What is Bipolar Disorder? Symptoms, Causes, and Treatment

Bipolar disorder is a complex mental health condition characterized by sharp fluctuations between manic (excessively energetic and euphoric) and depressive (hopeless and exhausted) episodes in a person's life. Affecting approximately 40 million people worldwide, this disorder has negative impacts on both a person's mental and physical health. In bipolar disorder, manic and depressive episodes can last for weeks. This situation can seriously hinder a person's functionality in important areas such as work life and social life. Thought to be influenced by a combination of genetic, environmental, and biological factors, this condition can begin at a young age and may require lifelong treatment.

What is Bipolar Disorder?

Bipolar disorder, also known by different names such as manic-depressive illness, mood disorder, or bipolar mood disorder, is a mental health problem where periods of depression alternate with manic states characterized by increased joy, excitement, and insomnia. In other words, bipolar disorder is a chronic condition characterized by transitions between manic (high-energy and euphoric) and depressive (hopeless and low-energy) episodes that cause severe fluctuations in people's moods. People with this disorder oscillate between periods of elevation, known as the manic phase, where they exhibit excessively energetic, enthusiastic, and often risky behaviors, and periods of decline, known as the depressive phase, where they experience intense sadness, hopelessness, and loss of energy. For this reason, people around the patients may think that this is just their temperament and character, and may have difficulty understanding that their loved ones are ill.

The manic phase of the disorder is a period where high energy, insomnia, joy, and enthusiasm come to the fore. During this period, the person feels excessively energetic, happy, and productive. In this phase, where the person is usually satisfied with very little sleep, their speed of thought and speech may increase. At the same time, the person may experience distractibility and exhibit risky behaviors such as unplanned spending or making impulsive decisions. In addition, some patients may lose touch with reality during this period. Therefore, severe cases may sometimes need to be kept under observation in a healthcare facility.

In the depressive phase, patients may struggle with feelings such as intense sadness, feeling worthless, and falling into hopelessness. Unlike the manic phase, patients have very low energy during this period. In the depressive phase, individuals do not enjoy daily activities and experience intense fatigue, guilt, and loss of self-confidence. Insomnia or a tendency to oversleep, changes in appetite, and the desire to end one's life can also be counted among the prominent features of this period. For this reason, the disease can sometimes be defined in different ways, such as bipolar eating disorder or bipolar sleep disorder.

These episodes may not follow the same course in every patient. Therefore, types of bipolar disorder are determined according to the episodes experienced. For example, those who have experienced one or more manic episodes are considered to have Bipolar I disorder, regardless of whether they have experienced a depressive episode. Patients who experience depressive episodes without having a full manic episode are treated as Bipolar II patients.

What Are the Symptoms of Bipolar Disorder?

Bipolar disorder symptoms, which differ during manic and depressive episodes, can also vary from person to person. Accordingly, the main symptoms of the manic phase are as follows:

The person may feel very energetic and active. During this period, they may constantly turn to new projects or ideas.

Excessive joy, happiness, and self-confidence can be observed in patients.

During this period, patients feel vigorous despite sleeping very little.

In this process, the person thinks fast, speaks fast, and may jump from topic to topic.

Individuals may engage in high-risk activities with impulsive decisions, such as turning to dangerous sports or spending excessive money unnecessarily.

In severe cases, patients may lose touch with reality, and hallucinations may occur.

In addition to the listed symptoms, different symptoms may be seen in the depressive phase in patients with bipolar disorder. These are as follows:

The person may find themselves in a state of prolonged sadness, deep melancholy, and hopelessness.

During this period, patients may feel excessively tired, and even daily activities may become challenging.

In the depressive phase, the person may stop enjoying activities they previously enjoyed.

A tendency to be unable to sleep or to oversleep may be observed in patients.

Slowing of thought, loss of concentration, and difficulty in making decisions are among the other symptoms of this period.

In this process, conditions such as excessive desire to eat or loss of appetite may be seen.

The person may feel worthless and guilty. This situation can lead to suicidal thoughts.

The listed symptoms negatively affect the person's quality of life. Therefore, it is important for patients with bipolar personality disorder to start treatment at an early stage.

How Does Bipolar Disorder Occur?

Many genetic, biological, and environmental factors play a role in the emergence of bipolar disorder. Accordingly, the main causes of bipolar disorder are as follows:

Genetic predisposition: Some studies show that the risk of bipolar disorder is higher in people with a family history of bipolar disorder. However, heredity alone is not sufficient to explain the disease.

Brain structure and function: Research shows that there are significant differences in the brain structure and neurotransmitter levels of people with bipolar disorder. Abnormalities and chemical imbalances in certain regions of the brain may play a role in the emergence of bipolar symptoms.

Environmental and psychological factors: Stress, trauma, and sudden changes can trigger bipolar disorder. For example, difficult life events such as being fired, the loss of a loved one, or problems in relationships can initiate the first episode of the disease when combined with genetic predisposition, and symptoms may worsen over time. In addition, unhealthy habits such as alcohol can also cause bipolar disorder.

