Mania and Depression in Bipolar Disorder.
The two faces of bipolar disorder
Bipolar disorder,previously known as manic-depression is characterised by serious shifts in mood which has implications for energy levels, thinking and behaviour.It can present fdifferently from one individual to the other.Many bipolar people have periods of wellness between the mood swings while others go from mania to depression and back again to mania without any normal phase in between.This is known as rapid cycling.Some individuals with this condition are prone to manic episodes while others mainly have depressed episodes.Symptoms vary greatly from one sufferer to the other in terms of severity,frequency and pattern.
Mania and depression are the two phases of the condition along with mixed episodes and hypomania.
Mania signs and symptoms
Increased energy,euphoria and creativity are common in the manic phase of bipolar.Talking a lot,sleeplessness and hyperactivity are typical of those in a manic phase.Delusions of grandeur are also common and a hallmark of the condition.
A manic episode can be pleasant at first until it spirals out of control.Recklessness with money,sexual promiscuity and making foolish decisions due to impaired judgment are common.Anger,irritability and aggression are also typical in a manic phase.In severe cases,the manic individual may have delusions or hear voices.
A less severe form of mania is known as hypomania in which bipolar individuals can feel euphoria,an increase in energy and productivity while getting on with their daily lives.The main difference between mania and hypomania is that the hypomanic person doesn't lose touch with reality or become psychotic which is the case with the manic individual.
Even so,hypomania can have negative consequences on careers,reputations and relationships.It can be followed by a depressive episode or develop into full mania.
In summary,increased irritability,delusions of grandeur,sleeplessness,flight of ideas,pressure of speech,inability to concentrate,poor judgment and impulsiveness are the hallmarks of someone in a manic state.If severe and untreated,the mania can become psychotic and the person becomes delusional or starts hearing voices which makes mania a dangerous phase of bipolar disorder
Depression in bipolar disorder
There are significant differences between bipolar depression and regular depression.Antidepressants are contra-indicated in bipolar disorder as they may trigger mania.
Restless,guilt,mood swingsand irritability are hallmarks of bipolar depression alonfg with weight gain and needing as lot of sleep.Loss of energy causes the bipolar person in a depressive phase tospeak and move slowly and they have a suicidal frame of mind.Guilt and feelings of worthless alongside difficulty with concentration are further hallmarks of the depressed bipolar individual. As with mania,the depression can become psychotic when loss of contact with reality occurs.A bipolar depression episode has negative implications for social interaction,relationships and one's career.
In a mixed manic-depressive episode depression coexists with irritability,insomnia,anxiety,lack of concentration and racing thoughts.Those in this state are at a high risk for suicide. Suicide is more common in bipolar disorder than in those with depression.
Bipolar disorder can be triggered in those with a genetic predisposition by stressful life events e.g.getting married,going away to college,death of a loved one or moving house.There is an inherited predisposition to developing bipolar disorder but this is influenced to a large extent by environmental factors.
Living within a healthy routine for both sleep and activities of daily living will help to keep bipolar manageable.It is interesting to noe that depression and mania often have a seasonal pattern with mania more common in the Summertimeand depression more common in the Wintertime.
A combination of medication,social support,lifestyle changes and therapy is the most effective treatment strategy for bipolar disorder.
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