BIPOLAR DISORDER

Illness with greatest genetic linkage!

Bipolar disorder, (also known as manic-depression), is a psychiatric illness in which patients experience the extremes of mood that is, major depression plus mania/hypomania. The patient’s mood alternates between depression and mania.

SYMPTOMS OF MANIA

at least 3 symptoms must occur for 1 week or more

DIG FAST

D – distractibility

I – insomnia

D – delusions of grandeur

F – flight of ideas

A – increase in Activity

S – reduced Sleep

T – talkativity

SYMPTOMS OF DEPRESSION

at least 5 symptoms must occur for 2 weeks or more

SIG E CAPS

S – sleep change

I – loss of Interest/ pleasure (anhedonia)

G – guilt/ worthlessness

E – lack of Energy

C – loss of Concentration

A – appetite change

P – psychomotor agitation or retardation

S – suicidal ideation

MANIA V/S HYPOMANIA:

Patients labeled as having mania or hypomania have similar symptoms. The difference lies in the patient’s daily day life. In case of mania, the patient feels inconvenient to perform routine tasks as he would hence it leads to disturbance in patient’s life. Where as in hypomania, the patient does not lead a disturbed life.

TYPES OF BIPOLAR DISORDER:

Type 1 Type 2
Usual Presentation – Mania is more prominent  

Major depression+ history of hypomnia (at least 1 episode)

Men:Women – 1:1 1:1
Frequency – Less common More common

 

TREATMENT:

To asses if the patient requires hospitalization or can be treated as an out-patient case

Pharmacotherapy:

  • Antipsychotic drugs including benzodiazapines are effective in the acute treatment of mania.
  • Antidepressant drugs are used in the management of depressive episodes, though its controversial.
  • Mood stabilizers: lithium(Lithium has the strongest evidence for long-term relapse prevention), divalproex, valproic acidcarbamazepine, lamotrigine, topiramate, gabapentin

Psychotherapy:  Individual psychotherapy is also indicated

 

References

http://www.sciencedirect.com/science/article/pii/S0140673613608570