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Bipolar Spectrum Disorder - Causes, Symptoms, and Treatment

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The spectrum of bipolar disorder includes symptoms of other mental illnesses like depressive disorder and generalized anxiety disorder. Read on to learn more.

Medically reviewed by

Dr. Vishal Anilkumar Gandhi

Published At June 5, 2023
Reviewed AtApril 4, 2024

Introduction

Bipolar disorder is a disorder of the brain that causes alterations in a person's mood, energy, and ability to function. People with bipolar disorder usually experience intense emotional states that occur over a period of days to weeks, called mood episodes. They get mania (abnormal happiness) or depressed (sad mood). Patients with bipolar disorder also usually have periods of neutral mood. People with bipolar disorder can lead a normal and productive life with treatment. Even people without bipolar disorder have mood swings. However, these mood swings usually last for hours instead of days. Moreover, these changes are not usually accompanied by the extreme degree of behavioral changes that people with bipolar disorder exhibit during episodes of mood or difficulties with daily living and social interactions. It can disrupt relationships with loved ones and cause difficulties at work or school. The Bipolar Spectrum Diagnostic Scale was developed by psychiatrist at Tufts university school of medicine, Ronald Pies. It can show where a person is on the spectrum scale.

What Is Bipolar Spectrum Disorder?

Bipolar disorder includes a variety of signs and symptoms of varying severity. These symptoms include mood swings, changes in energy levels and thinking, and sleep disturbances. Some mental health professionals describe bipolar disorder as a spectrum disorder. This is because individuals experience both very high moods and very low moods, and moods on both ends of the spectrum can be involved. However, it is possible to experience both ends of the spectrum simultaneously, known as mixed episodes. Several psychiatric disorders other than bipolar affective disorder share common symptoms that overlap between disorders. For example, many people with borderline personality disorder experience depression along with severe mood swings and impulse control problems.

The Bipolar Spectrum Diagnostic Scale (BSDS) is a psychiatric screening rating scale for bipolar disorder. The scale consists of 19 questions and two sections. It differs from most in that instead of listing individual items; it presents short paragraphs talking about things that people with bipolar disorder commonly experience. If they match an experience of a person then they should put a check on it accordingly. Bipolar spectrum disorder includes bipolar types I and II and other cases that do not meet the criteria for these disorders.

What Are the Causes of Bipolar Spectrum Disorder?

The causes of bipolar spectrum disorder include:

1. Genetics - Genes inherited from the parents may predispose an individual to develop bipolar spectrum disorder.

2. Dysfunctional Brain Chemistry - People suffering from bipolar disorder are thought to have problems with neurotransmitters in the brain, especially serotonin. Neurotransmitters are chemical messengers the brain uses to transmit signals between brain cells. Changes in serotonin levels are associated with depression, aggression, and difficulty controlling destructive impulses.

3. Problems With Brain Development - People with bipolar disorder have smaller activity in some parts of the brain and delayed growth. These parts include

  • Amygdala - Plays an important role in regulating emotions, especially more "negative" emotions such as fear, aggression, and anxiety.

  • Hippocampus - Helps regulate behavior and self-control.

  • Orbitofrontal Cortex - Involved in planning and decision-making.

Problems in these parts of the brain can certainly contribute to symptoms of bipolar disorder. The development of these parts of the brain is affected by early upbringing and are also involved in regulating mood, which people with bipolar disorder have in intimate relationships. It may explain some of the problems.

4. Environmental Factors - Many environmental factors appear to be common and prevalent in people with bipolar disorder. These include:

  • Being the victim of emotional, physical, or sexual abuse.

  • Exposed to prolonged anxiety or stress as a child.

  • Ignored by one or both parents.

  • Bipolar disorder or alcohol or substance abuse problems who grew up with another family member who had a severe mental illness.

What Are the Symptoms of Bipolar Spectrum Disorder?

People with bipolar disorder show two symptoms, depressive and manic.

Manic Period-

  • During periods of mania, a person acts impulsively, makes decisions without good judgment, and takes unusual risks. Also, the person does not ignore or recognize the negative effects of unpredictable behavior.

  • A feeling of absolute happiness that nothing (even bad news or tragic events) can change.

