Bipolar I Disorder

02 May, 2020
Bipolar I disorder (pronounced "bipolar one") is a mental illness where the patients show behaviors and habits that affect their quality of life.

Bipolar I disorder, also known as manic depression, is the most extreme form of manic-depressive disorder, whose main characteristic is the appearance of manic or mixed episodes, alternated with at least one episode of major depression.

Patients affected by this mental illness have had at least one manic episode in their life. During this emotional state they feel euphoric and full of energy, with abnormal behavior that can interrupt their daily life.

Often, the first manic episode is preceded by one or more episodes of major depression. These intense moods considerably affect quality of life, since they interfere with personal relationships and, many times, lead to suicide attempts.

However, between the manic and depressive episodes, many people with bipolar I disorder can live a normal life. Additionally, you can keep the symptoms under control by following a plan that includes medication and psychological therapy.

Causes of bipolar I disorder

The exact cause of bipolar I disorder is unknown, but it seems to be related to genetic, biological, and environmental factors. A person is more at risk of suffering this mental illness if they:

  • Have a blood relative (like a father or a brother) with bipolar disorder
  • Suffered through traumatic experiences or abuse as a child
  • Are constantly exposed to stressful situations
  • Abuse psychoactive substances and alcohol
  • Have recently suffered the loss of a loved one
  • Have neurological or endocrine disorders

Discover: What’s It Like to Be Bipolar?

A woman with bipolar disorder.

Symptoms of bipolar I disorder

To know that it’s bipolar I disorder and not another mental illness, the person should have had at least one manic episode, preceded by a hypomanic or major depressive episode. Occasionally, mania can cause a disconnect from reality or psychosis.

Symptoms of a manic episode

Frequently, mania or a manic episode, is characterized by an excessively happy or overexcited mood. The symptoms are similar to those of hypomania, but they are more intense and usually cause problems in social and work activities. The most common symptoms are:

  • Reduced need to sleep
  • Elevated self-esteem
  • Abnormal episodes of optimism, nervousness, or tension
  • Increase in energy and agitation
  • Exaggerated feeling of well-being (euphoria)
  • Frenzy of ideas
  • Talking excessively
  • Impulsive or imprudent actions
  • Risky sexual conduct
  • Substance abuse
  • Compulsive purchases

Symptoms of a major depressive episode

Symptoms of depression can appear shortly after the manic episode. However, sometimes it takes weeks or months to appear. To be considered a major depressive episode, the symptoms should be sufficiently severe to cause clear difficulties in daily activities. These symptoms include:

  • Depressive mood, with a constant feeling of sadness and hopelessness
  • Wanting to cry
  • Loss of interest in fun activities
  • Sudden weight fluctuations
  • Insomnia or sleeping too much
  • Agitation or lethargy
  • Chronic fatigue
  • A feeling of uselessness or guilt
  • Indecision and difficulty concentrating
  • And, finally, thoughts of suicide

Read also: Posttraumatic Stress Disorder Symptoms

Diagnosis

The first steps for a diagnosis of bipolar I disorder include physical and clinical analyses to identify if there’s a medical problem that could be causing the symptoms. Then, after some questions, the doctor might suggest:

  • Psychiatric evaluation: which analyzes thoughts, feelings, and actions to determine if they correspond to bipolar I disorder. You might also have to fill out a self-evaluation or questionnaire.
  • Psychiatric evaluation: the psychiatrist can compare the patient’s symptoms to the criteria for bipolar disorder and related disorder. These criteria are described in the Diagnostic and Statistical Manual of Mental Disorders DSM-5 published by the American Psychiatric Association.

Treatment for bipolar I disorder

For proper management of bipolar I disorder you need supervision from a specialist in mental illnesses (psychiatrist). This professional is then able to design a program with proper controls for each case.

Medicine on shelves.

It’s likely that the treatment team will also have psychologists, social workers, and psychiatric nurses. The medication and psychotherapy are focused on controlling the symptoms and lessening the episodes.

Medication

In order to control the manic and depressive episodes of bipolar I disorder, you need medication like mood stabilizers, antipsychotics, antidepressants and hypnotic sedatives like benzodiazepines.

Psychotherapy

Psychotherapy is an essential part of the treatment of bipolar I disorder. It can either be done individually, as a family, or in a group. Although the main objective is to help control your mood, it also helps to stabilize your daily routine.

  • Interpersonal therapy: it’s necessary to have more control of your mood and recover your social rhythm
  • Cognitive behavioral therapy: centered 0n identifying negative behavior to find solutions. It also helps you determine what sets off bipolar episodes.
  • Psychoeducation: helps patients and family members to understand bipolar disorder and its effects.
  • Family-centered therapy: family support is needed to avoid relapses. In addition, it allows the family to be alert to any warning sign due to mood changes.

Treatment for bipolar I disorder should be continuous, even at times when there are no symptoms. You should take the medication for life, or until the psychiatrist tells you. Likewise, it helps if you adopt healthy habits.

Furthermore, having a routine for sleeping, eating, and physical activity can help to control your mood. It’s also important to stay away from alcoholic drinks and recreational drugs.

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, DSM-IV-TR. Washington, DC: 2000.
  • Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry 2011; 68 (3): 241–251.
  • Pini S, de Queiroz V, Pagnin D, et al. Prevalence and burden of bipolar disorders in European countries. Eur Neuropsychopharmacol 2005; 15 (4): 425–434.
  • Roger S. McIntyre, MD, Joanna K. Soczynska, and Jakub Konarski “Bipolar Disorder: Defining Remission and Selecting Treatment” Vol. XXIII, (2006) No. 11 
  • Martínez-Arán, A; Vieta, E; Reinares, M; Colom, F; Torrent, C; Sánchez-Moreno, J; Benabarre, A; Goikolea, JM; Comes, M; Salamero, M (2004), «Cognitive Function Across Manic or Hypomanic, Depressed, and Euthymic States in Bipolar Disorder», American Journal of Psychiatry 161 (2): 262-270