Everybody have their ups and downs, but, with Bipolar disorder, these peaks and valleys are severe and troublesome. The symptoms of bipolar disorder can result in one losing one’s job, deteriorate performance at school, damage relationships, and disrupt individual’s daily life. The symptoms vary widely in their pattern, severity, and frequency.

abeer naseemBipolar disorder (also known as manic depression) causes serious shifts in mood, energy, thinking, and behavior–from the highs of mania on one extreme, to the lows of depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with one’s ability to function.

There are four types of mood episodes in bipolar disorder: mania, hypomania, depression, and mixed episodes.

  • During a manic episode, a person might impulsively quit a job, spend huge amounts on credit cards, or feel rested after sleeping for only two hours. During a depressive episode, the same person might be too tired to get out of bed and full of self-loathing and hopelessness over being unemployed and in debt.
  • Hypomania is a less severe form of mania. People in a hypomanic state feel euphoric, energetic, and productive, but they are usually able to carry on with their day-to-day lives. However new research has shown that people in hypomanic stages can also suffer from psychosis. Hypomania can result in bad decisions that harm relationships, careers, and reputations.
  • Bipolar depression is more likely to involve irritability, guilt, unpredictable mood swings, and feelings of restlessness. People with bipolar depression also tend to move and speak slowly, sleep a lot, and gain weight. In addition, they are more likely to develop psychotic depression–a condition in which they’ve lost contact with reality. Most people with bipolar depression are not helped by antidepressants. The depressive phase of bipolar disorder is often very severe, and suicide is a major risk factor. In fact, people suffering from bipolar disorder are more likely to attempt suicide than those suffering from regular depression. 
  • A mixed episode of bipolar disorder features symptoms of both mania or hypomania and depression. Common signs of a mixed episode include depression combined with agitation, irritability, anxiety, insomnia, distractibility, and racing thoughts. This combination of high energy and low mood makes for a particularly high risk of suicide.  

Causes of Bipolar disorder

  • Genetics: It appears that certain people are genetically predisposed to bipolar disorder. Yet not everyone with an inherited vulnerability develops the illness, indicating that genes are not the only cause. 
  • Physiological reasons: Other research points to neurotransmitter imbalances, abnormal thyroid function, circadian rhythm disturbances, and high levels of the stress hormone cortisol. 
  • External environmental and psychological factors: These are also believed to be involved in the development of bipolar disorder. These external factors are called triggers.
  • Stress: Stressful life events can trigger bipolar disorder in someone with a genetic vulnerability. These events tend to involve drastic or sudden changes–either good or bad–such as getting married, going away to college, losing a loved one, getting fired, or moving.
  • Substance Abuse: While substance abuse doesn’t cause bipolar disorder, it can bring on an episode and worsen the course of the disease. Drugs such as cocaine, ecstasy, and amphetamines can trigger mania, while alcohol and tranquilizers can trigger depression.
  • Medication: Certain medications, most notably antidepressant drugs, can trigger mania. Other drugs that can cause mania include over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid medication.
  • Seasonal Changes: Episodes of mania and depression often follow a seasonal pattern. Manic episodes are more common during the summer and depressive episodes more common during the fall, winter, and spring.
  • Sleep Deprivation: Loss of sleep—even as little as skipping a few hours of rest—can trigger an episode of mania.

Three types of therapy are especially helpful in the treatment of bipolar disorder:

Cognitive-behavioral therapy 

In cognitive-behavioral therapy, one is taught to examine how thoughts affect one’s emotions. One can learn how to change negative thinking patterns and behaviors into more positive ways of responding. For bipolar disorder, the focus is on managing symptoms, avoiding triggers for relapse, and problem-solving.

Interpersonal and social rhythm therapy

Interpersonal therapy focuses on current relationship issues and helps individuals improve the way they relate to the important people in life. By addressing and solving interpersonal problems, this type of therapy reduces stress in one’s life. Since stress is a trigger for bipolar disorder, this relationship-oriented approach can help reduce mood cycling.

For bipolar disorder, interpersonal therapy is often combined with social rhythm therapy. People with bipolar disorder are believed to have overly sensitive biological clocks, the internal timekeepers that regulate circadian rhythms. Social rhythm therapy focuses on stabilizing social rhythms such as sleeping, eating, and exercising. When these rhythms are stable, the biological rhythms that regulate mood remain stable too.

Family-focused therapy

Living with a person who has bipolar disorder can be difficult, causing strain in family and marital relationships. Family-focused therapy addresses these issues and works to restore a healthy and supportive home environment. Educating family members about the disease and how to cope with its symptoms is a major component of the treatment. Working through problems in the home and improving communication is also a focus of the treatment.