  • Sudden anger or extreme irritability.

  • The person may have wildly ambitious delusions or strong beliefs that have no rationale. The person may claim to have a special relationship with a god, celebrity, or historical figure.

  • Unrealistic beliefs present in one's own abilities.

  • Inability to control impulsive actions and risky behavior such as splurging on things that are not required, unrealistic business investments, reckless driving, or extreme sexual behavior.

  • Running of uncontrollable thoughts continuously in mind.

  • Hyperactivity, restlessness, and inability to sleep.

  • Difficulty in concentration and inability to do normal activities.

  • Feeling frustrated and always irritable.

  • Rapid speech and jumping from one thought to another really fast.

  • Loss of sense of reality, which often leads to psychosis (seeing or hearing things that are not actually there).

  • Cleaning or organizing things obsessively.

  • Listening to the same music on repeat for days.

  • Trying to dominate other people.

Depressed Phase -

During the depressive phase, the person suffering from bipolar spectrum disorder may experience the following:

  • Extreme sadness or despair.

  • Feeling hopeless.

  • Lack of interest in activities once enjoyed.

  • Feeling lethargic and tired most of the time.

  • Difficulty in sleeping and insomnia.

  • A significant amount of weight loss.

  • Difficulty concentrating and making decisions.

  • Thoughts of killing oneself and self-harm.

How Is Bipolar Spectrum Disorder Diagnosed?

The diagnosis of bipolar disorder is done in the following ways:

  • Physical Examination - The doctor may do physical and laboratory tests to identify any medical problems that may be causing the symptoms.

  • Psychiatric Evaluation - The doctor may refer to a psychiatrist to discuss thoughts, feelings, and behavior patterns. One can also complete a psychological self-assessment or questionnaire. With the help of a questionnaire and checklists, doctors can find out where in the spectrum the person falls on.

What Is the Treatment for Bipolar Spectrum Disorder?

The treatment of Bipolar spectrum disorder is done in the ways listed below:

  • Drugs - An individual needs to start taking medications right away to help balance their mood.

  • Continued Treatment - Bipolar disorder requires lifelong drug treatment, even when you feel better. People who skip maintenance therapy are at increased risk of recurrence of symptoms or of minor mood swings turning into full-blown mania or depression.

  • Hospitalization - If a person is behaving risky, suicidal, or disconnected from reality (psychosis), their doctor may recommend hospitalization. Psychiatric treatment in a hospital can help keep people calm, safe, and stable, despite having a manic episode or a depressive episode.

  • Psychotherapy - It is an integral part of the treatment of bipolar disorder and can be done by trained individuals, a family, or groups.

How to Prevent Bipolar Spectrum Disorder?

Bipolar spectrum disorder can be prevented in the following ways:

  • Pay Attention to Symptoms - Treating symptoms early can prevent episodes from getting worse. A person may have identified patterns of bipolar episodes and what causes them. Call the doctor immediately if going into depression or mania. Have family and friends watch for warning signs.

  • Avoid Drugs and Alcohol - Alcohol and recreational drug use can make symptoms worse and increase the chances of recurrence.

  • Take the Medication Exactly As Directed - There may be a temptation to stop the treatment. In case of stopping the drug, there might be withdrawal symptoms.

Conclusion

Bipolar disorder, formerly known as manic-depressive illness, is a mental illness that causes extreme mood swings that include highs and lows. This illness is a broad group of symptoms where symptoms of other mental disorders overlap with this condition. Hence, it is called a bipolar spectrum disorder. In depression, a person may feel sad and lonely. A manic or hypomanic mood (less extreme than mania) can be euphoric or unusually energetic. These mood swings can affect energy, sleep, activity, judgment, behavior, and the ability to think clearly. Episodes of such mood swings may appear infrequently or several times a year. Most people experience emotional symptoms during an episode, but some do not. Bipolar disorder is a lifelong condition, but mood swings and other symptoms can be managed by following a treatment plan. Most often, bipolar disorder is treated with medication and psychological counseling (psychotherapy).

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Dr. Vishal Anilkumar Gandhi
Dr. Vishal Anilkumar Gandhi

Psychiatry

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