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MOOD DISORDERS WITH EMPHASIS ON BIPOLAR DISORDER


Mood disorders are a category of illnesses that describe a serious change in mood. Though many different subtypes are recognized, three major states of mood disorders exist: depressive, manic, and bipolar.
Bipolar disorder previously referred to as manic depression is a multifactorial illness with uncertain aetiology. It is a mental health condition that causes extreme mood swings that include emotional highs like depression and mania. The cycling between both depressed and manic moods is what characterises bipolar mood disorder.


Epidemiology
Epidemiological studies have suggested a lifetime prevalence of around 1% for bipolar type I in the general population. A large cross-sectional survey of 11 countries found the overall lifetime prevalence of bipolar spectrum disorders was 2.4%, with a prevalence of 0.6% for bipolar type I and 0.4% for bipolar type II.
There are several types of bipolar and related disorders including cyclothymic disorder but the two types of bipolar I disorder and bipolar II disorder are of higher significance.
Bipolar I disorder. Individual has experienced at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
Bipolar II disorder. Individual has experienced at least one major depressive episode and at least one hypomanic episode, but never had a manic episode. Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.


Aetiology and risk factors
The aetiology of bipolar is not well understood and research is still ongoing. Possible causes are summarised as genetic or environmental; familial genetic risk, early life stress, childhood trauma and perinatal infections.

Symptoms and diagnosis
The main symptoms of bipolar disorder are alternating episodes of extreme euphoria, or mania, and major depression. Some studies have shown that people with bipolar disorder have enhanced creativity but mood swings makes it difficult to sustain the attention required for the projects or follow through with plans, resulting in the person having multiple uncompleted projects.

There may also be periods of unusually intense emotion, changes in sleep patterns depending on the episode the individual is having for example in:

Manic episodes,
Individuals may:
  • Feel very up, high, or elated
  • Be agitated, irritable, or touchy
  • Do risky things, like spend a lot of money or have reckless sex
While in Depressive episodes,
Individuals may:
  • Feel very sad, down, empty, or hopeless
  • Have very little energy
  • Have decreased activity levels
  • Have trouble concentrating
  • Think about death or suicide


Management
Diagnosis of bipolar prevalently occurs between the ages of 15 and 25 years, but it may be picked up at any age. The incidence is approximately equal in both males and females. Management options are mainly by psychotherapy and pharmacotherapy, using drugs like mood stabilizers, atypical antipsychotics and antidepressants. Electroconvulsive therapy (ECT) is also considered predominantly in individuals who are contraindicated to drug therapy such as pregnant women. However ECT has its own side effects like disorientation, confusion and memory loss. Treatment helps many people but bipolar disorder is a lifelong illness which unfortunately is subjected to the stigma and labelling associated with mental disorders in Ghana.

Author: Peter Opoku K. Amponsah



REFERENCES
https://www.medicalnewstoday.com/articles/37010.php

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116765/#bibr23-2045125318769235

2. https://www.psychologytoday.com/blog/hide-and-seek/201203/bipolar-disorder-and-creativity

3. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
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