PSYCHOLOGY PROJECT – BIPOLAR DISORDER

Bipolar disorder, also known as manic depression or manic-depressive illness, is a brain disorder that causes
unusual and extreme shifts in mood, energy, activity levels, and severely affects the person’s ability to carry out
day-to-day tasks. The extreme mood swings usually vary between mania (emotional highs) and depression
(emotional lows).

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities.
When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy
or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability
to think clearly.

There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity
levels.

1) Bipolar I Disorder
Bipolar I disorder can cause dramatic mood swings. During a manic episode, people with bipolar I
disorder may feel high and on top of the world, or uncomfortably irritable and “revved up.“ During a
depressive episode they may feel sad and hopeless. There are often periods of normal moods in
between these episodes. Bipolar I disorder is diagnosed when a person has a manic episode.

2)Bipolar II Disorder

Bipolar II disorder involves a person having at least one major depressive episode and at least one
hypomanic episode (see above). People return to usual function between episodes. People with
bipolar II often first seek treatment because of depressive symptoms, which can be severe. People
with bipolar II often have other co-occurring mental illnesses such as an anxiety disorder or substance
use disorder.

3)Cyclothymic Disorder

Cyclothymic disorder is a milder form of bipolar disorder involving many mood swings, with
hypomania and depressive symptoms that occur often and fairly constantly. People with cyclothymia
experience emotional ups and downs, but with less severe symptoms than bipolar I or II.

Cyclothymic disorder symptoms include the following:

o For at least two years, many periods of hypomanic and depressive symptoms (see above), but the
symptoms do not meet the criteria for hypomanic or depressive episode.
o During the two-year period, the symptoms (mood swings) have lasted for at least half the time and
have never stopped for more than two months.

4)Other Specified and Unspecified Bipolar and Related Disorders

Defined by bipolar disorder symptoms that do not match the three categories listed above.

SIGNS AND SYMPTOMS

People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and
activity levels, and unusual behaviors. These distinct periods are called “mood episodes.” Mood episodes are
drastically different from the moods and behaviors that are typical for the person. Extreme changes in energy,
activity, and sleep go along with mood episodes.
 People having a manic episode may: People having a depressive episode may:

 Feel very “up,” “high,” or elated  Feel very sad, down, empty, or hopeless
 Have a lot of energy  Have very little energy
 Have increased activity levels  Have decreased activity levels
 Feel “jumpy” or “wired”  Have trouble sleeping, they may sleep too
 Have trouble sleeping little or too much
 Become more active than usual  Feel like they can’t enjoy anything
 Talk really fast about a lot of different  Feel worried and empty
things  Have trouble concentrating
 Be agitated, irritable, or “touchy”  Forget things a lot
 Feel like their thoughts are going very fast Eat too much or too little
 Think they can do a lot of things at once  Feel tired or “slowed down”
 
Do risky things, like spend a lot of money or Think about death or suicide
have reckless sex

Symptoms in children and teens

Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether
these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other
than bipolar disorder.

Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can
vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may
have periods without mood symptoms between episodes.

The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that
are different from their usual mood swings.

Diagnosis

Proper diagnosis and treatment help people with bipolar disorder lead healthy and productive lives. Talking
with a doctor or other licensed mental health professional is the first step for anyone who thinks he or she
may have bipolar disorder. The doctor can complete a physical exam to rule out other conditions. If the
problems are not caused by other illnesses, the doctor may conduct a mental health evaluation or provide a
referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and
treating bipolar disorder. The following methods can be used:

 Physical exam. Your doctor may do a physical exam and lab tests to identify any medical problems that
could be causing your symptoms.

 Psychiatric assessment. Your doctor may refer you to a psychiatrist, who will talk to you about your
thoughts, feelings and behavior patterns. You may also fill out a psychological self-assessment or
 questionnaire. With your permission, family members or close friends may be asked to provide
information about your symptoms.

 Mood charting. You may be asked to keep a daily record of your moods, sleep patterns or other factors
that could help with diagnosis and finding the right treatment.

 Criteria for bipolar disorder. Your psychiatrist may compare your symptoms with the criteria for bipolar
and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published
by the American Psychiatric Association.

