Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). Patients usually have their first attacks in their early 20s. These attacks are mania, depression and hypomania (the less severe and shorter episodes of mania attacks). The progression of the disease over time may vary widely among patients. Patients either experience only episodes of mania or hypomania, or both episodes and depressive episodes. Some patients may have multiple episodes, even one year, and there are only one manic episode during their lifetime.
Depressive episodes of bipolar disorder are like episodes of depressive disorder. Manic attacks are specific to this disease. In contrast to the depressive episode. In manic episodes, the patient is highly extroverted. They feel unusually “good. Their mood is overly cheerful. The need for sleep reduces considerably, a few hours of sleep per day is sufficient for the patient. Increased interest and appetite with all kinds of activities. They eat a lot, talk a lot, the speed of speech increases the integrity of their sentences gets weeker.
They want to travel a lot, meet new people. However they make strange inappropriate jokes, gestures and facial expressions. Sexual desire increases, they may have risky relationships with someone they don’t know. Alcohol and substance abuse may increase. Can drive fast, conduct criminal behavior. In other words, patients are more likely to perform all kinds of activities involving danger and risk during manic episodes.
What Can They Do?
Treatment should start immediately. In the treatment of manic episodes, many patients need to be hospitalized.
Hypomania attacks are the ones with the mild symptoms of the symptoms listed above. The patient feels better than his or her normal state, has increased self-confidence and is energetic. If the severity of the attack is low, it may not be obvious from the outside. So the patient can continue his work, and can maintain his daily functions at a significant rate. Hypomania attacks do not cause thought disorder (delusion).
Regular sleep is important for people with bipolar disease. Usually the first symptom of manic attack is the reduced need for sleep, shortening the duration of sleep. On the other hand irregularities in sleeping,even if the patient is treated, can cause manic attacks. That’s why patient should take care of their sleeping. And shouldn’t work in night shift jobs.
Drug treatment is the first step to prevent these attacks. Mood balancing drugs, anti-psychotic drugs can be used. Even if it’s used for preventing manic attacks,these drugs can even cause attacks or it’s intensity.
In severe manic and depressive episodes, patients should be hospitalized. In bipolar disorder, it is very important for the patient to use his medication regularly for a long time, even if the episode is over. This is because the risk of recurrence A patient who has had their first manic episode should receive preventive medication regularly for at least two years. This time will increase as the number of attacks increases. Some patients may need to take this treatment throughout their life.
In addition to drug therapy, the application of some types of psychotherapy (supportive psychotherapy, cognitive-behavioral psychotherapy) during inter-episode periods provides important contributions to increase the compliance of patients, improve their quality of life, and increase their strength to combat the negative effects of the disease.
Finally, it is necessary and important to inform both patients and their relatives in detail about bipolar disorder, symptoms and their recognition as early as possible.