Bipolar Disorder

The various types of bipolar disorder and their symptoms are described below:

Bipolar I
This applies to patients who have one or more manic or mixed episodes, often combined with depression. Patients with bipolar I disorder typically have severe manic (high) episodes along with shorter depressive episodes. In other words, they are ‘high’ more often than they are low – which can make this condition hard to recognise.

Bipolar II
Patients with bipolar II disorder tend to have longer periods of depression that alternate with shorter manic episodes. In other words, depression is the dominant factor.

Bipolar Disorder Not Otherwise Specified (BD-NOS)
When a person doesn’t follow all the patterns of other known forms of the condition, they are said to have BD-NOS, and/or sometimes when bipolar occurs as part of other coexisting mental health conditions.

Bipolar disorder is thought to be caused by a combination of biochemical, genetic and environmental factors. It may be due to a lack of serotonin (the ‘happy’ hormone) or an irregular release of other hormones in the brain.

Bipolar disorder tends to run in families and may lie dormant for years, only to be triggered by a traumatic event such as a relationship break-up, divorce, job loss, change of home, bereavement, etc.

The so-called ‘manic’ stage of the condition means a person is likely to be bursting with energy and ideas, intense and prone to seemingly bizarre behaviour such as excessive spending, heavy drinking or wild sexual behaviour.

Symptoms include:

• Exaggerated euphoria
• Insomnia
• Grandiosity
• Racing ideas
• Rapid speech
• Reckless behaviour

While a person battling depression may not realise they have the condition, fortunately it tends to be fairly straightforward for us to identify here at The London Psychiatry Centre.

The patient may feel disproportionately angry or sad, seemingly about nothing. They may have frequent crying bouts and fantasise about dying. Patients often say their lives have become unmanageable, they feel overwhelmed and their confidence is at rock bottom.

Symptoms include:

• Frequent crying or sad mood
• Lethargy (e.g. not wanting to get up in the morning)
• Insomnia or excessive sleeping
• Obsessive thought patterns
• Feelings of guilt, pessimism and low self-esteem
• Thoughts about/attempts at suicide

Many factors are involved in diagnosing bipolar disorder. Factors that we will consider before making a bipolar diagnosis include:

• A patient’s family medical history, such as whether anyone has or have had bipolar disorder/depression
• Any pronounced mood swings – and for how long they have been occurring

We may also suggest a thorough examination to look for illnesses that may be causing the symptoms, such as thyroid problems or possible drug use.

Note: Drug use may cause some bipolar symptoms. But this doesn’t mean the patient doesn’t have bipolar disorder. In fact, they may be ‘self medicating’ their symptoms.

Bipolar disorder can be effectively treated, but there is always a chance it will re-occur. That is why at The London Psychiatry Centre we encourage our patients to practice ongoing awareness, and we are always available should they need any further help.

The major goals of treatment are to:

• Treat and reduce the severity of acute episodes of mania or depression when they occur
• Reduce the frequency of episodes
• Avoid the cycling from one phase to another
• Improve the patient’s overall quality of life

An important aspect of treatment is to determine what might have triggered a bipolar episode and work at minimising its negative impact. We work with our patients to identify key emotional triggers and anything that might interfere with the treatments prescribed.

Here at The London Psychiatry Centre we use both medication as well as repetitive Transcranial Magnetic Stimulation (rTMS) to treat bipolar disorder.

We are also the only clinic in the world to offer Precision Medicine treatment for bipolar disorder.  This treatment uses the concept of precision medicine to look for genetic characteristics, combined with rTMS, enabling tailoring of treatment for more effective results and minor side effects – sometimes none.

In addition to medical treatments, psychotherapy and sleep management are also parts of bipolar disorder treatment. They can help reduce symptoms and prevent relapse.