Bipolar disorders: challenges for patients and care givers

Dr. M.S.Reddy, M.D (Psy) at Christian Medical College (CMC) Vellore, Health Care Management at Indian School of Business (ISB), Director, Asha Bipolar Clinic (ABC) Hyderabad, Hony’ Secretary of Society for Bipolar Disorders, India (SBDI) 

Bipolar disorder is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.

People with bipolar disorder exhibit two sets of symptoms during the depressive and manic phases. During periods of mania, the person behaves impulsively, makes decisions without proper judgment, and takes unusual risks. Also, the person ignores or is unaware of any negative consequences of their unpredictable actions. However, during the depressive phase, the person may experience intense sadness or despair, feeling of hopelessness, lack of interest in activities they once enjoyed, loss of energy, difficulty in sleeping, and change in appetite and thoughts of self-harm, death or suicide.

If you know someone with bipolar disorder, encourage them to consult a mental health expert and get treatment. The person may not be willing to accept that they have a problem. In such a situation, you may have to meet the doctor first and then take the person along. You can:

• Try to remain calm and relaxed when communicating with them. Your calmness can influence the person in a positive manner.
  Encourage the person to follow an activity plan and regularize their daily tasks, which will help them control the symptoms.
• A mixed episode in bipolar disorder can be frustrating and risky.
• Reassure the person that with regular treatment, they can get better and live a normal life.

Caregivers also undergo a lot of stress and emotional turmoil. Most often, women caregivers feel a lot more stressed, exhausted, and anxious than their male counterparts and may be at risk of developing depression. Caregivers are so concerned about their loved one's health that they forget to take care of themselves.

The difference between unipolar and bipolar depression is defined by the symptoms of unipolar depression. Major or long-term minor depression without highs is considered unipolar depression by default. Although the diagnosis is more complex than that, it does serve as a starting point. For example, symptoms of unipolar depression are similar to major depression, including feelings of hopelessness, loss of interest in once pleasurable activities, low energy, sleeping problems, difficulty concentrating, feelings of guilt, loneliness, and suicidal thoughts. In addition, the symptoms of mania are noticeably absent in unipolar depression, but they're present in bipolar depression.

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