Bipolar disorder is not just mood swings -Psychiatrist

Lara Adejoro

A psychiatrist and psychotherapist at the Pinnacle Medical Services, Lagos, Dr. Maymunah Kadiri, says bipolar disorder is very different from common mood swings, even as it is a medical condition characterised by mood swings between the ‘highs’ of bipolar mania and the ‘lows’ of depression.

According to her, people with bipolar disorder experience extreme changes in energy, activity, and sleep that are not typical for them.

Speaking in an interview with PUNCH HealthWise, Kadiri said bipolar means sharing two poles of high and low.

“Bipolar disorder is not a constant state of illness. It is an episodic illness. In-between episodes of bipolar mania and/or depression, there will usually be periods of stable or normal moods.

People may go for months, sometimes even years, without an episode if they manage the illness well.

“It is a disorder characterised by two or more episodes in which the patient’s mood and activity levels are significantly disturbed.

“This disturbance consists, on some occasions, of an elevation of mood and increased energy and activity (hypomania or mania); and on others of a lowering of mood and decreased energy and activity (depression).

“Repeated episodes of hypomania or mania only are classified as bipolar.

“The differential diagnosis of bipolar disorder includes other conditions that may have manic-like symptoms, including organic mood disorders such as endocrine or metabolic conditions, drug intoxication, and tumors.

“Mania occurring in the context of substance abuse would be called a secondary mania,” she said.

She added that mania and hypomania are two distinct types of episodes, but they have the same symptoms.

“Mania is more severe than hypomania and causes more noticeable problems at work, school, and social activities, as well as relationship difficulties. Mania may also trigger a break from reality and require hospitalization,” she said.

The expert said although the bipolar disorder can occur at any age, it is typically diagnosed in the teenage years or early 20s and symptoms vary over time from person to person.

She, however, said the symptoms of bipolar disorder can be difficult to identify in children and teens.

“It’s often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder.

“Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.

“The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.”

According to her, both a manic and a hypomanic episode include three or more symptoms of abnormally upbeat, jumpy or wired, increased activity, energy or agitation, an exaggerated sense of well-being and self-confidence (euphoria), decreased need for sleep, unusual talkativeness.

Other symptoms include racing thoughts, destructibility, and poor decision-making.

“A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities, or relationships. An episode includes five or more of these symptoms.

“Depressed mood, such as feeling sad, empty, hopeless, or tearful (in children and teens, depressed mood can appear as irritability).

“Marked loss of interest or feeling no pleasure in all, significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight, as expected, can be a sign of depression), either insomnia or sleeping too much, either restlessness or slowed behavior.

“Fatigue or loss of energy, feelings of worthlessness or excessive or inappropriate guilt, decreased ability to think or concentrate, or indecisiveness, thinking about, planning or attempting suicide,” she added.

Continuing, she said the causes of bipolar disorder can be linked to interactions between genetics and one’s environment.

“It is not caused by alcoholism or drug abuse. However, the condition can influence the use of these substances.

“Bipolar disorder is a manageable condition. With proper management which includes medication, therapy, and a good support system, people with bipolar disorder can live successful, complete lives.

“Bipolar disorder is a condition that affects both children and adults. It’s most often diagnosed in older children and teenagers, but bipolar disorder can occur in children of any age. As in adults, bipolar disorder in children can cause mood swings from the highs of hyperactivity or euphoria (mania) to the lows of serious depression,” she said.

She noted that the disorder is not just mood swings, which everybody and it is not fake or a made-up disorder for attention.

“People with bipolar disorder cannot just pull themselves together or snap out of it,” she said.

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