What is the Definition of Bipolar Disorder?
Bipolar disorder is a chronic disease characterized by recurrent episodes of mania, hypomania, mixed and depression. It has been determined that environmental and genetic factors play an important role in the pathogenesis of the disease. Although mood disorder is the core symptom during the disease, disruption in biological rhythm, behavior and cognitive functions are the main effective factors on the course. Bipolar disorder, or manic depressive illness, is probably the first psychiatric disorder that can be associated with the term "chemical imbalance." The use of different drugs in bipolar disorder and the different effectiveness of these pharmacological agents in manic or depressive periods point to the complexity underlying the biochemical basis of the disease. Stressful life events, family conflicts, social relations, disruptions in the sleep-wake cycle, drug addiction, etc., are added to the genetic and chemical basis of the disease. It has been determined that triggers such as impaired adaptation play an important role in the emergence of recurrences. The age of onset of bipolar disorder is most commonly around the age of 20. In contrast, it is very rare for mania to first appear in old age. The frequency of postpartum bipolar disorder depressive episodes is relatively high, and most patients with postpartum depression have bipolar disorder. By its nature, the disease progresses with hypomanic, manic and depressive periods. It has been determined that manic and hypomanic periods increase in spring and summer, while depressive periods increase in winter. Between periods there are euthymic periods in which there are no symptoms of the disease.
Manic episode symptoms: Elasting for at least a week (any length of time if hospitalization is required), unusually and persistently elevated, exuberant or irritable apart Having a low mood episode, exaggerated increase in self-esteem, decreased need for sleep, being more talkative than usual or struggling to keep talking, experiencing flight of ideas or subjectively racing thoughts, attention being too easily drawn to an unimportant or irrelevant external stimulus, social As a result, there is a state of participating in pleasurable activities that are likely to lead to bad consequences, such as increased activity at work or school or sexually, unlimited shopping, reckless sexual attempts, aimless business investments.
Hypomanic period symptoms: The intensity of the symptoms seen in the manic period is at a level that does not require hospitalization and the duration of the symptoms is at least four days.
Depressive period symptoms: The patient's symptoms last at least two weeks. Having a daily depressed mood, either self-reported or observed by someone else, loss of interest in all activities, or inability to enjoy them as much as before. Additionally, during this period, there may be significant weight loss or weight gain while not fasting. Insomnia or difficulty falling asleep, movement and mental restlessness or slowness are observed every day. It is accompanied by fatigue and loss of energy. Thoughts of worthlessness and inappropriate guilt prevail. Distraction, difficulty in concentration, and recurring thoughts of death may be observed.
When diagnosing bipolar disorder, the manic period is more noticeable and makes diagnosis easier. However, the disease may manifest itself with recurrent depressive episodes. This is a situation that makes it difficult to make a correct diagnosis. It requires differentiation from unipolar depression. Because the disease manifests itself as depression, which appears in adolescence or early adulthood. It can show with . Sometimes these depressive episodes are serious enough to attract clinical attention, but sometimes these periods are defined as teenage problems or "bad periods" by the adolescent and his environment. What is more confusing is that sometimes the first episode of mania can be difficult to distinguish from the first episode of schizophrenia if it has severe and psychotic features (such as auditory and visual hallucinations or distortions of thoughts about seeing evil). Studies have shown that it takes up to 10 years for bipolar disorder patients to receive the correct diagnosis.
Which Diseases Is Bipolar Disorder Confused With?
Bipolar disorder differs in terms of disease symptoms. It may be confused with psychiatric disorders. While schizophrenia and schizoaffective disorder are accompanied by psychotic symptoms, borderline personality disorder can be confused with bipolar disorder due to rapidly changing mood, instability in social relationships, and quick anger. The inadequacy in mobility and impulse control mechanisms seen in attention deficit hyperactivity disorder can cause it to be confused with bipolar disorder. .
Bipolar Disorder Treatment
In addition to pharmacotherapy, psychotherapies are also important for the treatment of bipolar disorder. The main goals of psychotherapy are to explain the patient's illness, to relieve his uneasiness and hopelessness, to reduce the feeling that there is nothing he can do by making the patient feel the importance of the variables under his control, and to increase treatment cooperation. Education about the disease should also be provided during psychotherapies. The most important contribution of psychoeducation is to reduce the frequency of disease and increase compliance with medication. Critical, hostile and overly emotional attitudes (expression of high affect) in the family increase disease recurrence. As expected, family-focused therapies also have an important place among psychosocial treatments. By regulating social and circadian rhythms, the patient's appropriate light intake should be ensured and sleep and wakefulness patterns should be maintained.
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