Bipolar disorder, also known as manic-depressive illness, is a mental health condition characterized by extreme mood swings that range from episodes of mania to episodes of depression. These mood swings can greatly impact an individual's day-to-day life, relationships, and overall well-being. It is estimated that approximately 2.8% of the global population suffers from bipolar disorder, making it a prevalent mental illness that requires proper treatment and management.

Bipolar disorder is a complex mental health condition characterized by extreme mood swings that include periods of elevated mood, known as mania or hypomania, and periods of sadness and low mood (depression). These mood swings can have a significant impact on a person's day-to-day life, affecting their relationships, work performance, and overall quality of life. Individuals with bipolar disorder may experience manic episodes marked by increased energy, racing thoughts, impulsivity, and euphoria, followed by depressive episodes characterized by sadness, lethargy, and hopelessness.

Ways to Diagnose Bipolar Disorder

Diagnosing bipolar disorder involves a comprehensive assessment by a qualified mental health professional, typically a psychiatrist or psychologist. The diagnosis is based on a combination of clinical observation, self-reported symptoms, medical history, and diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Here are some common methods used to diagnose bipolar disorder:

1. Clinical Interview: The initial step in diagnosing bipolar disorder involves a thorough clinical interview with a mental health professional. During this interview, the clinician will gather information about the individual's symptoms, medical history, family history of mental illness, and any past episodes of mood disturbance. The clinician may also ask about the individual's sleep patterns, energy levels, appetite, and other relevant factors.

2. Symptom Assessment: The clinician will assess the presence and severity of symptoms associated with bipolar disorder, including manic or hypomanic episodes, depressive episodes, and any history of mixed episodes (where symptoms of mania and depression occur simultaneously). The individual may be asked to provide detailed descriptions of their mood swings, as well as any associated symptoms such as changes in sleep, energy, or behavior.

3. Diagnostic Criteria: The DSM-5 outlines specific criteria for diagnosing bipolar disorder, including the duration, severity, and frequency of mood episodes. To meet the criteria for bipolar disorder, an individual must have experienced at least one manic or hypomanic episode, typically accompanied by one or more depressive episodes. The clinician will carefully assess whether the individual's symptoms meet these criteria.

4. Psychological Testing: In some cases, psychological testing may be used to assess cognitive functioning, personality traits, and emotional functioning. While psychological testing is not typically used as the sole basis for diagnosing bipolar disorder, it can provide additional information to support the diagnosis and guide treatment planning.

5. Observation Over Time: Bipolar disorder is characterized by recurrent episodes of mood disturbance, so clinicians may observe the individual's mood and behavior over some time to confirm the diagnosis. This may involve monitoring mood symptoms, sleep patterns, and other relevant factors over several weeks or months.

Common Treatments for Bipolar Disorder

1. Psychotherapy: In addition to CBT, other forms of therapy such as interpersonal and social rhythm therapy (IPSRT) can help individuals with bipolar disorder manage their symptoms and improve their overall functioning.

2. Medication: Mood stabilizers such as lithium, anticonvulsants like valproate or lamotrigine, and atypical antipsychotics are commonly prescribed to help stabilize mood and prevent mood swings in individuals with bipolar disorder. Advisory: Before taking any medication, it is advisable to consult a psychiatrist online or offline.

3. Electroconvulsive Therapy (ECT): In cases where medication and psychotherapy are not effective, or in severe cases of bipolar disorder with psychotic features, ECT may be considered as a treatment option. ECT involves administering electrical currents to the brain to induce controlled seizures, which can help alleviate symptoms of depression or mania.

4. Hospitalization: In cases of severe mania or depression, hospitalization may be necessary to ensure the safety of the individual and provide intensive treatment and support.

Managing Bipolar Traits

In addition to therapy and counseling, there are several strategies individuals with bipolar disorder can use to manage their symptoms and maintain stability:

1. Regular Routine: Establishing and maintaining a routine can help individuals with bipolar disorder manage their symptoms and reduce the risk of mood swings. This includes maintaining consistent sleep patterns, eating healthy meals at regular intervals, and engaging in regular exercise and self-care activities.

