What does bipolarism mean? And how to recognize who suffers from this mental disorder? Here’s what you need to know when it comes to bipolarism and mood disorders.
graphic illustration of bipolar disorder / Itl.cat
What does it mean that a person is bipolar? And how to recognize who suffers from this type of disorder? After the case of the Nigerian peddler Alika Ogorchukwu killed on the street in Civitanova Marche since 32 year old Filippo Ferlazzo from SalernoAnd the terrible story of Giacomo Seydou Sygrandson of the famous actor Kim Rossi Stuart, many are wondering what bipolarism is and what it really means when it comes to bipolar disorder, a psychiatric syndrome classified as a mood disorder and characterized by episodes of mania and depression, which can alternate, although many patients have a predominance towards one or the other condition. This disorder, formerly also referred to as manic depressive syndrome or bipolar depression, is in fact characterized from abnormal mood swings, but also the energy and the level of activity carried out during the day. As explained by the experts, it is a particularly complex psychiatric pathology as well as one of the mental disorders with the highest inheritance rate, characterized by a chronic course with onset that generally occurs during adolescence or around 20-30 years. The prevalence of this disorder, second estimates from the National Institute of Mental Health (NIMH), the Federal Agency for Mental Disorders Research of the National Institutes of Health (NIH) of the United States, it is equal to 2.8% in the last year, although the data shows that approximately 4.4% of US adults have suffered from bipolar episodes at some point in their lives. To date, the exact cause of this disorder has not been fully understood but, as mentioned, some hereditary factors may play an important role, as well as the level of changes in the level of neurotransmitters and psychosocial factors.
What is bipolar disorder
As stated, bipolarism it is a mental disorder which causes unusual changes in mood, energy, activity levels and concentration, with repercussions on the performance of daily activities. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), the taxonomic and diagnostic tool published by the American Psychiatric Association, the specific chapter of bipolar disorders classifies the pathology in different forms of disorder, including:
- bipolar I disorder, defined by the presence of at least one manic episode (i.e., interrupting normal social and professional function) and usually depressive episodes. The incidence is about the same in men and women;
- bipolar II disorderdefined by the presence of major depressive episodes with at least one hypomanic episode, but not true manic episodes. The incidence of this condition is slightly higher in women.
Bipolar disorders are also called cyclothymic disorder (also called cyclothymia and characterized by hypomanic and mini-depressive periods lasting only a few days, followed by a fluctuating and less severe course than bipolar disorder), the drug-induced bipolar disorder (such as some antidepressants), drugs (cocaine and amphetamines) and alcohol, and the bipolar disorder not otherwise specifiedcharacterized by obvious bipolar characteristics that do not meet the specific criteria for one of the other bipolar disorders.
How to recognize bipolar disorder
People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns, activity levels, and unusual behaviors, often without recognizing the likely harmful or unwanted effects. In medical jargon, these distinct periods they are called “mood episodes” and they are very different from the moods and typical behaviors of the person. During an episode, symptoms persist for most of the day and they can also last for longer periods, such as several days or weeks.
Bipolar disorder, they explain the MSD manuals, begins with an acute phase of symptoms, followed by a repetition of remissions and relapses. Remissions are often complete, but many patients have residual symptoms, and for some, the ability to work is severely impaired. Relapses are distinct episodes of more intense symptoms, which can be manic, depressive, hypomanic, or a mixture of depressive and manic characteristics. Such episodes last from a few weeks to 3-6 months, and depressive episodes are generally longer than manic or hypomanic episodes. The duration of the cycles (i.e. the time between the onset of one episode and the onset of the next) varies from patient to patient: some have frequent episodes, others only a few in the course of life, while others still have forms of disorder with rapid cycles (usually defined as 4 or more episodes per year). Only a minority of patients alternates between mania and depression with each cyclewhile in most cases, episodes of mania or depression predominate one over the other.
Both stages can be very dangerous: in the depressive phases the greatest danger is associated with suicidal behaviors, as evidenced by the lifetime suicide incidence of patients suffering from this disorder, estimated to be at least 15 times higher than that of the general population. In the manic phases, where the mood often leads to the refusal of therapies, the bipolar patient can engage in risky behaviors (such as driving hard, abusing substances, engaging in uninhibited sexual behavior, endangering oneself and others. Hypomanic episodes are a less extreme form of mania, which include a distinct episode lasting 4 days or more with distinctly different behavior from usual and three or more symptoms of mania, such as hypertrophic self-esteem or grandiosity, reduced need for sleep, more talkativeness than usual, accelerated retirement, distractibility and over-involvement in activities with a high potential for negative consequences.
Diagnosis and treatment of bipolar disorder
The diagnosis of bipolar disorder is based on identifying symptoms, plus a history of remission and relapse. Treatment of the disorder is based on drug therapies based on mood stabilizers (e.g. lithium and some anticonvulsants, particularly valproate, carbamazepine and lamotrigine) alone or in combination with a second generation antipsychotic (e.g. aripiprazole, lurasidone, olanzapine, quetiapine, risperidone, ziprasidone, cariprazine), as well as support and psychotherapy.
The treatment takes place usually in three stagesacute (to stabilize and control initial manifestations), continuation (to achieve complete remission), and maintenance and prevention for the management of patients in remission.
The choice of drug therapy for bipolar disorder it can be complex, because all drugs have significant adverse effects, drug interactions are frequent, and no drug is universally effective. The selection must therefore be based on what has already been effective and well tolerated in a given patient. Other treatments include electroconvulsive therapy, transcranial magnetic stimulation and phototherapy, sometimes used in the treatment of depressive symptoms and effective, in the case of electroconvulsive therapy, also on mania.
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What do we mean when we say that a person is bipolar
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