Also known as Bipolar Affective Disorder, this also is disorder of the mood of the patient. This disorder can be understood as consisting of episodes of Mania and Depression. Depression is persistent low mood or feeling of sadness as explained here in detail. Mania, on the other hand is persistent elated or expansive mood.

The common presenting symptoms of Mania are (Symptoms must persist for atleast 7 days for diagnosis):

– Distinct period of abnormally excessive happy/elated mood, or having very irritable mood. The patient may feel very happy without any apparent reason, not for minutes or hours, but for many days at length. May start abnormally laughing or smiling without any reason. May also get irritable very easily without any provocation and be ready to fight or challenge anyone, which was not his usual personality.

– Increased energy levels and doing excessive activities. When in Mania, a frail or average person may start feeling excessive energy levels. He may start doing excessive household or other works without break, which may be tiring for other normal persons. A patient may indulge in different new hobbies which is not explained by his usual personality.

– Increased talkativeness. Patients suffering from Mania, are commonly seen to speak excessively. They get so many excessive thoughts in their mind that they continuously shift from topic to topic in each sentence while speaking. It may also become difficult to stop these patients from talking. They may also get overfamiliar with unknown people and talk/speak for hours to them.

– Decreased need for Sleep. Patients suffering from Mania generally feel fresh and energetic even after sleeping for 2-3 hours or even less per day for many days.

– Delusions. Patients may develop false beliefs that they are very powerful or they possess some extraordinary abilities which are not true and sometimes even not possible. For example, a patient may start believing that he has the power to destroy any person by just a touch of his hands.

– Risk taking behaviour. Patients may start indulging in reckless driving or other risky activities as their self-confidence becomes too high. It is also seen very commonly that patients start spending excessive amount of money on things which are not required or needed. Patients may buy new new jewellery, or new property that they had no plan to buy previously.

– Distractibility. Patients in Manic phase of Bipolar Disorder are easily distracted from any work they are doing. Due to excessive thoughts and inability to concentrate properly, patients in active phase of illness may be unable to function  properly at their workplace.

HYPOMANIA – Another category of Bipolar Disorder consists of phases of Hypomania and Depression. Hypomania can be considered as milder form of Mania with less severe symptoms for lesser duration of time with lesser affect on functioning of the patient.

• ICD 11 criteria for Bipolar Disorder

WHAT SHOULD BE DONE

Consult a psychiatrist. Proper diagnosis of the disorder should be made. Hospital admission may be required in active phases of illness.

Ask about the illness and its phases in detail. Discuss the treatment options with your doctor. Do not self-medicate. Do not stop medicines without consultation with our doctor.

TREATMENT:

Treatment consists of medications which are called mood stabilizers. These medications help in preventing the Manic or Depressive phases of Bipolar Disorder to occur. Other medications may also be required in active phases of illness.

Non-pharmacological management also plays a crucial part in the treatment.

1. Psychotherapy: Cognitive-behavioral therapy (CBT) and family-focused therapy have shown efficacy in preventing relapses. These therapies help patients understand their condition, manage stress, and develop coping skills.

2. Lifestyle Modifications:

   • Good Nutrition: A balanced diet can positively impact mood stability. Consume nutrient-rich foods and stay hydrated.

• • Regular Exercise: Physical activity helps regulate mood and reduces stress. Regular exercise routines are recommended.

• • Adequate Sleep: Proper sleep hygiene is essential. Try to maintain a consistent sleep schedule.

• • Weight Management: Maintaining a healthy weight contributes to overall well-being.

3. Stress Reduction Techniques

• • Mindfulness and Relaxation: Practices like meditation, deep breathing, and progressive muscle relaxation can help manage stress.
  • Social Support: Encourage patients to connect with friends, family, or support groups. Social interactions provide emotional support.

4. Mood Charting: Patients can keep a daily record of their moods, sleep patterns, and other relevant factors. This helps identify patterns and triggers.

5. Substance Abuse Avoidance: Alcohol and drug use can exacerbate bipolar symptoms. Substance abuse treatment is crucial for effective management.