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Bipolar disorder is a mental health condition that is characterized by extreme mood swings that vary between episodes of mania (elevated mood and energy) and depression (low mood and energy). Bipolar disorder affects about 2.5% of the population worldwide, and it can occur at any age, although it usually emerges during late adolescence or early adulthood.
DSM-5 Diagnostic Criteria for Bipolar Disorder:
To be diagnosed with bipolar disorder, the DSM-5 diagnostic criteria require the presence of at least one manic or hypomanic episode, and one major depressive episode. The diagnostic criteria are:
A. Criteria for a manic episode:
A distinct period of abnormally elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
inflated self-esteem or grandiosity
decreased need for sleep
more talkative than usual or pressure to keep talking
flight of ideas or subjective experience that thoughts are racing
distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed
increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
B. Criteria for a hypomanic episode:
A distinct period of abnormally elevated, expansive, or irritable mood, lasting at least four consecutive days.
During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
inflated self-esteem or grandiosity
decreased need for sleep
more talkative than usual or pressure to keep talking
flight of ideas or subjective experience that thoughts are racing
distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed
increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
C. Criteria for a major depressive episode:
A period of at least two weeks during which there is either depressed mood or loss of interest or pleasure in nearly all activities.
During the period of mood disturbance, five (or more) of the following symptoms have persisted and have been present to a significant degree:
depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful)
markedly diminished interest or pleasure in almost all activities most of the day, nearly every day
significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day
insomnia or hypersomnia nearly every day
psychomotor agitation or retardation nearly every day
fatigue or loss of energy nearly every day
feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
diminished ability to think or concentrate, or indecisiveness, nearly every day
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The episode is not attributable to the physiological effects of a substance or to another medical condition.
The episode is not better accounted for by schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
Types of Bipolar Disorder:
There are three main types of bipolar disorder:
Bipolar I Disorder: characterized by at least one manic episode and usually one or more major depressive episodes.
Bipolar II Disorder: characterized by at least one hypomanic episode and one or more major depressive episodes.
Cyclothymic Disorder: characterized by numerous periods of hypomanic symptoms and depressive symptoms that last for at least two years (one year in children and adolescents).
Psychological Treatment for Bipolar Disorder:
While medications such as mood stabilizers and antipsychotics are often used to manage bipolar disorder, psychological therapies can also be an essential component of treatment. Some of the most commonly used psychological therapies for bipolar disorder include:
Cognitive Behavioral Therapy (CBT): focuses on identifying and challenging negative thoughts and behaviors that can trigger mood swings.
Interpersonal and Social Rhythm Therapy (IPSRT): helps patients stabilize their daily routines and relationships to reduce the frequency and severity of mood episodes.
Family-Focused Therapy: involves educating family members about bipolar disorder and working with them to improve communication and problem-solving skills.
Psychoeducation: involves providing information about bipolar disorder and its treatment to patients and their families.
Mindfulness-Based Cognitive Therapy: a combination of CBT and mindfulness practices that can help patients better regulate their emotions and reduce the risk of relapse.
Self-help Strategies for Managing Bipolar Disorder:
In addition to medication and therapy, there are several strategies that individuals with bipolar disorder can use to help manage their condition. Some of these strategies include:
Get enough sleep: Maintaining a regular sleep schedule can help regulate mood and reduce the risk of manic or depressive episodes.
Monitor mood changes: Keep track of changes in mood, energy levels, and other symptoms and share them with your healthcare provider.
Avoid drugs and alcohol: Substance use can trigger mood swings and interfere with the effectiveness of medications.
Exercise regularly: Exercise can help reduce stress and improve mood.
Eat a balanced diet: A healthy diet can help regulate mood and improve overall physical health.
Build a support system: Connecting with friends, family, and support groups can help individuals with bipolar disorder feel less isolated and better manage their symptoms.
Manage stress: Identify and avoid triggers of stress and use relaxation techniques such as meditation or deep breathing to reduce stress.
Take medications as prescribed: Follow medication instructions carefully and notify your healthcare provider if you experience any side effects.
Attend therapy regularly: Regular therapy sessions can help individuals with bipolar disorder learn new coping skills and manage symptoms more effectively.
Be prepared for episodes: Develop a plan for managing manic or depressive episodes, including contacting healthcare providers or support networks and making lifestyle changes.
