Bipolar Disorder: Cause, Symptoms and Treatment without Medication

What is Bipolar Disorder?

Bipolar disorder is a mental health condition that is characterized by intense emotional states that affect a person’s mood and the way they function. The highlight of this mental health condition is “MOOD EPISODES”. 

To understand what bipolar disorder is, let's take it this way: people suffering from bipolar disorder are stuck in a cycle. It might lead to these two: 

• Manic episode: This is a period where the person might feel extremely elated, energized or irritable. 
• Depressive episode: this episode leads a person to become hopeless, indifferent, sad and depressed.  

This change can make it difficult for a person to function normally in their daily life.

It is important to note that the episodes experienced in bipolar disorder are very different from mood swings. Mood swings are often associated with the circumstances that occur in an individual’s life. Mood episodes on the other hand can be persistent and lead a person to intense emotional states. 

Is Bipolar Disorder a Mental Illness?

Bipolar disorder explained in simplest terms relates to the presence of two moods. It is a serious mental illness that causes mood swings ranging from mania to depression. It also affects a person’s energy and activity levels. 

Prevalence In India:

The prevalence of the disorder can be seen throughout India:

• Currently, 0.3% of the population in India suffers from bipolar disorder. 
• The mean onset of the disorder is around 26 years. 
• Around 11-13% of the adult population suffers from acute episodes of bipolar disorder. 
• Manic episodes are more frequent than depressive episodes but depressive episodes are found to last longer. 

Global Prevalence:

• Globally, an estimated 46 million people live with bipolar disorder. 
• Out of all the mood disorders, bipolar disorder is found to cause the most severe impairment. 
• People ages 18 to 29 years old had the highest rates of bipolar disorder (4.7%) followed by 30- to 44-year-olds (3.5%). 

Types of bipolar disorder:

Currently, bipolar disorder is classified into three types, depending on the symptoms that people display. They are:

1. Bipolar I Disorder: Experiences of manic episodes that last for at least seven days or are severe enough to require hospitalization. Depressive episodes should last two weeks as well. 
2. Bipolar II Disorder: Unlike Bipolar I, individuals with Bipolar II experience hypomanic episodes, which are less severe than full-blown manic episodes. Similar to Bipolar I, depressive episodes are a component of Bipolar II. 
3. Cyclothymia: Cyclothymia is characterized by chronic fluctuations in mood, but the highs (hypomanic symptoms) and lows (depressive symptoms) are less severe compared to Bipolar I and II. To be diagnosed with cyclothymia, the symptoms must persist for at least two years in adults.

What Happens in Bipolar Disorder? 

The word bipolar denotes two polarities. This means that a person suffering from bipolar disorder will have moods that shift from extremely happy or euphoric (mania) to extremely sad with feelings of guilt (depression). Sometimes, a person might also experience mania but one with lighter intensity. This is called hypomania. 

To understand what happens in bipolar disorder, let us take the example of Rishi. Rishi experienced emotional abuse when he was a child.

After many years, recently while Rishi was conducting his daily life, he felt extremely energetic and active while at home. He had racing thoughts and found himself speaking faster than usual. He also found himself driving recklessly to his work.

This went on for a week after which he found a bit of relief in the symptoms. Soon he started to develop feelings of hopelessness and sadness. The grief engulfed he experienced fatigue, sleeplessness and decreased appetite. 

From this example, we understand how the mood swings and the bipolar disorder episodes range. The contrasting nature of the episodes makes it difficult to function normally. 

What Causes Bipolar Disorder?

It is difficult to pinpoint exactly what causes bipolar disorder. However, research suggests that several factors contribute to the onset of the symptoms. The bipolar disorder causes are:

1. Genetic history:

Family studies suggest that genetic history has a strong link to the development of bipolar disorder. A specific set of genes is associated with the disorder but they are yet to be studied in detail. A person suffering from bipolar disorder is more likely to have a family member suffering from the same thing. 

2. Childhood trauma:

Experiencing emotional distress in childhood can also be a contributing factor to bipolar disorder. Experiencing childhood trauma can have a big effect on the way a child processes their emotions. This can act as a trigger and lead to the development of the disorder. 

