BIPOLAR

 Mety Tri Nurnuzulwati, S.Psi., M.Psi, Psikolog

OVERVIEW

Bipolar disorder is a serious mental illness that causes unusual shifts in mood, energy, thinking, behavior, and sleep. These shifts can range from extreme highs (mania or “manic” episodes) to lows (depression or “depressive” episodes). A person who has bipolar disorder may find it difficult to carry out day-to-day tasks, go to work or school, and maintain relationships during bipolar mood episodes. There are several risk factors for bipolar disorder, including genetics, brain structure and function, and environmental factors. Some research suggests that people with certain genes are more likely to develop bipolar disorder. Signs and symptoms of bipolar disorder can vary depending on the type of episode and the severity of the illness. During a manic episode, a person may experience symptoms such as feeling extremely happy or irritable, having a lot of energy, talking quickly, and engaging in risky behaviors. During a depressive episode, a person may experience symptoms such as feeling sad or hopeless, having little energy, and losing interest in activities they once enjoyed. It is important to seek help if you think you may have bipolar disorder. Treatment for bipolar disorder typically involves a combination of medication and therapy. Keeping a mood journal and updating your primary care physician can also be helpful in managing the illness.

Bipolar disorder can severely disrupt a person’s life, but treatment can drastically improve their quality of life. However, it is important to note that pediatric bipolar disorder can severely affect normal development and psychosocial functioning, and increases the risk for behavioral, academic, social and legal problems, as well as psychosis, substance abuse, and suicide.

THE DIFFERENT TYPES OF BIPOLAR DISORDER

There are several types of bipolar disorder, each with its own characteristics. The different types of bipolar disorder include:

1. Bipolar I Disorder: This type of bipolar disorder is characterized by manic episodes, which can last for at least 7 days or require hospitalization. Individuals with Bipolar I Disorder may also experience depressive episodes that last for at least 2 weeks.
2. Bipolar II Disorder: Bipolar II Disorder involves recurring episodes of both hypomania (less severe than full mania) and major depressive episodes. Hypomanic episodes typically last for at least 4 days.
3. Cyclothymic Disorder: Cyclothymic Disorder is characterized by numerous periods of hypomanic symptoms and depressive symptoms that last for at least 2 years in adults (1 year in children and adolescents). However, the symptoms do not meet the criteria for a full manic or depressive episode.
4. Other Specified Bipolar and Related Disorders: This category includes bipolar disorders that do not fit into the above classifications. It may include conditions such as short-duration hypomanic episodes, recurrent hypomanic episodes without depressive episodes, or other variations.
5. Unspecified Bipolar and Related Disorders: This category is used when symptoms of bipolar disorder are present, but the specific type cannot be determined or does not fit into the defined categories.

It's important to note that the specific type of bipolar disorder can be determined by a healthcare professional based on the duration, intensity, and pattern of symptoms experienced by an individual.

HYPOMANIA

Hypomania is a less severe form of mania and is a defining feature of Bipolar II Disorder. During a hypomanic episode, a person may feel elated, energized, or even irritable. Symptoms of hypomania can include the following:

1. Feeling happy, euphoric, or a sense of wellbeing
2. Being very excited, like you can't get your words out fast enough
3. Being irritable and agitated
4. Having increased sexual energy
5. Having racing thoughts
6. Being easily distracted
7. Having exaggerated self-confidence
8. Engaging in risky behaviors, such as spending sprees, impulsive sexual encounters, or reckless driving

It's important to note that hypomanic episodes are less severe than manic episodes and do not cause significant impairment in social or occupational functioning. However, hypomania can still be disruptive and can lead to poor decision-making and risky behaviors. If you are experiencing symptoms of hypomania, it is important to seek help from a healthcare professional.

HYPOMANIA vs MANIA

Hypomania and mania are both periods of elevated mood and increased energy that are associated with bipolar disorder. However, there are some key differences between the two:

Hypomania:

1. Hypomania is a milder form of mania.
2. It typically lasts for a shorter period, usually a few days, although the length of time can vary.
3. Symptoms of hypomania include increased energy, elevated mood, racing thoughts, decreased need for sleep, increased productivity, and engaging in pleasurable activities.
4. Hypomanic episodes do not cause significant impairment in social or occupational functioning.
5. Hospitalization is usually not necessary for hypomania.

Mania:

1. Mania is a more severe form of elevated mood and energy.
2. It typically lasts for a week or longer, unless it is cut short by treatment.
3. Symptoms of mania are more intense and severe compared to hypomania. They can include extreme euphoria, irritability, rapid speech, grandiose beliefs, reckless behavior, and impaired judgment.
4. Manic episodes often cause significant impairment in social, occupational, and personal functioning.
5. Hospitalization may be necessary for individuals experiencing a manic episode, especially if they are at risk of harm to themselves or others.

In summary, while both hypomania and mania involve elevated mood and increased energy, hypomania is less severe, of shorter duration, and does not cause significant impairment in functioning compared to mania. It is important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment if you suspect you may be experiencing either hypomania or mania.

BIPOLAR I VS BIPOLAR II

Bipolar I disorder and bipolar II disorder are two of the most common types of bipolar disorder. Here are the differences between the two:

Bipolar I Disorder:

1. Involves at least one manic episode, which can last for at least 7 days or require hospitalization.
2. May or may not involve a major depressive episode.

Bipolar II Disorder:

1. Involves at least one hypomanic episode, which is a less severe form of mania that lasts for at least 4 days.
2. Always involves a major depressive episode.
3. Other differences between bipolar I and bipolar II disorder include:
4. The intensity of manic episodes: Bipolar I involves severe mania, while bipolar II involves less severe hypomania.
5. The frequency and duration of depressive episodes: Depressive episodes are more frequent, enduring, and disabling over the patient's lifetime in both bipolar I and II subtypes, but are more prevalent in bipolar II disorder.

It is important to note that the distinction between bipolar I and bipolar II disorder is not always clear-cut, and the range of symptoms can vary widely from person to person. A careful psychiatric history is necessary to determine the specific subtype of bipolar disorder. Treatment for both bipolar I and bipolar II disorder typically involves a combination of medication and therapy.

REFERENCES

1. FOCUS - Psychiatry Online. (2003). Bibliography for Bipolar Disorder. Retrieved from https://focus.psychiatryonline.org/doi/10.1176/foc.1.1.32
2. FOCUS - Psychiatry Online. (2007). Bibliography Bipolar Disorder. Retrieved from https://focus.psychiatryonline.org/doi/10.1176/foc.5.1.40
3. Wiley Online Library. (n.d.). Bipolar Disorders. Retrieved from https://onlinelibrary.wiley.com/journal/13995618
4. International Journal of Bipolar Disorders. (2023). Home page. Retrieved from https://journalbipolardisorders.springeropen.com
5. StatPearls. (2023). Bipolar Disorder Article. Retrieved from https://www.statpearls.com/ArticleLibrary/viewarticle/18332
6. NCBI Bookshelf. (2023). Bipolar Disorder - StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK558998/