Mood Disorders

Bipolar disorder

What is Bipolar Disorder?

Bipolar disorder — also called manic depression or bipolar affective disorder, is a brain disorder  (not  to be confused with Borderline Personality Disorder) that causes unusual shifts in mood, energy, and ability to function.  These mood shifts include alternating periods of depression and mania.  These are not the normal ups and downs;  the symptoms of bipolar disorder are severe.   Manic episodes  last at least 7 days, which are usually so severe the person may need  immediate hospital care.  Depressive episodes occur as well, typically lasting at least 2 weeks or possibly more.

Mania

In order to be clinically diagnosed with Bipolar Disorder it is necessary to meet the following criteria for at least one manic episode:

A.  A distinct period of an abnormal persistently elevated, expansive or irritable which includes increased activity or energy, nearly ever day. The mood must be severe enough to cause marked impairment in social or occupational functioning, or requires hospitalization, or there are psychotic features (hallucinations), and the episode cannot be cause by a substance (drug abuse, medication, treatment) examples may be cocaine, methamphetamine, or steroid treatment such as injections or oral medications.  The manic episode may have been preceded by hypomanic or major depressive episode.

B.  During this period of elevated mood three or more of the following symptoms (four if only irritable) must be present and highly noticeable and unusual for one’s behavior.

  1.  Inflated self-esteem/grandiosity (absurd exaggeration, over-the-top)
  2. Decreased need for sleep- feels rested after 2-3 hours of sleep
  3. More talkative – rapid, pressured speech, appears they cannot talk fast enough
  4. Flight of ideas  – jumping from one subject to another, confusing subjects as thoughts are racing
  5. Distracted – attention easily drawn to unimportant stimuli
  6. Increased goal directed activity at work, at school or sexually, increased physical agitation (purposeful non-goal directed activity)
  7. Excessive involvement in activities that have painful consequences – unrestrained shopping, giving all their money away, investing in foolish business schemes, sexual infidelities.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) 2013

You may find symptoms of clinical depression here :  Major Depressive Disorder

mood disorders 1
Graph of the spectrum of mood Euthymia (normal even mood) Hypomania, Mania, Depression and Mixed episode (having both manic and depressive symptoms

What is Hypomania?

A hypomanic episode is defined as a distinct period of an abnormal persistently elevated, expansive or irritable which includes increased activity or energy, nearly ever day for at least four days.

A.  The episode is associated with a change in function.  The mood and change in function are observable by others.  The episode is not severe enough to cause impairment in social or occupational function and does not require hospitalization  (as this would be mania).  The episode cannot be cause by a substance (drug abuse, medication, treatment) examples may be cocaine, methamphetamine, or steroid treatment such as injections or oral medications.   Hypomania may be a precursor to a manic episode or may be a symptom of Bipolar II Disorder.

B.  During this period of elevated mood three or more of the following symptoms (four if only irritable) must be present and highly noticeable and unusual for one’s behavior.

  1.  Inflated self-esteem/grandiosity (absurd exaggeration, over-the-top)
  2. Decreased need for sleep- feels rested after 2-3 hours of sleep
  3. More talkative – rapid, pressured speech, appears they cannot talk fast enough
  4. Flight of ideas  – jumping from one subject to another, confusing subjects as thoughts are racing
  5. Distracted – attention easily drawn to unimportant stimuli
  6. Increased goal directed activity at work, at school or sexually, increased physical agitation (purposeful non-goal directed activity)
  7. Excessive involvement in activities that have painful consequences – unrestrained shopping, giving all their money away, investing in foolish business schemes, sexual infidelities.
 The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) 2013

Bipolar II Disorder

For a diagnosis of Bipolar II Disorder it is necessary to have had at least one hypomanic episode and a major depressive episode.

You may find symptoms of clinical depression here :  Major Depressive Disorder

Treatment of Mood Disorders

  • medication, such as Mood Stabilizers
  • referral to a psychologist for counseling, psychotherapy
  • peer support, such as support groups and classes
  • stress management and relaxation training
  • Exercise