• Childhood experiences like sexual or emotional abuse
• Neglect
• Losing a loved one
• Experiencing traumatic events like disaster 

3. Stressful life events:

Studies show that stress can trigger a mood episode. Experiencing some life-altering stressful event can lead to the onset of the disorder. For most people, the onset of the disorder is due to some stressful life events like:

• Financial burdens
• Break up or divorce
• Immense pressure in the work-life
• Being abused or bullied or facing racism
• Big changes in personal life

As said earlier, too much stress can act as a trigger for bipolar disorder and also worsen the symptoms if not managed. 

4. Brain chemistry:

Studies have shown that people suffering from bipolar disorder have an imbalance of one or more neurotransmitters in the brain. Neurotransmitters are the chemical messengers of our brain that are responsible for the proper functioning of our brain. The primary neurotransmitters are:

• Noradrenaline
• Serotonin
• Dopamine

An imbalance in neurotransmitters like noradrenaline can cause symptoms of mania while an imbalance in serotonin and dopamine can lead to the occurrence of depressive symptoms. 

Drugs like SSRIs, SNRIs, and Tricyclic antidepressants can help. They can be used for depressive symptoms while mood stabilizers, benzodiazepines and antipsychotics can be given for manic symptoms. 

5.Medications, drugs and alcohol:

Drug abuse or drinking excessive alcohol can lead to the development of depressive symptoms or even manic symptoms sometimes. Some studies suggest that using drugs can increase the risk of developing bipolar disorder. This is because the use of drugs causes changes in the brain chemistry. How to Know If You Are Suffering From Bipolar Disorder?

Common Signs and Symptoms of Bipolar Disorder 

Bipolar disorder is like a roller coaster ride. At one moment, a person suddenly feels euphoric followed by neutral moods or moods of extreme sadness. 

People suffering from symptoms of bipolar disorder have a lot of ups and downs and they can be differentiated into symptoms of mania, depressive symptoms and hypomania symptoms.  All of the symptoms experienced by people are physical, emotional and behavioural symptoms.  

When a person has manic symptoms, they might have a euphoric mood which is very different from the usual optimism a person possesses. Some of the features include:

Manic symptoms of bipolar disorder include:

1. Extremely elevated mood: very upbeat and jumpy 
2. Increased energy levels
3. Inflated self-esteem
4. Unusually irritable
5. Uncontrollable fleet of thoughts 
6. Highly distractible 
7. Impulsivity, hence poor decision-making, tends to get involved in risky sexual behaviours and mindless shopping 

Mania and hypomania have similar symptoms but both differ in severity. A person suffering from manic symptoms might also experience psychosis. A person might also require hospitalization 

Depressive symptoms lie on the other end of the spectrum. 

A person might have persistent feelings of guilt, hopelessness, low mood and difficulty in doing things for a while. This state can be dangerous for a person as it often leads to suicidal thoughts. 

Some of the features are:

1. Low mood and energy 
2. Persistent feelings of sadness, hopelessness
3. Worthlessness and guilt
4. Fatigue/ tiredness
5. Irritability 
6. Decreased capacity to think and concentrate 
7. Disturbed sleeping and eating habits
8. Suicidal thoughts and attempts 

When to Seek Professional Help?

It is very difficult to understand when to seek help for bipolar disorder. On one side we have mania and hypomania while we have depressive symptoms on the other. 

The cycle of manic and depressive episodes can have a significant impact on your life. However, there will always be signs that you need help for bipolar disorder. The mania can cause a person to be highly euphoric and act on impulse. On the other hand, the depressive state can severely affect the way one perceives life. Above all, suicidal tendencies are a looming threat. 

Without having a formal diagnosis, managing a person suffering from bipolar disorder can only help so much. If you know somebody who is experiencing any of the mentioned symptoms, it is time to seek professional help. 

You can consult a psychologist of your choice and get the initial diagnosis done. The earlier the problem is detected, the easier it is to treat the symptoms. Hence one should seek professional help on the first signs of discovering any of the symptoms. 

Diagnosis of Bipolar Disorder

The diagnosis of bipolar disorder includes testing the mental as well as the physical health of a person. Physical examination includes:

• A thorough physical examination
• Thorough medical history which includes symptoms, lifetime and family history.
• A complete blood work comprising of all the routine tests alongside tests to check the thyroid activity. Ruling out the possibility of under-activity or overactivity of the thyroid will help the doctors further. 

To understand how is bipolar disorder diagnosed by mental health professionals, you must first understand the criteria considered by them.  If a person is suffering from bipolar disorder, they must have experienced at least one episode of mania or hypomania. 