2. Mood Tracking: Keeping track of mood changes, energy levels, sleep patterns, and other symptoms can help individuals with bipolar disorder identify triggers and early warning signs of mood episodes. Mood tracking can be done through journaling, mood-tracking apps, or mood charts provided by healthcare providers.

3. Stress Management: Stress can trigger episodes of mania or depression in individuals with bipolar disorder. Learning stress management techniques such as mindfulness, deep breathing exercises, and relaxation techniques can help individuals cope with stress more effectively and reduce the risk of mood episodes.

4. Avoiding Triggers: Identifying and avoiding triggers that may exacerbate symptoms of bipolar disorder, such as substance abuse, sleep deprivation, or excessive caffeine intake, can help individuals maintain stability and prevent mood episodes.

5. Limiting Substance Use: Substance abuse, including alcohol and drugs, can exacerbate symptoms of bipolar disorder and interfere with treatment effectiveness. Individuals with bipolar disorder should avoid or limit the use of substances that may trigger mood episodes or interfere with medication.

6. Sticking to Treatment Plan: Consistently following the treatment plan prescribed by healthcare providers, including taking medication as directed and attending therapy sessions regularly, is essential for managing bipolar disorder symptoms and maintaining stability. Even during periods of remission, it's important to continue treatment to prevent relapse.

Benefits of Therapy and Counseling for Bipolar Disorder

Therapy and counseling can be valuable tools in the treatment and management of bipolar disorder, offering individuals coping strategies, support, and insight into their condition. Cognitive-behavioral therapy (CBT) is one approach commonly used to help individuals identify and challenge negative thought patterns, develop healthy coping skills, and manage symptoms of both depression and mania.

Research by Lam et al. (2003) has shown that individuals with bipolar disorder who received CBT alongside medication experienced significant improvements in mood stability and functioning compared to those who received medication alone. Additionally, psychoeducation, which involves learning about the symptoms, triggers, and treatments of bipolar disorder, can help individuals and their families better understand the condition and how to manage it effectively.

Real-Life Examples

Consider the case of Ms. Z, a 32-year-old woman diagnosed with severe bipolar disorder. Through a combination of medication management, CBT, and lifestyle changes, Ms. Z has learned to manage her symptoms effectively. She attends regular therapy sessions where she learns coping skills to manage stress and identify early warning signs of mood episodes. Ms. Z also takes her medication as prescribed and prioritizes self-care activities such as yoga and meditation to maintain stability.

Bipolar disorder is a challenging condition that requires comprehensive treatment and management strategies. Therapy and counseling, medication management, and lifestyle changes are all important components of a holistic approach to managing bipolar disorder and improving overall quality of life. By working closely with healthcare providers and implementing effective coping strategies, individuals with bipolar disorder can achieve stability and thrive despite the challenges of their condition.

Conclusion

Although bipolar illness is a difficult mental health disease, people can significantly improve their quality of life with thorough therapy and appropriate management. Success requires a trifecta of medicine, psychotherapy, and lifestyle modifications. Interpersonal and social rhythm therapy (IPSRT) and cognitive-behavioral therapy (CBT) aid in symptom management, and mood stabilizers and atypical antipsychotics control mood swings. For safety and intense care, severe cases may need electroconvulsive therapy (ECT) or hospitalization. Essential tactics include creating a routine, monitoring mood swings, controlling stress, avoiding triggers, and following treatment programs. Individuals who receive ongoing treatment and counseling are better equipped with the coping mechanisms they need. Leading mental health experts in India may be found at Psychowellness, and    TalktoAngel is one of the best online counselling sites that connect people with qualified therapists for easily accessible online therapy. By using these tools, people with bipolar illness may take control of their symptoms, find stability, and enjoy happy, full lives.

Contributed by: Dr (Prof) R K Suri, Clinical Psychologist & Life Coach &  Mr. Utkarsh Yadav, Counselling Psychologist

Reference:

1. https://www.nhs.uk/mental-health/conditions/bipolar-disorder/treatment/

2. https://www.helpguide.org/articles/bipolar-disorder/bipolar-disorder-treatment.htm

3. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961#:~:text=People%20with%20bipolar%20disorder%20may,what%20triggers%20your%20bipolar%20episodes.

4. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-1410197656063.pdf