, current hypotheses, and future research directions, biochemical, structural, and functional abnormalities in primary bipolar disorder could also occur secondary to seizures. The challenges that people with bipolar disorder and epilepsy face is while there is a great deal of focus and information on depression, there is a lack of information on bipolar depression, and very little information about mania (Mazza et. al, 2007).
According to Mayo Clinic, the following treatment options for bipolar disorder are:
Medication: mood stabilizers, antipsychotics, antidepressants, antidepressant-antipsychotics, and antianxiety medications are used.
Interpersonal and social rhythm therapy (IPSRT)- establishing a consistent routine for better mood management.
Cognitive behavioral therapy (CBT)- helps to identify triggers and learn coping strategies to deal with them.
Psychoeducation- educating oneself about bipolar disorder to help understand the condition, get support, and make plan to comply with treatment
Family-focused therapy- family support/communication to help individual stick to and comply with treatment.
(Mayo Clinic, 2022)
Risk factors of having bipolar disorder
One risk factor for having bipolar disorder is having a parent or sibling who has bipolar disorder. Symptoms can emerge during teenage years; the average onset is twenty-five years of age. People with traumatic events in their past are at higher risk for developing bipolar disorder. Childhood events such as abuse, neglect, or the death of a parent can increase that risk. Highly stressful events such as losing a job, or a severe lack of sleep can increase the risk of a manic episode. People that have bipolar disorder have a tendency to self-medicate. Substance abuse does not cause bipolar disorder, but it can worsen manic symptoms. Bipolar disorder affects men and women equally, but women are more likely to experience rapid mood episodes, as well as more likely to experience depression and mixed bipolar disorder, compared to men (Smith, 2021).
Bipolar disorder is a mental health condition that essentially involves highs and lows, characterized by manic and depressive episodes. Some symptoms of bipolar disorder include irritation, elevated mood, as well as lack of motivation or pleasure in activities. Bipolar disorder can be diagnosed through physical examination as well as psychiatric evaluation. Medication and psychotherapy are options to treat bipolar disorder. People with bipolar disorder are more likely to experience epileptic seizures.
Mayo Clinic (2022). Bipolar disorder, diagnosis & treatment. Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961
Mazza, M., Di Nicola, M., Della Marca, G., Janiri, L., Bria, P., & Mazza, S. (2007). Bipolar disorder and epilepsy: a bidirectional relation? Neurobiological underpinnings, current hypotheses, and future research directions. The Neuroscientist: a review journal bringing neurobiology, neurology and psychiatry, 13(4), 392–404. https://doi.org/10.1177/10738584070130041101
NYU Langone Health (n.d.). Diagnosing Bipolar Disorder. NYU Langone Health. Retrieved from: https://nyulangone.org/conditions/bipolar-disorder/diagnosis
Smith, K. (2021). Bipolar Disorder Causes. Psycom. Retrieved from: https://www.psycom.net/bipolar-disorder-causes
Truschel, J. (2020). Bipolar Definition and DSM-5 Diagnostic Criteria. Psycom. Retrieved from: https://www.psycom.net/bipolar-definition-dsm-5