Bipolar disorder – A roller coaster of moods

Bipolar disorder, also called manic depression, is a disease that causes sometimes brutal mood changes in affected individuals. The person may exhibit periods of depression followed by periods of euphoria or irritability, for no apparent reason and without any drug or alcohol use involved. Bipolar disorder is a cyclical disease: manic episodes follow depressive episodes at intervals that vary widely from one person to the next, and the episodes may or may not be separated by periods of “normal” mood.

It’s perfectly normal to have happy days and down days. It’s reasonable to feel exuberant when we get a series of good news, and to feel depressed when circumstances seem to conspire against us. And while moods can vary, we can usually control them or at least overcome them on our own.

Bipolar disorder, also called manic depression, is a disease that causes sometimes brutal mood changes in affected individuals. The person may exhibit periods of depression followed by periods of euphoria or irritability, for no apparent reason and without any drug or alcohol use involved. Bipolar disorder is a cyclical disease: manic episodes follow depressive episodes at intervals that vary widely from one person to the next, and the episodes may or may not be separated by periods of “normal” mood. The depressive episodes are generally more frequent and longer-lasting that the manic episodes. Bipolar disorder can present along a wide spectrum of symptom intensity, ranging from mild to severe.

It is estimated that 1.5 percent of the population is affected by bipolar disorder and that it strikes equally among men and women. It commonly manifests in late adolescence or early adulthood. If it remains untreated, it can lead to serious emotional problems, as well as to legal and financial difficulties that can impact several spheres of life. Symptoms of bipolar disorder can result in depleted social relationships, poor performance in school or work, and even suicide. However, persons suffering from this disease can get treated and then lead a full life highlighted by various successes. This is why it is important to get help early in order to avoid sinking into a downward spiral.

Manic episodes Manic episodes often appear suddenly and last at least a week, during which time affected individuals may express grandiose ideas or great irritability, among other behaviours, sleep and/or eat less and be more active than usual. For example, these individuals may begin shopping compulsively or investing all their savings in ill-conceived business ventures. Symptoms of mania include:
- feelings of euphoria, extreme optimism and exaggerated self-esteem,
- rapid speech and racing thoughts,
- a lesser need for sleep,
- extreme irritability,
- impulsive and agitated behaviour,
- diminished judgment.

Depressive episodes Depressive episodes usually last much longer than manic episodes. During these periods, affected individuals are more likely to ask for help. This is why many bipolar disorder sufferers are initially diagnosed with depression. When experiencing a depressive episode, they may show:
- sadness, anxiety, guilt and irritability,
- hopelessness,
- sleep disturbances,
- eating disorders,
- fatigue,
- suicidal thoughts or behaviours,
- a loss of interest in everyday activities,
- problems concentrating.

Cause The exact cause of bipolar disorder is unknown. It is thought to be a complex genetic disorder affected by environmental factors and caused by a wide range of biological abnormalities. Among other things, we know that children who have a parent or sibling with the disease are four to six times more likely to also develop it. Environmental factors that could contribute to triggering the disease include stressful events, low self-esteem, alcohol or drug use, and changes in the sleep/wake cycle.

Prevention There is no sure way to prevent bipolar disorder. Initiating treatment as soon as symptoms appear, however, can stop the condition from worsening.

Diagnosis Bipolar disorder is not easy to diagnose. Symptoms may be perceived as isolated problems and not be recognized as being part of an overall condition. Some people may therefore suffer from the disease for years before they are correctly diagnosed and receive the appropriate treatment. As with diabetes and other chronic diseases, bipolar disorder is a chronic condition that must be carefully managed throughout one’s life. In cases where physicians suspect that patients may have bipolar disorder, they usually have them undergo a series of medical and psychological tests in order to eliminate other possible problems, determine the diagnosis and identify any complications.

Treatment Bipolar disorder is not yet curable. It is a chronic disease that requires long-term treatment in order to reduce the episode frequency and gravity, and to lead a balanced and enjoyable life. Treatment must be continued even during “normal” periods; otherwise the person could have a greater risk of relapse or of having a minor episode turn into full-blown mania or depression.

Psychiatric care is usually the cornerstone of treatment, although other healthcare professionals (such as psychologists and social workers) can also provide support for persons affected, depending on their needs. Medication and psychotherapy are often used together to control symptoms.

Various types of medication (e.g. mood stabilizers, antidepressants) are used to treat bipolar disorder. Drug therapy does not act rapidly; improvements may not be noticed for a few weeks. Treatment is tailored to the patient’s specific needs, and it is sometimes necessary to try several different drugs before finding the one that works best.

As with any medication, the drugs used to treat bipolar disorder can sometimes have adverse effects. Most of these reactions appear early in the treatment and disappear over time, while some develop a little bit later in the treatment. It is very important to let your doctor or pharmacist know if you experience an adverse effect or if you have any concerns. They will be able to tell you whether the reaction is a result of the medication, give you tips for alleviating the effect, or change the drug treatment if necessary. Never abruptly stop taking any prescribed medication without first discussing the matter with your physician.

What should you do if you suspect you suffer from bipolar disorder? If you exhibit symptoms of bipolar disorder, see a doctor as soon as possible. The disease cannot be treated without medical help and it does not disappear on its own. If you are having suicidal thoughts of a concrete or immediate nature, go to the hospital emergency department or speak to someone you trust.

How can you help someone who has bipolar disorder? Often, people suffering from bipolar disorder do not ask for the help they need, mainly because their symptoms prevent them from recognizing how serious their condition is. If you are worried about a loved one, discuss the matter openly with that person. You can’t force someone to get help, but you can offer your support and encouragement to help that individual find a healthcare professional. If you fear that your loved one could commit suicide, drive him or her to the emergency or call emergency services. Friends and family members can also help support the affected individual by learning more about bipolar disorder and therefore helping dispel misconceptions. There are support groups for persons with bipolar disorder, and also for their loved ones.

Questions or concerns? Don’t hesitate to speak to your pharmacist!