If you or somebody you know is experiencing such symptoms, you can arrange an appointment with a psychologist. If a psychologist suspects bipolar disorder, they might refer you to a psychiatrist. 

The psychiatrist will confirm the diagnosis of the disorder and start with the treatment. Mental health professionals make use of various diagnostic tools that can confirm the diagnosis of bipolar disorder. 

Treatment for Bipolar Disorder

Medication for Bipolar Disorder

1. Mood stabilizers:

Currently, several bipolar disorder medication options are available. Generally, mental health professionals prescribe “Mood stabilizers” as the first line of medications. They help to stabilize the rapid changes in emotions and help to resolve sleep difficulties, racing thoughts and engaging in risky behaviours. Mood stabilizers do this by regulating the flow of chemical messengers in our brain - the neurotransmitters. 

2. Second-generation neuroleptics (also called antipsychotics):

Mental healthcare professionals often use second-generation neuroleptics (antipsychotics) along with mood stabilizers for patients experiencing manic and depressive episodes. Some of these medication for bipolar disorder is used for long-term use.  

3. Antidepressants:

These are primarily used to treat the depressive symptoms of bipolar disorder. In many cases, these anti-depressants are combined with mood stabilizers.

Note: Do not consume any of these medications without a prescription from a mental health professional. The dosage and frequency of the medications to be consumed differ for every patient. 

Therapy for Bipolar Disorder

Psychotherapy - also known as “Talk Therapy” is considered one of the best therapy for bipolar disorder. It uses a variety of tools to identify and change troubling moods, thoughts and behaviours. 

Some of the most common therapies for bipolar disorder are:

1.Interpersonal and Social Rhythm Therapy:

This therapy helps a person improve their mood by building a regular routine and improving their interpersonal relationships. The idea behind this therapy is that a difference in a person’s routine or difficulty in their relationships can trigger mood episodes. For example, not having enough nutrients in the diet can cause feelings of sadness. Similarly, fighting with a partner or a loved one can cause significant emotional stress. 

The therapist will help the person track their daily rhythms and social metrics for example:

• Time of waking up/ going to sleep
• Time of eating meals
• Time of conducting activities
• Whom do they meet first thing in the morning

2. Psychoeducation:

In simple terms, psychoeducation means learning about a mental health condition in detail. A mental heal health professional will do this to help the person, as well as the loved ones, understand the disorder better. Since bipolar disorder is a complex disorder, learning about it can help the person as well as the family manage and cope with it in a better manner. 

3. Cognitive Behavioural Therapy:

Cognitive Behavioural Therapy is one of the most widely used therapies. It is a goal-oriented therapy where the psychologist aims to target negative thoughts and emotions. They help the patient understand how their thoughts and emotions affect them. Once they do this, the psychologist helps the person learn various tools and strategies to cultivate healthier thinking patterns. 

4. Family-focused Therapy:

Family-focused therapy (FFT) is an evidence-based intervention for adults and children with bipolar disorder (BD) and their caregivers. This therapy for bipolar disorder includes the use of conjoint sessions of psychoeducation regarding bipolar illness, communication enhancement training, and problem-solving skills training.

Can Bipolar Disorder Be Managed Without Medication Permanently?

If you are wondering - can bipolar disorder be managed without medication? Or does bipolar disorder go away by itself?

The answer is no. The symptoms of bipolar disorder are managed with the help of mood stabilizers, antipsychotics or antidepressants. Without the help of these, there is a risk of the symptoms becoming more severe.

How to overcome bipolar disorder without medication

While medication is an important part of the treatment, several therapies/ techniques can help to manage the symptoms of bipolar disorder effectively. When done in combination with the medicines, management of the disorder becomes simpler. 

Here are 6 Tips on How to Manage Bipolar Disorder Natural Coping Strategies

1. Lifestyle changes:

Making small changes in your lifestyle can significantly improve your mental health and help you manage the disorder better. Lifestyle changes for bipolar disorder include exercising more, sticking to a routine, avoiding alcohol and drugs, etc. Following a healthy lifestyle levels up your energy, uplifts your mood and improves the quality of your sleep. 

2. Changes in diet:

Eating healthy not only provides nutrition to your body but also impacts the way you think and conduct your life. A diet rich in proteins, carbohydrates, vitamins and minerals is crucial for maintaining brain health. There is no specific diet for bipolar disorder but some studies say that people who consume good amounts of healthy fruits, vegetables, legumes, dairy and omega-3-rich foods are at a lower risk of depression. 

