Bipolar mood disorder, also known as manic-depressive psychosis
(MDP), is a type of mood disorder characterised by mood swings.
Many people experience normal mood swings from "Monday morning
blues " to mild euphoria.
In bipolar mood disorder, there are swings from extreme depression
to great elation or mania and hyperactivity, occasionally at times
losing touch with reality. However, there are also long periods of
complete normality. Manic depressives suffer from an extreme of
mood change over a more prolonged period and are regarded as being
clinically ill during these attacks. A doctor or psychiatrist will
look at whether an attack of mania is accompanied by depression
before diagnosing bipolar mood disorder.
Bipolar mood disorder typically begins in adolescence or early
adulthood and continues throughout life. It is often not recognised
as an illness and people who have it may suffer needlessly for
years or even decades.
Causes
Much research is being carried out as to the causes of bipolar mood
disorder but there are no definite conclusions yet. There may be a
genetic predisposition to the illness such that other family
members may also suffer from this illness. It could also be
triggered by major stress events or hormonal changes such as those
occurring after childbirth. It may also be due to a chemical
imbalance affecting that area of the brain responsible for "moods",
thus causing changes in feelings and behaviour.
Symptoms
1. Depression
depressed or in low mood
a loss of interest and enjoyment in life
a lack of drive and motivation that makes even simple tasks and
decisions difficult or impossible
utter fatigue
agitation and restlessness
loss of appetite with loss of weight
insomnia
loss of outward affection, loss of interest in sex
loss of self-confidence, avoiding people
feeling useless, inadequate, bad, helpless and hopeless
feelings of guilt, worthlessness and helplessness
feeling worse at a particular time of day, usually mornings
suicidal thoughts; these are very common in depression and they are
signs that help is needed.
2. Mania & Hypomania
elated mood
increased activity & energy
inability or unwillingness
to sleep
rapid speech, flow of ideas & thoughts
inflated self-esteem
irritability & impatience
increased sexual drive & lack of sexual inhibitions
loss of judgment & impulsive decision making
irrational spending of money & involvement in questionable
endeavors
grandiose delusions
An early sign of bipolar mood disorder may be hypomania. This is a
state in which the person shows a high level of energy, excessive
moodiness or irritability, and impulsive or reckless behaviour.
Hypomania may feel good to the person who experiences this and the
sufferer seldom thinks that anything is wrong and may object quite
violently if anyone tries to point this out to him or her.
With experience, it is possible for some people to recognise their
condition but often in an extreme state, all understanding is lost.
It is not unusual for someone suffering an attack to break the law
perhaps during a flight of fancy, about of excessive spending,
committing a fraud, or fortunately, very rarely, of committing a
physical assault.
3. Mixed States
A few people sometimes experience a combination of symptoms from
both mania and depression. For example, a high level of activity
may be combined with a low level of concentration and a depressed
attitude towards life. This can lead to an increased risk of
suicide attempt.
Mood swings in many cases (60-80%) can be controlled or reduced by
medications such as mood stabilisers. The most frequently used
medication is lithium carbonate. This requires careful monitoring
with regular blood tests to check for effective levels.
Treatment
Lithium can keep mood swings within socially and individually
acceptable levels and can stave off the worst of the attacks. The
treatment can allow the person to lead a normal and useful life.
Unfortunately for a minority of sufferers, this treatment either
has little significant effect or for an even smaller minority, has
unacceptable side effects. Some of the side effects of lithium
carbonate are:
frequent urination and thirst
hand tremors
skin rashes
Other mood stabilisers include anti-convulsants such as
carbamazepine and sodium valproate. At times other drugs are also
used to treat either the depression or the mania. Sometimes, more
than one drug is required. These drugs include antidepressants,
antipsychotics and benzodiazepines. For every drug, there is a
"side effect". These drugs are used only to hasten a return to
normality and it is seldom that they have to be continuously
given
Another treatment sometimes used in cases of severe depression and
occasionally mania is Electro-Convulsive Therapy (ECT). When
administered, the patient is given a muscle relaxant and a short
acting general anaesthetic. A strictly controlled electrical
current is passed across the brain from electrodes placed against
the head. There may be a loss of memory for the period of the
treatment but there is no evidence of long-term effects on memory.
Generally severe depression can be successfully improved by
ECT.
