Bipolar disorder, also known as manic depression, is a mental health problem that causes changes in mood. Sometimes one feels excessively elated, impulsive or irrational (referred to as mania) or hypomania (milder form of mania) and other times the same person feels excessively sad (called major depression).
Bipolar disorder can make it hard for one to perform well at the work place or school, have a relationship with friends and family, and increases risk of suicide, and yet can be effectively managed with great improved quality of life.
The exact cause of bipolar disorder, though not conclusively known, is related to an imbalance of chemicals in the brain. These chemicals allow cells to communicate with each other and play an essential role in all brain functions, including movement, sensation, memory and emotions.
Approximately, one per cent of people have bipolar disorder. People with a family history of bipolar disorder are at increased risk of developing the condition. Most people develop the first symptoms of bipolar disorder between ages 15 to 30 years. It is not common to develop the first symptoms as a child or an adult over the age of 65 years. Bipolar disorder ranks as the sixth amongst all medical disorders in years of life lost to death and disability among people aged 15 to 44 years.
How to tell one is suffering from bipolar disorder
A person suffering from bipolar disorder will have symptoms of mania or hypomania alternating with symptoms of depression.
Mania causes you to feel abnormally and persistently happy, angry, hyperactive, impulsive, and irrational at different times. These feelings last at least one week, and may be so severe that one requires hospitalisation. Other symptoms may include: feeling of special powers and superiority, decreased need for sleep or restless, excessive talking, increased activity, racing thoughts, short attention span, inappropriate spending sprees or sexual activities.
Hypomania is less severe than mania, but can cause a change in mood that is abnormal, usually briefer than manic episodes, although it lasts for at least four days. Hypomania might not seriously affect your ability to work or go to school, and some people function better during a hypomanic episode. Hypomania might not require hospitalization, but should be treated with medicines because it may lead to a manic or depressive episode.
People with bipolar disorder suffer from depressive episodes, and they feel very sad and have trouble doing ordinary things like bathing, getting dressed, and cooking. They may feel sad most of the day or have little or no interest in any activity. They often experience other symptoms such as: weight loss or gain (due to change in eating habits), difficulty in falling or staying asleep or often sleeping too much (disturbed sleep patterns), easily irritated, fatigue, loss of energy or sluggishness, feeling of worthlessness, difficulty concentrating and making decisions, recurring thoughts of death or suicide.
More than 60 per cent of people with bipolar disorder abuse alcohol or drugs.
The risk of suicide is also higher in people with bipolar disorder compared to people with other psychiatric illnesses (including depression) and is often as a result of feeling hopeless, and is more likely in people with severe symptoms who must be hospitalised for treatment. Hence if a family member, friend threatens to commit suicide or tells you that they have suicide ideas, you should consider this a serious threat or a psychiatric emergency and find a way of seeking immediate psychiatric or medical care.
Medical diagnosis of bipolar disorder is based upon medical and psychiatric history and a physical mental status examination as there is no specific test to diagnose it. Laboratory and other tests may be performed to rule out other diagnoses.
Bipolar disorder is manageable
Bipolar disorder can be clinically managed with medication and continuous talk therapy. These medicines affect the brain by keeping your mood stable and preventing big mood changes, calming your mind and making your sadness go. You may be treated as an outpatient or hospitalised depending on the severity of your symptoms. There is another form of treatment called electro-convulsive therapy (ECT) where an electric current is passed through your brain, triggering a seizure that helps in restoring normal balance of chemicals in the brain, and this treatment is especially effective for people with severe forms not responding to medicines, pregnant mothers who cannot tolerate medicines.
After the symptoms have gone away, ensure to continue taking your medicine as prescribed and go for medical reviews as advised. Continue with counselling as this will help you with family and friends and stop drinking alcohol or other substances that affect your brain stability. Avoid noisy situations, stress and ensure adequate sleep to prevent future episodes.
Dr. Ian Shyaka is a general practitioner based in Kigali.