Risk Factors

Scientists are studying the possible causes of bipolar disorder. Most agree that there is no single cause.
Instead, it is likely that many factors contribute to the illness or increase risk.

Brain Structure and Functioning: Some studies show how the brains of people with bipolar disorder may differ
from the brains of healthy people or people with other mental disorders. Learning more about these
differences, along with new information from genetic studies, helps scientists better understand bipolar
disorder and predict which types of treatment will work most effectively.

Genetics: Some research suggests that people with certain genes are more likely to develop bipolar disorder
than others. But genes are not the only risk factor for bipolar disorder. Studies of identical twins have shown
that even if one twin develops bipolar disorder, the other twin does not always develop the disorder, despite
the fact that identical twins share all of the same genes.

Family History: Bipolar disorder tends to run in families. Children with a parent or sibling who has bipolar
disorder are much more likely to develop the illness, compared with children who do not have a family history
of the disorder. However, it is important to note that most people with a family history of bipolar disorder will
not develop the illness.

Treatment

Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health
conditions (psychiatrist) who is skilled in treating bipolar and related disorders. You may have a treatment
team that also includes a psychologist, social worker and psychiatric nurse.

Bipolar disorder is a lifelong condition. Treatment is directed at managing symptoms. Depending on your
needs, treatment may include:

 Medications:

A number of medications are used to treat bipolar disorder. The types and doses of medications
prescribed are based on your particular symptoms.

Medications may include:

 Mood stabilizers. You'll typically need mood-stabilizing medication to control manic or hypomanic
episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex
sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).

Antipsychotics. If symptoms of depression or mania persist in spite of treatment with other

medications, adding an antipsychotic drug such as olanzapine (Zyprexa), risperidone (Risperdal),
quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine
(Saphris) may help. Your doctor may prescribe some of these medications alone or along with a mood
stabilizer.

Antidepressants. Your doctor may add an antidepressant to help manage depression. Because an
antidepressant can sometimes trigger a manic episode, it's usually prescribed along with a mood
stabilizer or antipsychotic.

Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and

the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer.

Anti-anxiety medications. Benzodiazepines may help with anxiety and improve sleep, but are usually
used on a short-term basis.

 Continued treatment. Bipolar disorder requires lifelong treatment with medications, even during
periods when you feel better. People who skip maintenance treatment are at high risk of a relapse of
symptoms or having minor mood changes turn into full-blown mania or depression.

 Day treatment programs. Your doctor may recommend a day treatment program. These programs
provide the support and counseling you need while you get symptoms under control.

 Substance abuse treatment. If you have problems with alcohol or drugs, you'll also need substance
abuse treatment. Otherwise, it can be very difficult to manage bipolar disorder.

 Hospitalization. Your doctor may recommend hospitalization if you're behaving dangerously, you feel
suicidal or you become detached from reality (psychotic). Getting psychiatric treatment at a hospital can
help keep you calm and safe and stabilize your mood, whether you're having a manic or major
depressive episode.

The primary treatments for bipolar disorder include medications and psychological counseling (psychotherapy)
to control symptoms, and also may include education and support groups.

Psychotherapy is a vital part of bipolar disorder treatment and can be provided in individual, family or group
settings. Several types of therapy may be helpful. These include:
 Interpersonal and social rhythm therapy (IPSRT). IPSRT focuses on the stabilization of daily rhythms,
such as sleeping, waking and mealtimes. A consistent routine allows for better mood management.
People with bipolar disorder may benefit from establishing a daily routine for sleep, diet and exercise.

 Cognitive behavioral therapy (CBT). The focus is identifying unhealthy, negative beliefs and behaviors
and replacing them with healthy, positive ones. CBT can help identify what triggers your bipolar
episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.

 Psychoeducation. Learning about bipolar disorder (psychoeducation) can help you and your loved ones
understand the condition. Knowing what's going on can help you get the best support, identify issues,
make a plan to prevent relapse and stick with treatment.

 Family-focused therapy. Family support and communication can help you stick with your treatment plan
and help you and your loved ones recognize and manage warning signs of mood swings.