От мании к депрессии: как распознать биполярное расстройство

Bipolar disorder (bipolarity or bipolar depression), although not very common, is a serious and traumatic problem. It deserves clinical attention, and those who suffer from it are often unaware of its presence. Those affected by it tend to alternate between depressive phases followed by hypomanic or manic phases (bipolarity).

The depressive phases of bipolarity tend to last longer than the manic or hypomanic phases. Usually they last from several weeks and even up to several months, while manic phases, including hypomanic ones, last from one to two weeks. Sometimes in bipolar disorder the transition from one phase to another happens quickly. In other cases, it is interrupted by the usual mood swings. Sometimes the phase transition in bipolarity is slow and insidious, and sometimes it can be abrupt and sudden.

The editors of estet-portal.com decided to to sort out this insidious psychological disorder: symptoms and treatment. 

Phases of bipolarity – growing danger

Depressive phase

This phase is characterized by a very low mood, a feeling that nothing else can bring pleasure and general sadness for most of the day. In principle, depressive phases do not differ from depressive episodes of major unipolar depression. Consequently, during these bipolar phases sleep patterns change easily, appetite decreases, memory and concentration deteriorate, and suicidal thoughts occur.

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Manic Phase

The phases, which are described as the exact opposite of depressive ones, are characterized by a somewhat high spirits, a sense of omnipotence and excessive optimism. At these stages, thoughts very quickly arise in the mind and become so fast that they are difficult to follow. Behavior can be hyperactive, chaotic, making the person unrecognizable. The bipolar energy of a person in the manic (or hypomanic) stage is so great that he often does not feel the need to eat or sleep. He believes that he can do anything, up to impulsive behavior such as excessive spending, dangerous actions, having lost the ability to properly assess their consequences. Actual impulse control disorders are common (gambling, compulsive shopping, etc.).

List of common psychological disorders

Dysphoric phase

In many cases, the manic (hypo) phase is not characterized by an excess of euphoria and grandeur. At the same time, there is a constant feeling of anger and injustice. This leads to irritability and intolerance, and often to expressed aggression without a correct assessment of the consequences of

one's behavior.

What are the symptoms of bipolar disorder

To make a safe diagnosis of mania, there must be a distinct period of abnormal, marked feature of persistently elevated mood with expansive, irritable characteristics.

Mood disorders must be severe enough to compromise mental performance, job skills, social relationships.

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Manic symptoms

When manic episodes occur, some of the following symptoms of bipolar disorder are present:

  • Inflated self-esteem;

  • Increased verbal flow with difficulty stopping;

  • Instability in changing one's mind (one does not notice that one's thoughts change easily);

  • Reduced need for rest and sleep;

  • Slightly distractible (person pays attention to unimportant details, ignoring important elements);

  • Increasing the number of completed tasks;

  • Mental, physical arousal;

  • Increased involvement in activities that can lead to dangerous consequences (spending a lot of money, engaging in sexual activities that are unusual for a person).

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Depressive symptoms

For the diagnosis of

depression, a period of at least two weeks is required with a marked loss of interest, pleasure in all or most activities. Bipolar depression must be severe enough to cause a change in appetite, body weight, sleep, ability to concentrate in the way that feelings of guilt, inadequacy, or despair should be. Thoughts of death may also be present.

During a depressive episode, some of the following symptoms of bipolar disorder are present:

    Persistent depression and despair;

  • Severely diminished interest in an activity;

  • Loss of body weight or increased appetite;

  • Fatigue, loss of energy;

  • Increase or decrease sleep;

  • Swell or slow;

  • Feelings of inadequacy, guilt and/or loss of self-esteem;

  • Inability to concentrate and make any decisions;

  • Thoughts
  • of suicide, death.
Bipolarity, humoral instability and other ailments

Sometimes a person suffering from bipolarity may experience only episodes of depression, with normal mood swings, or only episodes of mania.

When only mania is present, the illness is still called bipolar disorder. But if only depression is present, the illness is described as major depressive disorder.
However, it should be noted that mood instability characteristic of bipolarity can also be found in many personality disorders, especially in

borderline disorder.

Treatment for Bipolar Disorder – all you need to know

Treatment of bipolar disorder is focused on pharmacotherapy based on mood stabilizing drugs and antidepressants (tricyclics, SSRIs) under the close and constant supervision of a specialist physician.

Among the stabilizers, lithium is often used in the treatment of mania in the acute phase, but its main indications concern the prevention of manic, depressive crises. Valproic acid and carbamazepine are also used to treat acute manic bipolar disorder and to prevent relapse.


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Antipsychotics or neuroleptics are used in the treatment of mania in the acute phase and less commonly in the maintenance phase. Other medications such as benzodiazepines are also used in the treatment of acute manic conditions.

Antidepressants are used in the depressive phase to

treat bipolar depression: It is important to always remember that antidepressants usually take 2 to 6 weeks to be effective. In some cases, antidepressants can cause a transition from a depressive phase to a manic phase, and this, of course, requires special attention.

Unfortunately, some patients may take some time to find effective therapy.

Importance of Psychotherapy for Bipolar Disorder

Scientific studies have shown that pharmacological treatment (which remains fundamental) and psychotherapy, preferably a cognitive-behavioral approach, must be combined to improve mood stability. In the treatment of bipolarity, the latter is indispensable if it is secondary to a personality disorder.


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Psychotherapeutic protocols for bipolar disorder usually include several points of intervention and actions:

Help a person get medication. Without the help of a therapist, people tend to "forget" about taking medication. The individual's motivation for therapy should be maintained and increased;

  • Help the person quickly recognize the initial symptoms of the two phases so they know how to behave and how to prevent the situation from occurring;

  • Learn to discuss and change your irrational and dysfunctional thinking styles;

  • Learn more effective strategies for dealing with everyday problems such as managing your anger, improving communication skills;

  • Specifically work on the depressive phase, according to typical CBT conditions.
  • Bipolarity
is classified as an adult disorder. It is a discomfort that can interfere with work and interpersonal relationships and often leads to a distortion of daily life. It is often difficult to recognize such a disorder and tends to get worse if not properly treated.

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