Bipolar disorder – Best Treatment for bipolar disorder Symptoms and causes in 2023

Bipolar Disorder, the mysterious illness that swings the pendulum of life. It’s like standing at the edge of a precipice, one moment everything is clear and calm, the coming, a gust of wind comes and you are casting towards the ocean.

The rush is instigative, the fear is real, but when you hit the ground, the pain is unsupportable. Bipolar Disorder, the rollercoaster lift that nothing buys a ticket for. The ups are high, the campo are low, and occasionally you can not tell which is which.

One moment you are full of energy, grand ideas, and insolvable dreams. The coming, you are crushed under the weight of your own inadequacy, floundering to get out of bed, wondering if life is worth living.

Bipolar Disorder, the silent pincher that steals your life down. You can not control it, you can not prognosticate it, and you can not cure it. It takes over your studies, your feelings, and your geste
and you feel like a passenger in your own body. You do not know who you’re presently, and you do not know if you will ever get back. But there is stopgap. There is always stopgap. With the right treatment, the right support, and the right mindset, you can manage your bipolar disorder , and indeed thrive with it.

What is Bipolar Disorder?

Bipolar disorder used to be called ‘manic depressive illness’. It is known from this word that there are very serious ups and downs in your state of mind or mood. These usually last for several weeks or months and are much greater than the emotional ups and downs most of us experience.
These mood swings can be

1.Low or ‘depressed’

You feel low, sad and even hopeless.

2.High or ‘manic’

you feel extremely happy, euphoric and become very active.

3. You may develop very grandiose,

delusional ideas about yourself and your abilities.

4. Hypomanic

Your mood is high, but not as high as in mania.
Mixed –You feel a mixture of mania and depression – for example, you feel very depressed, but also have the restlessness and hyperactivity of mania.

Let us see all these things in detail in the article.

There are following 2 types Bipolar Disorder

1.Bipolar Disorder 0ne:

Bipolar Disorder 1 You have had at least one high or manic episode that lasted more than a week – usually much longer.
You may only have episodes of mania, although most people with bipolar one also have periods of severe depression.
Left untreated, an episode of mania will usually last 3 to 6 months.
Depressive episodes tend to last a long time – without treatment, for 6 to 12 months.

2.Bipolar Disorder (II) .

You have more than one episode of severe depression but only moderate episodes of mania – this is called ‘hypomania’.

You have four or more mood episodes in a 12-month period. It affects about 1 in 10 people with bipolar disorder and can occur with both types Bipolar Disorder one (I) and Two (II).
cyclothymia
Mood swings are less severe than those in people with full bipolar disorder, but may last longer. Over time this can develop into full-blown bipolar disorder.

Causes of bipolar disorder:

The same genetic ‘risk factors’ are involved in a person developing bipolar disorder, major depression or schizophrenia. –There are also environmental risk factors, and these, combined with genetic risk factors, can increase or decrease your risk of developing these diseases or conditions.

You may have genetic risk factors that mean you are more likely to develop bipolar disorder. However, if you grow up or live in a stable and positive environment, it can reduce your risk of developing a serious mental illness.

Having a parent with a serious mental illness, such as bipolar, is the strongest known risk factor for developing a serious mental illness. Children who have one parent with a serious mental illness have a 1 in 3 chance of developing a serious mental illness.

When thinking about what causes bipolar disorder it’s important to remember that there are a lot of different things involved, and bipolar disorder is not caused by any one risk factor.

What does bipolar disorder feel like?

• Emotional changes
• Feelings of unhappiness that don’t go away.
• Loss of interest in things.
• Not being able to enjoy things.
• Feeling restless and agitated.
• Losing confidence.
• Feeling worthless, unworthy and hopeless.
• Feeling more irritable than usual.
• Thinking about suicide.
• Problems related to your thinking
• You can’t keep positive or optimistic thinking.
• You have difficulty making even simple decisions.
• You are unable to work with full concentration.

Physical symptoms:

You don’t want to eat and you lose weight.
It is difficult to sleep.
You wake up very early – and can’t go back to sleep.
You feel absolutely tired.
You get constipated.
You lose interest in sex.

Behaviour:

It is difficult to start or finish things
Even everyday tasks.
You avoid other people.

Frenzy:

You feel great, energetic and optimistic so much so that it affects your thinking and decisions.
You may start to believe strange things about yourself, make poor decisions, and behave in embarrassing, hurtful, and  sometimes  dangerous ways.

Like depression itself, it can make it difficult or impossible to deal with day-to-day life. Mania can have a negative impact on both your relationships and your work.

When it is not very serious, it is called ‘hypomania’. It can still affect your decision-making ability and your interactions with other people.

In a state of insanity you can see that:

• are emotional
• Very happy and excited.
• very irritable
• Feeling more important than usual.

