Bipolar I Disorder

What is Bipolar I Disorder?

 

Bipolar I Disorder is a mood disorder defined by the occurrence of at least one manic episode. A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood, with persistently increased energy or goal-directed activity, lasting at least one week. This mood disturbance is severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization. The manic episode may also include psychotic features, such as delusions (false fixed beliefs, often grandiose) or hallucinations (experiencing things that are not there). While not required for the diagnosis, individuals with Bipolar I Disorder also commonly experience major depressive episodes.

 

Common symptoms include:

• During a Manic Episode:

  • Inflated self-esteem or grandiosity.

  • Decreased need for sleep (e.g., feeling rested after only 3 hours).

  • More talkative than usual or pressure to keep talking.

  • Flight of ideas or a subjective feeling that thoughts are racing.

  • Distractibility (attention easily drawn to unimportant stimuli).

  • Increase in goal-directed activity or psychomotor agitation.

  • Excessive involvement in activities with a high potential for painful consequences (e.g., unrestrained buying sprees, foolish business investments).

  • Psychotic features (if present) such as grandiose delusions (believing one has special powers) or hallucinations.

• During a Depressive Episode (if present):

  • Depressed mood most of the day.

  • Loss of interest or pleasure in activities (anhedonia).

  • Significant changes in sleep (insomnia or hypersomnia) or appetite.

  • Fatigue or loss of energy.

  • Feelings of worthlessness or guilt.

Medication Management

 

Medication is the cornerstone of treatment for Bipolar I Disorder.

• Mood Stabilizers: These are the primary medications used to control manic episodes and for long-term maintenance. Examples include Lithium and certain anticonvulsants (e.g., Valproic Acid, Lamotrigine).

• Atypical Antipsychotics: These can be used to treat acute manic episodes (especially those with psychotic features) and are often used as long-term mood stabilizers as well.

• Antidepressants: Antidepressants are used very cautiously, and almost always in combination with a mood stabilizer, as they carry a risk of triggering a manic episode when used alone.