3. Meditation:

Meditation for mental health is known to promote feelings of calmness and relaxation. Some people suffering from bipolar disorder are known to have post-trauma symptoms. In such cases, performing meditation can soothe them and make them feel calm. It can help them deal with their trauma and reduce the effect that it has on an individual. 

4. Mindfulness:

Mindfulness is the practice of being fully present in the moment. It helps a person become more aware of their feelings and acknowledge them as they come. You can practice mindfulness by starting with some simple breathing exercises. You can also do meditation. It requires simply to devote 15-20 minutes per day to it. Another way is by doing yoga. Yoga has been known to reduce symptoms of anxiety and depression drastically. It also enhances our body’s flexibility and works wonders in restoring the balance of our mental state. 

5. Journaling:

Writing down the thoughts deliberately slows a person down. Due to this, it becomes easy to address all the thoughts one by one and express all emotions. You can journal about anything, may it be a trivial detail that troubles you or a thing you are grateful for. The point is to let the innermost thoughts out. This helps empty your mind and make space for fresh and healthier thoughts. 

6.Art therapy:

This is one of the most creative and therapeutic ways to express emotions. People suffering from bipolar disorder can use art therapy to express emotions that are difficult to speak about. 

How to Help Someone Suffering from Bipolar Disorder 

Bipolar disorder can have a significant impact on a person’s relationship, work and mental well-being. Suffering through manic, hypomanic and depressive episodes can hinder the idea of leading a normal life. 

Helping someone with bipolar disorder is a task that many must take up carefully. You can do the following:

• Educate yourself
• Listen
• Offer them support for bipolar disorder
• Make safety plans
• Participate in their treatment 
• Express concerns if necessary

Remember, recovering from bipolar disorder is a long journey and will require patience, open communication and looking after your mental health as well. Make sure to reach out to a professional if things that too difficult to handle.

Alternative Therapies: Neurostimulation for Bipolar Disorder

Transcranial Direct Current Stimulation (tDCS)

Out of the many alternative therapies for mental health, tDCS has emerged as one of the most useful and trustworthy tools. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation (NIBS) technology that uses electric current to enhance brain activity. It excites the neurons (brain cells) and increases the synaptic transmission of neurons. This enhancement in the activity of neurons can lead to an increase or decrease in the activity of the brain. 

Studies suggest that it has been extremely useful in reducing the depressive system of bipolar disorder. One case report of tDCS reported a significant positive response to manic symptoms. It has been proven to be a safe, effective and side-effect-free treatment for treatment for bipolar disorder. 

At Mave Health, tDCS for bipolar disorder treatment is prescribed by mental health professionals if necessary. It treats bipolar disorder without the use of medications until necessary. 

Comparing Bipolar Disorder vs. Borderline Personality Disorder 

Both, Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) are characterized by mood instability and impulsivity, but there are also important distinctions. 

Both mental health conditions can hinder the normal functioning of a person. The key main differences between bipolar and borderline personality disorder are:

Is Bipolar Disorder a Depressive Disorder?

Whether you live with bipolar disorder or depressive disorder, you will experience periods of depression. You might be wondering - Is bipolar disorder a depressive disorder or not? 

The answer to this question lies in the word itself. Bipolar means two poles, and the two poles here are mania and depression. Both lie on the opposite ends of the spectrum. 

Depressive disorder on the other hand has just one phase - depression. The difference in bipolar v/s depressive disorder is the presence of an additional phase in bipolar disorder, which is mania.

Know how an Indian Rapper Honey Singh overcame Bipolar disorder and raised gain to a new height in his industry.

Conclusion

Bipolar disorder is like a loop where people experience episodes of mania and depression. While manic episodes might make you feel extremely happy and euphoric, depressive episodes can make you feel hopeless, sad and guilty. An additional risk of this depressive episode is the risk of developing suicidal ideations. It is a serious mental health illness that disrupts the normal functioning of life. Given that it is a serious condition, bipolar disorder can be treated and managed effectively. With the help of professional help, you can find a way to navigate through the episodes. You can consult a psychologist if you suspect the presence of any symptoms. If the psychologist feels that there is an underlying condition, they might consult you with a psychiatrist. The psychiatrist will confirm the diagnosis and help you start medications. These medications can help the person manage the disorder to a great extent. Apart from that, it is possible to overcome bipolar disorder naturally with the help of alternative therapies like meditation, journaling and making lifestyle changes. 

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