Bipolar disorder is a mood disorder. It is characterized by the occurrence of depressive episodes and episodes of euphoria which we call hypomania or, when the symptoms are more intense. By hypomania we mean an increase in energy, reduced need for sleep, as well as a non-normal increase in optimism and initiative.
There is a whole family of bipolar disorders, and we tend to think only of manic-depressive psychosis, which is one of the most stigmatized.
What can be the initial symptoms of bipolar disorder?
It is a mood disorder that tends to show its first manifestations during late adolescence and adulthood.
Generally, mood disorders initially present with anxiety, later depressive symptoms or irritability develop, which are the most common symptoms of bipolar disorder. Less frequently it starts with signs of euphoria.
In the presence of depressive anxiety symptoms, or irritability, assessment by a specialist is required to rule out the presence of bipolar spectrum affective disorder.
How is it diagnosed?
Diagnosis is very difficult and has a lot of variability, since we do not have many technological means other than talking to the patient and his family.
The specialist in Psychiatry makes a clinical diagnosis based on an interview with the patient and his family, based on his experience, training, listening and observation skills. It is necessary to collect a lot of information and know how to interpret it to be able to distinguish a mood fluctuation within the expected, or if it is the manifestation of a mental disorder.
It is also necessary to rule out, through medical tests, other organic diseases that may manifest with mood disorders, for example anemia or thyroid pathologies.
If the person also uses toxic substances (alcohol, cannabis, cocaine, etc.) the diagnosis becomes even more complex.
What is the treatment?
We have several lines of treatment.
We have more and more data on the effectiveness of non-pharmacological therapies: sports activity, mindfulness, psychoeducation, cognitive behavioral therapy, EMDR or interpersonal therapy. In addition, new drugs have been incorporated and classical drugs that favor mood stability (euthymics) are better understood.
The tricky thing is to find the right treatment for each person, as everyone has different levels of tolerability of the drugs.
In cases where the depressive episode persists, despite the treatments tried, we can use transcranial stimulation techniques, from the less invasive and tolerated transcranial magnetic stimulation, which can be performed on an outpatient basis, to electroconvulsive therapy for which hospitalization is necessary.
Can suffering from bipolar disorder lead to suicide?
Suicide is the most serious complication of this disorder, it is irreversible. One thing is the consummated suicide, whose risk can be up to 30 times higher than in the general population. On the other hand, attempted suicide is much more frequent.
Is bipolar disorder when you have two distinct personalities?
It is confused with multiple identity disorder with a bipolar disorder, which has only one personality and one way of being that, depending on the stability or decompensation of their disorder, may present a face more characterized by depressive or euphoric symptoms.
Can patients with bipolar disorder develop psychotic symptoms?
We define psychotic symptoms as delusions and hallucinations. In this case, patients with bipolar disorder may develop psychosis when they are in a depressive or manic episode.