Depression is becoming increasingly prevalent these days! Stay alert to mood fluctuations in your family members and yourself to maintain good health.
In this chapter, we move on to another class of disorders—bipolar disorder—and its clinical diagnostic standards.
Bipolar disorder is diagnosed based on five main criteria. If an individual consistently exhibits these symptoms for a week, they should undergo clinical assessment. Cases with shorter durations are considered manic mood swings rather than a disorder. Such cases are not classified under depression and do not require full assessment.
The Five Main Criteria:
Mood Changes
Patients with bipolar disorder often exhibit inflated self-esteem or grandiosity. Dr. Li recalls a patient who, when asked by hospital staff to take her meal, declared herself the First Lady, insisting she would only respond if the staff formally lined up to show their respect. This is a typical example of an inflated ego, where the patient sees themselves as superior in every way.
Sleep Disorders
Patients with bipolar disorder often experience severe sleep disturbances. They may go without rest for two nights in a row, appearing exhausted yet unable to sleep even when encouraged to do so. This inability to rest is often linked to heightened adrenaline levels, which keep them in a state of excessive excitement.
Sleep is essential for both physical and mental well-being. The brain continues working during sleep, organizing and processing information much like a 24-hour convenience store restocking shelves overnight. Without adequate rest, the body struggles to function properly, worsening the condition of patients with bipolar disorder.
Changes in Speech Patterns
A person who typically speaks sparingly may suddenly start talking excessively. Their speech may become rapid, sometimes twice as fast as usual. This heightened rate of speech signals an increase in hormone levels and an overexcited state of mind.
Jumping Thoughts
Linked to the previous symptom, individuals with bipolar disorder may frequently jump from one topic to another. While their listeners are still focused on one subject, they suddenly introduce unrelated ideas isorganized thought process, making conversations difficult to follow.
In some cases, this scattered thinking can lead to delusions of superiority, reinforcing self-aggrandizing behavior. A common example involves gambling addicts who believe they can make vast sums of money despite losses. They may borrow money, convinced they are making a wise financial decision, and dismiss any advice against gambling as ignorance. Their heightened confidence and lack of need for rest fuel this cycle.
Reckless Behavior
Individuals with bipolar disorder may make impulsive decisions without considering consequences. For example, a woman was shocked when her husband came home with a brand-new sports car that he had impulsively purchased without any prior discussion or financial planning.
Reckless decisions also manifest in financial ventures, where individuals invest large sums of money without careful analysis. While men are more likely to engage in high-risk financial behaviors, women often indulge in impulsive shopping sprees, buying unnecessary items that remain unused.
Although depression is more common in women, the outward manifestations of bipolar disorder—such as impulsivity and antisocial behavior—are more noticeable in men. In extreme cases, some men with bipolar disorder may engage in drug use or other socially unacceptable behaviors.
Are Vandalism and Littering Linked to Bipolar Disorder?
While some patients with bipolar disorder may exhibit reckless behavior, not all acts of irresponsibility—such as littering or vandalism—are linked to the disorder. These actions may instead stem from a lack of moral self-discipline. However, reckless behavior is often more severe in individuals diagnosed with bipolar disorder.
Manic Episodes and Diagnosis
A patient exhibiting five of the aforementioned symptoms for a week should undergo a clinical assessment for mania. Diagnosis is based on the individual’s daily behavior, the impact on their social functions, and the psychiatrist’s clinical expertise.
Treatment for Bipolar Disorder
Once symptoms of depression or mania are identified, medical treatment begins with medication. A psychiatrist typically prescribes fluoxetine (commonly known as Prozac) to stabilize hormone levels and bring them back to a healthy ranges.
It is crucial for patients to follow their prescribed medication regimen strictly. They should never adjust the dosage on their own. Treatment usually lasts at least six months, and stopping medication prematurely can lead to relapse or worsening symptoms. The importance of completing a full course of treatment is similar to taking antibiotics—stopping halfway can result in a stronger recurrence of the illness.
However, medications can have side effects such as hair loss, sluggish movements, or central obesity (fat accumulation around the abdomen). Some patients discontinue their medication when they perceive an improvement, but this can lead to a dangerous relapse.
The Role of Psychiatric Counseling
Counseling is a vital component of the recovery process. A trained counselor provides support and encouragement, helping patients navigate the challenges of treatment. Some patients may stop taking medication or increase their dosage without consulting their doctor. Counselors help ensure they stay on track and follow medical advice correctly.
Bipolar disorder is complex and can have genetic links, or in some cases, it may result from improper medication use. Some patients self-medicate, believing they have improved, only to develop manic symptoms due to an overdose.
Family members play a crucial role in supporting patients, ensuring they understand the importance of following their prescribed treatment. True care and love are demonstrated through actions, not just words.
Discussion Questions:
What is the difference between manic episodes and depression?
Identify the five major symptoms of mania.
Who is best qualified to carry out a diagnostic assessment for bipolar disorder?
Have you encountered individuals experiencing manic episodes? How can we help them?
