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What It Means to be Bipolar; Understanding symptoms and treatments

November 2018 – Everyone experiences normal ups and downs in their mood, but bipolar disorder – characterized by dramatic shifts in mood, energy and activity levels – can make day-to-day life far more challenging. Fortunately, this psychiatric condition can be effectively controlled with a variety of treatment approaches, according to psychiatrist and sleep specialist Alex Dimitriu, MD, founder of Menlo Park Psychiatry & Sleep Medicine.

An estimated 4.4% of adults in the United States experience bipolar disorder at some point in their lives, according to the National Institute of Mental Health. But what does it mean to be bipolar, and what can you expect if you or a loved one is faced with this diagnosis? Dr. Dimitriu points out that bipolar disorder – formerly called manic depression – includes both the emotional highs of mania or hypomania, and the lows of depression.

While the cause of bipolar disorder is unknown – though it appears to be influenced by genetics and brain changes – four basic types of the condition exist, and all involve mood shifts from up to down and back.

“It’s not unusual for people with bipolar disorder to swing between depression and manic symptoms several times a year, though sometimes mood episodes are spaced far apart,” he explains. “Bipolar disorder is a lifelong condition, but the ways it may affect patients are as individual as the patients themselves.”

Bipolar signs and symptoms
Intense emotions are part of bipolar disorder, and changes in sleep patterns and activity levels are also involved, says Dr. Dimitriu, who is dual board-certified in psychiatry and sleep medicine. What signs and symptoms should you watch for?

Manic episodes may include:

  • Extreme elation
  • Tons of energy
  • Feeling jumpy or wired
  • Trouble sleeping
  • Talking really fast about many different things
  • Being more active than usual
  • Extreme agitation or irritability
  • Grand notions about how many things can be done at once
  • Doing risky things, like spending lots of money or having reckless sex

Depressive episodes may include:

  • Extreme sadness, emptiness or hopelessness
  • Very little energy
  • Low activity levels
  • Trouble concentrating
  • Forgetfulness
  • Eating or sleeping too much or too little
  • Thoughts of death or suicide

“Although symptoms of various types of bipolar disorder may also include other features – such as psychosis, a sense of melancholy or anxious distress – most cases of the condition are marked by a combination of symptoms ranging from manic to depressive,” Dr. Dimitriu says. “Don’t try ‘just living with it’ if you or a loved one is experiencing extreme mood swings – seeing a doctor is vital.”

Variety of bipolar treatments
If bipolar disorder isn’t treated, it can lead to serious problems in patients’ day-to-day lives, Dr. Dimitriu says. These can include drug and alcohol abuse, legal or financial problems, poor work or school performance, relationship problems, and even suicide or suicide attempts.

“But there’s usually no reason someone with bipolar disorder can’t lead a healthy and fulfilling life,” he adds. “After going through a health evaluation, your doctor can help you seek treatment that can even out your moods and make life better again.”

Therapies and other treatment approaches include:

  • Medications such as mood stabilizers, antidepressants and antipsychotic drugs
  • Psychotherapy, which may be combined with medications
  • Electroconvulsive therapy, which passes an electric current through the scalp and is typically reserved for more severe cases
  • Sleep medications
  • Charting daily mood symptoms, sleep patterns, treatments and other events to discuss an overall bipolar management strategy with your doctor

“There’s no cure for bipolar disorder, but with a variety of ways to manage it, the condition doesn’t have to define you,” Dr. Dimitriu says.

Menlo Park Psychiatry & Sleep Medicine is located in Menlo Park, California.

Alex Dimitriu, MD, is dual board-certified in psychiatry and sleep medicine. He is the founder of Menlo Park Psychiatry & Sleep Medicine.

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