What bipolar disorder is
Bipolar disorder is a mood disorder with episodes of depression and of mania or hypomania, a milder form of mania. Between episodes, mood may be stable. In type I there is at least one manic episode; in type II, hypomanic and depressive episodes. Cyclothymia is a milder, persistent form with frequent mood swings that do not reach full episodes.
Signs and symptoms
During mania or hypomania:
- Unusual euphoria or irritability
- Less need for sleep without feeling tired
- Racing thoughts and rapid speech
- Inflated self-confidence and grand plans
- Impulsive spending, decisions or risky behavior
During depression: sadness, loss of interest, fatigue, changes in sleep and appetite and, at times, thoughts of death.
How it is diagnosed
Diagnosis requires a detailed history, because many people seek help only when depressed and hypomania goes unnoticed. The psychiatrist reviews previous episodes, family history, sleep patterns, substance and medication use and medical conditions that affect mood. Input from relatives is often valuable. Distinguishing bipolar disorder from depression matters, since some depression treatments can destabilize mood in bipolar disorder.
Treatment
- Mood stabilizers and other medications, when indicated, chosen by type, current phase and past response, with monitoring tests when needed
- Psychoeducation to recognize early signs of relapse
- Regular sleep and routine, a cornerstone of stability
- Psychotherapy as part of care
The goal is to treat the current episode and, above all, prevent new ones.
When to see a psychiatrist
When there are periods of very elevated or irritable mood, reduced need for sleep, unusual impulsivity, or recurrent depression. In a crisis, go to an emergency room or, in Brazil, call 188 (CVV).
Follow-up at the practice
At Dr. Petrus Raulino’s practice in Campinas, bipolar disorder is followed with regular visits, periodic review of treatment and attention to warning signs, in person or by video. Family members can take part when the patient wishes.
Staging: text awaiting medical review by Dr. Petrus before publishing.
This content is for information only and does not replace a medical consultation. Diagnosis and treatment depend on an individual assessment. In crisis or having thoughts of suicide? In Brazil call 188 (CVV, 24 hours, free) or go to the nearest emergency room. In an emergency, call 192 (SAMU).