Bipolar disorder

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Bipolar disorder, also known as manic-depressive illness, most commonly manifests itself by depression, mania and a mixed state of depression and mania. Everyone goes through feelings of happiness and sadness but for those with bipolar disorder these feelings can be extreme enough to interfere with daily life. Sometimes they can even be dangerous.


Why should I be aware of this?

Bipolar disorder is a lifelong condition which can often be difficult to diagnose. It can help to know as much about it to enable us to manage the condition.

Bipolar disorder and health

Difficult to diagnose

As most symptoms of bipolar disorder can be similar to other mood disorders it is often hard to detect. There have been instances where it has taken 10 years or more before it was correctly diagnosed.

When people are on maniac depression they feel "high on life" and don’t feel the need to seek help. But when people get into depression they can describe the conditions very clearly. For this reason nearly half of all patients who have bipolar disorder are first diagnosed with major depression. That’s why it is important for people to say how they have been feeling weeks and even months before the day they talk to their healthcare provider in order to make it easier for the right diagnosis.

Some other signs and symptoms of bipolar disorder can also be associated with illnesses, such as anxiety disorders and schizophrenia, making it even more difficult to diagnose correctly.

All about bipolar disorder

People with bipolar disorder have mood swings from very low (depression) to very high (mania). Bipolar disorder sometimes is confused with other types of depression. Though bipolar disorder is a lifelong illness, today there are many treatments.

Types of mood episodes

In bipolar disorder, or manic depression, each mood swing is called an “episode.” There are 4 main types of mood episodes fro people with bipolar disorder:

  • Depression — When people are very sad they are said to be under depression. Depression can prolong for a long time. When depressed one doesn’t feel like getting out of bed, or doing any of the routine things of the day.
  • Mania — Mania is the other extreme of bipolar disorder. Mania may have a very good feeling, or may also feel very irritable and angry. People with mania may do very risky things.
  • Hypomania — Hypomania is a milder form of mania. In this stage one may “feel good” but the feeling can suddenly change into mania or depression. Hypomania is different from mania and sometimes is not even noticed as a problem.
  • Mixed mood — This is when feelings of mania and depression go back and forth quickly, sometimes even in the same day.


Chances of recovery for Bipolar disorder patients are best if they are diagnosed on time, get proper treatment and stay on it for a lifetime. The treatment for Bipolar disorder includes therapy with a mood-stabilizer such as lithium, carbamazepine or divalproex/ valproic acid. Often this is in combination with an antipsychotic medication.

In cases of mania, an antipsychotic medication and /or benzodiazepine medication is often added to the mood-stabilizer. For depression, an antidepressant medication and /or lamotrigine is often added to the mood-stabilizer. Antidepressant medication can trigger mania, so this medication should always be combined with a mood-stabilizer or antipsychotic medication to prevent mania.

What can I do about it?

  • Read all you can about bipolar disorder and keep your family informed.
  • Have a regular routine. Go to bed and wake up at about the same time every day. Eat your meals and exercise at regular times.
  • Even if you start feeling better don’t stop taking your medicines
  • Avoid caffeine and over-the-counter medicines for colds, allergies and pain. Ask your doctor before you drink alcohol or use any other medicines.
  • Try to avoid stress.
  • Get to know what the early warning signs of your illness are. If you notice any change in your mood or behavior, consult your doctor.


In the last few decades there have been great advances in the treatment of Bipolar disorder in the last few decades, as a result of which many are able to lead a normal lives. Alternative treatments generally do not work for this condition and may leave the person vulnerable to further episodes. The only exception to this is high doses of Omega-3 fatty acids found in fish, flaxseed and some nuts (like walnuts) and oil. In high doses it can be as effective as mood-stabilizing medication in treating mild episodes and preventing further attacks.

Newer forms of psychotherapy called IPSRT (Interpersonal and Social Rhythm therapy) have been found to be effective in minimizing the amount of medication required and in reducing relapses. Patients who received this therapy report a much higher quality of life.

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