Furthermore, accidents such as brain trauma can also cause bipolar disorder in some cases. In bipolar disorder, which is formed by the combination of the listed factors, symptoms can be brought under control with the right treatment method.

How is Bipolar Disorder Diagnosed?

During the diagnosis of bipolar disorder, experts examine the patient's mood swings, behavioral changes, and the frequency and severity of these in detail. One of the most important steps in diagnosis is to analyze the duration of the manic and depressive episodes the person has experienced, the age of onset, and the events that triggered these episodes. In the diagnosis of bipolar disorder, experts generally use the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria. These criteria can provide ideas for experts in determining the type of bipolar disorder. For example, at least one manic attack supports a Bipolar I diagnosis, while hypomanic and depressive episodes may point to a Bipolar II diagnosis.

During the diagnostic process, different bipolar subtypes such as cyclothymic disorder and other specified bipolar and related disorders are also considered. Cyclothymic disorder is a disorder in which mild hypomanic and depressive symptoms last for 1 year in children and adolescents, and at least two years in adults. However, cyclothymic disorder does not fully meet the criteria for manic or depressive attacks. Additionally, in individuals who do not fully meet the diagnostic criteria for bipolar 1, bipolar 2, and cyclothymic disorder but exhibit abnormal mood changes, experts may diagnose other specified or unspecified bipolar and related disorders.

In addition, since some physical health problems can show symptoms similar to bipolar symptoms, experts may use blood tests to examine thyroid functions and vitamin levels to rule out other health problems. During the diagnostic process, experts also consider the patient's family history and environmental factors.

How is Bipolar Disorder Treated?

Bipolar disorder is a chronic mental health disease that causes sudden and extreme changes in mood and progresses with manic and depressive episodes. During the treatment of bipolar disorder, the primary goal of experts is to control these changes and improve the person's quality of life. With early diagnosis and treatment, symptoms can be controlled in many people, and the person can lead a balanced life.

During the treatment process, experts usually use mood-stabilizing medications and psychotherapy methods together. Medications can help reduce the frequency and severity of manic and depressive episodes. However, medication use alone may not be sufficient to manage symptoms. Therefore, psychotherapy techniques that help the person become aware of their illness, develop skills to manage their emotions, and cope with stress also play an important role in the treatment process.

In this process, especially cognitive behavioral therapy (CBT) can help the person recognize negative thought patterns and develop healthy thoughts in their place. In addition, methods such as social rhythm therapy can positively affect mood balance by ensuring a sleep routine.

In some patients where traditional treatment methods are insufficient, experts may apply brain stimulation therapies such as electroconvulsive therapy or transcranial magnetic stimulation (TMS). These treatments can be particularly effective in people who do not respond to medication or who experience severe symptoms.

Making changes in the patient's lifestyle also plays an important role in the success of the treatment. Habits such as regular sleep, healthy nutrition, and physical activity can help keep the mood in balance.

Frequently Asked Questions

Bipolar disorder may be related to genetic predisposition. The risk of developing the disease may be higher in people with a family history of bipolar disorder types. However, genetic factors alone cannot explain the emergence of the disease. Factors such as environmental factors and changes in brain structure can also cause the disease. Bipolar 1 disorder is a subtype of bipolar disorder in which at least one manic attack is experienced. Manic episodes can seriously affect an individual's functionality and may sometimes require hospitalization. Bipolar disorder manifests itself with sudden mood changes such as the transition from excessive energy, joy, and enthusiasm to deep melancholy and sadness. When you notice symptoms like these, it is important to get help from a specialist physician. While a person feels excessively energetic, enthusiastic, and vigorous during the manic phase of bipolar disorder, they may experience hopelessness, fatigue, and loss of interest during the depressive phase. When bipolar personality disorder is not treated, the frequency and severity of attacks may increase. As a result, problems may arise in work, family, and social relationships. In addition, the risk of suicide may be high in untreated cases. The behaviors of bipolar individuals differ according to the phase of the disease. In the manic phase, the person may be excessively energetic and exhibit risky behaviors. In the depressive phase, they may become withdrawn and experience a loss of interest. Bipolar attacks emerge with manic or depressive symptoms. In a manic attack, excessive energy and uncontrolled behaviors may be at the forefront. In a depressive attack, symptoms such as fatigue, changes in sleep patterns, changes in appetite, hopelessness, and loss of interest may be seen. During the diagnosis of bipolar disorder, experts evaluate the patient's mood swings, behavioral changes, the frequency of the fluctuations, when they started, and their severity in detail. Bipolar disorder is a serious chronic mental health problem. However, with the right treatment and support, symptoms can be controlled. If bipolar personality disorder is not treated, life expectancy may be shortened due to the risk of the person ending their life and accompanying physical illnesses. On the other hand, with regular use of medication and healthy lifestyle changes, patients can live as long as other people.

Bipolar disorder can seriously affect quality of life. If you are experiencing frequent mood swings or notice some of the symptoms in yourself, you can make an appointment with our expert psychiatrists without delay to have the necessary check-ups. With early diagnosis and treatment, symptoms can be controlled.