Mood Disorders

Bipolar Disorder

Bipolar Disorder is a chronic mood disorder characterized by episodes of mania (or hypomania) and depression. During manic episodes, individuals may feel euphoric, energetic, and impulsive. During depressive episodes, they experience sadness, fatigue, and hopelessness. The disorder significantly impacts relationships, work, and daily functioning without proper treatment.

Symptoms

Manic episodes: elevated or irritable mood, decreased need for sleep, racing thoughts, rapid speech, grandiosity, increased goal-directed activity, risky behaviors (spending sprees, sexual indiscretions)

Depressive episodes: persistent sadness, loss of interest, sleep and appetite changes, fatigue, guilt, difficulty concentrating, suicidal thoughts

Mixed episodes: simultaneous manic and depressive symptoms

Psychotic features may occur in severe episodes

Causes

Strong genetic component (80-90% heritability)
Brain structure and function differences
Neurotransmitter imbalances
Disrupted circadian rhythms
Stressful life events (can trigger episodes)
Substance abuse (can precipitate or worsen episodes)

Diagnosis

Requires careful psychiatric evaluation including detailed mood history, family history, and ruling out medical conditions and substance-induced mood changes. Often misdiagnosed as depression (depressive episodes are more frequent). Mood charting and collateral history from family members are valuable.

Treatment Options

Mood stabilizers: Lithium (gold standard), Valproate, Lamotrigine, Carbamazepine

Atypical antipsychotics: Quetiapine, Olanzapine, Aripiprazole

Antidepressants (with caution, always with mood stabilizer)

Psychoeducation about the illness

Cognitive Behavioral Therapy

Interpersonal and Social Rhythm Therapy

Lifestyle management: regular sleep schedule, stress reduction

Long-term maintenance treatment (essential to prevent relapse)

When to Seek Help

Seek help if you experience extreme mood swings, if you have periods where you need very little sleep yet feel energetic, if mood changes are affecting your relationships and work, or if you have thoughts of suicide during depressive episodes.

Your Action Plan

1.Step 1: Accept the diagnosis — bipolar disorder is lifelong but highly manageable with proper treatment

2.Step 2: Commit to medication: mood stabilizers are NOT optional — they prevent episodes and protect your brain

3.Step 3: Track your mood DAILY: use an app or paper diary. Rate mood, sleep hours, energy, medication taken

4.Step 4: Protect your sleep: disrupted sleep is the #1 trigger for manic episodes. Consistent sleep schedule is critical

5.Step 5: Know YOUR warning signs: what happens first when a manic or depressive episode is starting?

6.Step 6: Avoid substances: alcohol and drugs destabilize mood and interact with medications

7.Step 7: Build a support team: psychiatrist, therapist, trusted family member with whom you share your mood tracking

8.Step 8: Create an action plan for episodes: when mood goes above/below certain thresholds, have pre-agreed steps

9.Step 9: If medication side effects are intolerable, discuss alternatives with your doctor — DON'T just stop

10.Step 10: Psychoeducation: learn everything about your condition — informed patients have better outcomes