Bipolar symptoms due to manic-depressive illness or bipolar disorder can develop quite rapidly. It usually begins with depression and includes episodes of mania. The patient is usually unaware of the illness because he feels elated most of the time while at the same time experiencing periods of irritability and hostility.
In the first stages of the disease there is a feeling of energy, increased mental ability, inflated ego and boasting behaviour. This can make him impatient, and aggressive when challenged. The person may have false ideas of his power, genius and even personal wealth. He may even believe that he has Godly powers and is invincible.
The patient may also hallucinate, believing he is hearing and seeing things. He becomes extremely agitated, embarks on many different endeavours, some possibly dangerous to his well-being. The energy he feels will lessen the need for sleep and without treatment he may die from physical exhaustion.
In the most severe case, called bipolar I disorder, the depression and intense mania alternate with each other. In bipolar II disorder, short depression periods alternate with hypomania (a milder form of mania).
A third condition called mixed bipolar state has the person feeling simultaneously manic and depressive. All stages require close monitoring and diagnosing by a physician as treatment with antidepressants can cause swings from one stage of the disease to another…bipolar I to bipolar II, etc.
- feeling of hostility, irritability, extreme energy
- periods of tearfulness
- delusions of wealth, godliness, genius
- delusions of great abilities, physical and artistic
- constantly changing ideas and thoughts, inability to concentrate on any one of them
- meddlesome behaviour, sexual indiscretions and desires, poor business judgement
- hallucinations both visual and audible
- increased energy levels but decreased need for sleep
- weight loss from poor eating habits and increased activity
Immediate treatment by a qualified physician/psychotherapist is mandatory. The treatment drug of choice is often in the form of antidepressants, from tricyclic and similar antidepressants to selective serotonin reuptake inhibitors to monoamine oxidase inhibitors and psychostimulants.
Lithium, which takes 5 to 10 days to become effective is often used. A more rapidly effective drug is haloperidol, but this drug often causes muscle stiffness and unusual movements, and it is therefore given in smaller doses. Newer drugs have evolved over the years and the treatment regimen is often geared to the patient’s personal tolerance to the possible adverse side effects experienced while on these drugs.
Psychotherapy is often recommended for patients taking these mood stabilizing drugs and group therapy is also helpful for spouses and family so that they can better understand the illness and have the ability to cope with the person undergoing these episodes and mood swings.
Bipolar disease recurs in nearly all cases, often switching and alternating from periods of depression to mania or vice versa. Sometimes there is no normal period between the two conditions and the patient often has as many as four or more episodes per year. The disease can develop in men and women and usually begins in the teens, 20s or 30s, ultimately affecting slightly less than two percent of the population.