Thinking:

Full of new and exciting ideas.
Jumping quickly from one thought to another, and forgetting about what you are trying to think or convey.
Hears sounds that other people can’t hear.

Physical

Are full of energy and more active than usual
Unable or unwilling to sleep
May take more interest in sex.

Behaviour

Making plans that are grandiose and unrealistic.
Very active, moving around very quickly.
Behaving differently than usual.

Talking too fast

so fast that other people may have a hard time understanding what you’re talking about.

Making strange decisions on the spur of the moment, sometimes decisions with dire consequences.
Spending your money without thinking.
Are over-acquainted with other people or criticize without thinking.
Generally less shy.

If you are in the midst of a manic episode for the first time, you may not realize that something is wrong – although usually your friends, family or colleagues will notice. If someone tries to tell you this, you may even get angry. You start becoming indifferent to day-to-day issues and other people’s feelings.

Psychotic symptoms

If an episode of mania or depression becomes very severe, you may develop delusional thoughts.

 In a mania episode

these would be grandiose thoughts about yourself – that you are on an important mission or that you have special powers and abilities.

In a depressive episode

you may feel that you are uniquely to blame, that others are worse off, or even that you are not there.
Along with these unusual thoughts, you may experience hallucinations – when you hear, smell, feel or see something, but there is nothing (or anyone) there to prove it.

Between episodes

Some people with bipolar disorder feel that they are completely fine in between mood swings – but many people do not. You may remain depressed and continue to have trouble thinking, even when you appear better (to others).

An episode of bipolar disorder may mean you have to stop driving for a period of time – you must tell the Driver and Vehicle Licensing Agency or the DVLA (relevant department) if you have bipolar disorder. There is information about this on the DVLA website.

Treatment:

First you..You can see a P (general practitioner), especially if you have had a depressive episode. But, if they diagnose bipolar disorder, they will have to refer you to a specialist – a psychiatrist. NICE guidance suggests that mood-stabilisers need to be started by a specialist, even if you are subsequently looked after by a GP.

Once any medicines you are taking are established and seem to be effective, your GP can take over most of your care, although they will usually want you to be in contact with a psychiatrist and CMHT.

Medications for bipolar disorder

There are some things that can help control mood swings so they don’t become full-blown episodes of mania or depression. These are mentioned below, but medication is often needed:

to stabilize your mood (prevention)
To treat manic or depressive episodes.
Medications to stabilize mood
There are many mood stabilisers, some of which are also used to treat epilepsy or to help with schizophrenia. Your psychiatrist may need to use more than one medication to effectively control mood swings.

Lithium

Lithium has been used for decades as a mood stabilizer – but it’s still unclear how it works. It is still the first choice for long-term treatment of bipolar disorder and can be used to treat both mania and depressive episodes.

Treatment by lithium should be started by a psychiatrist. The difficulty comes in maintaining proper levels of lithium in the body  too little will not work, and too much can harm you. Therefore, you’ll need regular blood tests over the first few weeks to make sure you’re getting the right dose. Once your dose is stabilised, your GP can prescribe you lithium and arrange regular blood tests for the long term.

The amount of lithium in your blood is very sensitive to how much or how little water you have in your body. If your body becomes dehydrated, the level of lithium in your blood will increase, and you will be more likely to have side effects, or even toxic effects1 Therefore, it is important that:

Drink plenty of water

Drink more water in hot weather or when you’re active.
Be careful about drinking tea and coffee – they increase the amount of water in your urine.
It may take three months or longer for lithium to work properly. The tablets should be continued to be taken even if the mood swings continue during this time.

Side effects:

These may start in the first few weeks after starting lithium treatment. These can be painful and unpleasant, but often disappear or get better with time.

Their side effects include:

Feeling thirsty.
Urinating more than usual (and more often).
Weight gain.

Common side effects are:-

Blurred vision.
Slight weakness in muscles.
Occasional diarrhoea.
Slight trembling of hands.
Feeling slightly sick.
These can usually be improved by reducing the dose of lithium.

 If there is something like this, immediately show it to the doctor:

You feel very thirsty.
You are having a lot of diarrhea or vomiting.
There is a perceptible vibration in your hands and feet.
Your muscles twitch.
You get confused or confused.
blood and urine tests

You will initially need blood tests every few weeks to make sure you have the right level of lithium in your blood. You will need these tests for as long as you take lithium, but after the first few months the tests will need to be done less frequently.

Long-term use of lithium may affect the kidneys or thyroid gland. To make sure these organs are still functioning properly, you will need to have blood and urine tests every few months. If any problems arise, you may need to discontinue lithium and discuss alternatives with your doctor.

Take a balanced diet.

