Bipolar Affective Disorder

Bipolar Affective Disorder

Dr.Selvizhi Subramanian profile Authored by Dr.Selvizhi Subramanian on 3 Sep 2014 - 11:00.

Bipolar Affective Disorder, generally called as Bipolar disorder, is a serious mental illness which causes extreme mood swings ranging from depression to elevated mood. A person during mania may act abnormally happy and extremely energetic unless mood shifts to the other side (depression), which may cause the patient to feel sad and hopeless. Frequency of mood shift varies, as few patients experience these occasionally and others more often. The condition needs to be managed carefully owing to a high risk of suicide and self-harm in these patients.

Depending on the severity and duration of episodes, Bipolar disorder is divided into three main types as:

  • Bipolar I Disorder: It is the most severe type with menacing episodes of mania.
  • Bipolar II Disorder: It is less severe than the above type with hypomania episodes instead of mania. Duration of episode for depression is comparatively longer than bipolar I type.
  • Cyclothymic Disorder: It is the mildest form of Bipolar disorders.

There is no particular cause for the disease, but some factors are known to cause or trigger the condition.

  • Physical changes in the brain
  • Imbalance of neurotransmitters
  • Hormonal imbalance
  • Stress, abuse or other related factors

Symptoms are divided based on the phase experience by the patient.

Symptoms During Manic Phase

Symptoms During Depressive Phase

  • Rapid speech
  • Euphoria
  • Poor judgment
  • Over restless
  • Over confidence
  • Risky behavior
  • Increased sex drive
  • Careless use of drugs
  • Sadness
  • Tiredness
  • Hopelessness
  • Anxiety
  • Suicidal thoughts
  • Restlessness
  • Chronic pain with no cause
  • Sleep problems

Some patients may experience combination of both symptoms, which are known as mixed symptoms.

Several diagnostic tests can be used to pinpoint the diagnosis by ruling out other diseases and complications:

  • Physical examination: Your doctor may examine you physically to check for any signs related to the disease.
  • Laboratory tests: Blood or urine tests may help in identifying a cause in some patients.
  • Psychiatric evaluation: Your doctor may ask you certain questions regarding your behavior and may also assess the pattern of mood shift to confirm diagnosis.

Risk of Bipolar disorder is high in people associated with:

  • People in early 20s of age
  • High stress
  • Alcohol abuse
  • Major life changing event
  • A relative with Bipolar disorder

Patients suffering from Bipolar disorders will generally need to take medications for longer period of time. A psychiatrist will treat you with medications and may suggest you to get hospitalized if your behavior gets out of control. You are strictly advised to take medications on time as relapse or recurrence of symptoms may take place if you skip medications.

There are various drugs available for the treatment of Bipolar disorder. Based on your disease severity and type, a single drug or a combination of drugs may be prescribed. Depending on the progress, additional medications are added or the previous medication is replaced by another drug.

Medications used in the treatment are:

  • Lithium
  • Lamotrigine
  • Anticonvulsants like valproic acid and divalproex
  • Antipsychotics like quetiapine, aripipazole and olanzapine
  • Antidepressants only when absolutely necessary
  • Benzodiazepines when indicated

Mood stabilizers and antipsychotic drugs can be used effectively, either alone or in combination to treat both phases of the disorder.

Therapies other than medications involve:

  • Cognitive behavioral therapy
  • Psychoeducation
  • Family-focused therapy
  • Interpersonal and social rhythm therapy

Lifestyle modification:

  • Maintaining good sleep habit to beat tiredness, which can trigger manic episodes
  • Avoiding alcohol and caffeinated beverages
  • Reducing stress at home and at work
  • Reducing stress at home and work along with regular yoga, can help reduce the number of relapses


Bipolar disorders, if left undiagnosed or untreated, may lead to several consequenceslike suicide and physical harm, apart from social, personal and work-related problems.

  • Address minor symptoms before it worsens
  • Do not stress yourself
  • Get enough sleep
  • Avoid drugs and alcohol
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.