Bipolar disorder

Tutor: What do you know about bipolar disorder ?

Nurse: It’s characterized by extreme mood changes, like mania and depression.

Tutor: Tell me more about these mood swings…

Nurse: Well, mania manifestations can range from being very happy, full of energy and self-importance, to very quickly talking, being easily distracted, irritated, agitated, delusional, having illogical thinking and hallucinations, not being able to sleep and not eating.

Tutor: And what about the depression symptoms ?

Nurse: I guess it’s when the person would feel sad and hopeless and at times also irritable, lacking energy, not concentrating or remembering things and events, would lose interest in everyday life and feel emptiness, pessimism and even despair, would have self-doubt, lack of appetite, sleep and in extreme cases would have suicidal thoughts. Between these two high and low episodes, the person would seem to have a normal mood, though some might swing quickly from one mood to another, and still others might show a mixed state of the two. The problem is that the person might be unaware of this.

Tutor: This is all true. And any known causes for this condition ?

Nurse: Oh, I have no exact idea on that!

Tutor: Well, there isn’t any exact cause. Specialists say that there are many factors like the chemical imbalance of the brain, that’s the neurotransmitters like the serotonin, dopamine and noradrenaline. It also seems to run in families, though no single gene seems to be responsible, but rather genetic and environmental influences are thought to trigger it. In this context, the factors that might trigger bipolar disorder could be relationship breakdown, any kind of abuse, the death of family member, physical illness or overwhelming problems of everyday life.

Nurse: But then is there a clear diagnosis for bipolar disorder ? !

Tutor: Generally, if the GP suspects this, he or she would make a referral to a psychiatrist to make sure he isn’t wrong. The psychiatrist will make an assessment by checking the family history and the person’s medical background, but will also check if you have an underactive or an overactive thyroid, and probably most of all how the person feels just prior to, and during, an episode of mania and/or depression, and if this leads to the idea of self-harm.

Nurse: And anything about the treatments that we’d propose for this condition ? I’m afraid I know nothing special about that as we don’t study this at school.

Tutor: It would generally be a mix of therapies.

Nurse: Can you be more specific ?

Tutor: Well, depending on the mania or depression episodes that might last between three months to a whole year, there are many treatment options that go from medicine, like mood stabilizers to prevent the symptoms, to behavioral and phycological therapies to recognize and manage the signs, and lifestyle advice, in the context of occupational therapy, to enjoy daily activities and find purpose in life.

Nurse: I guess I know much better on the subject now. Thank you.