Regularly consume liquids without sugar. This helps to balance the salt and fluid in your body. Stay away from colas and soft drinks with a lot of sugar.

Eat regularly

this will also help maintain your fluid balance.
-Be careful with caffeine – in tea, coffee or cola. This can make you urinate more, and therefore your lithium levels may get worse.

other mood stabilizers
There are other drugs, besides lithium, that may help. How these are used will depend on whether they are for manic or depressive swings, or to prevent them from occurring – and whether the person is already taking anti-depressants.

Anti-epileptic drugs / anticonvulsants:

Sodium valproate is an anticonvulsant that may work in a similar way to lithium, but we don’t yet have enough evidence that this is the case.

It may harm an unborn baby if taken during pregnancy, so it should not be prescribed to anyone who may be pregnant.
Carbamazepine and lamotrigine are also effective for some people.

Antipsychotic medications:

haloperidol, olanzapine, quetiapine, and risperidone.

When to start a mood stabilizer
After just one episode, it is difficult to predict how likely you are to have a second episode or episodes. Some people do not want to start a mood stabilizer at this point, but episodes of mania can be very severe and very harmful.

If you have a second episode, there is a strong possibility of having further episodes. So, at this point, a mood stabilizer would be more strongly recommended.

For how long should one take a mood stabilizer?

At least: up to two years after an episode of bipolar disorder.up to five years, if
have had several previous relapses
have had psychotic episodes
has had alcohol or substance abuse (substance abuse)
There has been constant stress at home or work.
If you decide to stop your medication, you should discuss it with your doctor. It’s usually best to follow up with your psychiatrist for 2 years after stopping medication for bipolar disorder so they can check you for signs of relapse.

If your troublesome mood episodes continue, you may need to take medication for a longer period of time.

Pregnancy and treatment of bipolar disorder

You should discuss any pregnancy plans with your psychiatrist. Together you can take arrangements for how to manage your mood swings during pregnancy and for the first few months after the baby is born.

Lithium and sodium valproate should not be prescribed if you are pregnant or planning to become pregnant.

If you become pregnant while taking lithium, it is best to discuss with your psychiatrist whether you should stop taking lithium. Although lithium is safer in pregnancy than other mood stabilizers, there is a greater risk of heart problems for the baby. This risk has to be compared to your risk of becoming depressed or manic.

The risk is highest during the first three months of pregnancy. Lithium is safe after the 26th week of pregnancy, you should not breastfeed your baby if you are taking lithium as it can be toxic to your baby.

Psychological therapy for bipolar disorder:

During a depressive episode, or between episodes of mania and depression, psychological treatments may be helpful1 . These may include:

Psychology-Education

Learning More About Bipolar Disorder

Mood Monitoring

You learn to recognize when your mood swings are starting to happen.
help develop general skills to cope
Depressive episodes as well as the periods between such episodes are accompanied by cognitive behavioral therapy or cognitive behavioral therapy.

Cognitive behavioral therapy:

CBT is a talking therapy. Talking therapy is also known as psychotherapy. You can find more information about psychotherapy and psychological treatments on our information page. CBT helps you to learn the theoretical approach and more useful way to react.

Once treatment has started, symptoms usually get better within a few days, but complete recovery may take several weeks. If you want to drive while taking this type of medicine, you should ask your doctor first.

Controlling your mood swings

Self-Monitoring

Learn to recognize the signs that your mood is getting out of control so you can get help quickly. This may help you avoid both having a full-blown episode and being hospitalized. Keeping a mood diary can help you identify which things in your life help you – and which don’t.

Information

Find out as much as you can about your illness and what support is available. There are sources of further information at the end of this leaflet. See below for support groups and caring organizations.

Tension

Try to avoid particularly stressful situations – these can trigger a manic episode or a depressive episode. It’s impossible to avoid all stress, so learning how to better deal with it can be helpful. You can do relaxation training with the help of CDs or DVDs, join a relaxation group, or consult a clinical psychologist.

Relationship

Depression or mania can put a lot of strain on friends and family – you may need to rebuild relationships after an episode.

It helps if you have at least one person you can lean on and confide in. When you are well, try to explain your illness to the people who are important to you. They need to understand what’s going on with you – and what they can do for you.

Activities

Try to balance your life and work, leisure and relationships with your family and friends. Your over-preoccupation may lead to an episode of mania.

Make sure you have enough time to rest. If you are unemployed, consider taking a course or doing some volunteer work that is not related to mental illness.

Exercise

Doing 20 minutes or more of moderately intense exercise three days a week has been shown to improve mood.

joy or fun

Make sure you regularly do things that you enjoy and that give your life meaning.

Continue your medication

You may want to stop your medication before your doctor feels comfortable – but this may lead to another mood swing. When you’re feeling well, talk to your doctor and your family about this.