- Genetics: Bipolar disorder tends to run in families, suggesting a strong genetic component. If a close relative has the condition, the risk is higher.
- Brain structure and function: Differences in the brain structure and chemical imbalances (neurotransmitters like serotonin, dopamine, and norepinephrine) are thought to play a role.
- Stress: Traumatic events, significant life changes, or chronic stress can trigger episodes in susceptible individuals.
- Sleep disruption: Irregular sleep patterns or severe sleep deprivation can sometimes trigger manic or hypomanic episodes.
- Drug or alcohol abuse: Substance abuse can worsen symptoms or trigger episodes, though it's not a direct cause.
- Manic Episode (severe high):
- Elevated, expansive, or irritable mood
- Increased activity or energy
- Decreased need for sleep
- Racing thoughts
- Pressured speech (talking rapidly and loudly)
- Inflated self-esteem or grandiosity
- Distractibility
- Engaging in high-risk behaviors (e.g., reckless spending, impulsive sexual activity)
- Hypomanic Episode (less severe high):
- Similar to mania but less severe, typically not causing significant impairment in daily functioning or requiring hospitalization.
- Noticeable change from usual behavior.
- Depressive Episode (low):
- Profound sadness, hopelessness, or irritability
- Loss of interest or pleasure in activities once enjoyed
- Significant weight loss or gain, or changes in appetite
- Insomnia or hypersomnia (sleeping too much)
- Psychomotor agitation or retardation (restlessness or slowed movements)
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Difficulty concentrating, thinking, or making decisions
- Recurrent thoughts of death or suicide
- Psychiatric evaluation: A mental health professional (psychiatrist, psychologist) will conduct an in-depth interview to gather information about:
- Your symptoms (mood, energy, sleep, thoughts, behavior)
- Your personal and family medical history
- Any substance use
- Mood charting: You may be asked to track your moods, sleep patterns, and daily activities to help identify patterns and triggers.
- Physical exam and lab tests: To rule out other medical conditions (e.g., thyroid problems, vitamin deficiencies) that could cause similar symptoms.
- Medications:
- Mood stabilizers: The cornerstone of bipolar treatment. Examples include lithium, valproate (Depakote), lamotrigine (Lamictal), and carbamazepine (Tegretol).
- Antipsychotics: May be used to control manic or mixed episodes, or for long-term maintenance (e.g., olanzapine, quetiapine, risperidone, aripiprazole).
- Antidepressants: May be used cautiously and often in combination with a mood stabilizer or antipsychotic to treat depressive episodes, to avoid triggering mania.
- Anti-anxiety medications: May be prescribed for short-term use to manage anxiety or sleep problems.
- Psychotherapy:
- Cognitive Behavioral Therapy (CBT): Helps identify and change unhealthy thought patterns and behaviors.
- Family-Focused Therapy: Involves family members to improve communication and problem-solving.
- Interpersonal and Social Rhythm Therapy (IPSRT): Focuses on stabilizing daily routines and sleep-wake cycles to help regulate mood.
- Lifestyle management:
- Regular sleep schedule: Crucial for mood stability.
- Stress management techniques: Mindfulness, meditation, exercise.
- Healthy diet and regular exercise.
- Avoiding alcohol and recreational drugs.
- Electroconvulsive Therapy (ECT): May be considered for severe manic or depressive episodes that don't respond to medication or for cases with psychosis.
- Transcranial Magnetic Stimulation (TMS): A non-invasive brain stimulation technique, sometimes used for depression that hasn't responded to other treatments.