Bipolar Mood Disorder

International Bipolar Mood Disorder Day (30th March)

Dr Atul Dhage (Psychiatrist, sexologist, deaddiction specialist and counsellor) from Mind Care Hospital for Mental and Sexual Health, Ratnagiri has written an article in order to come us aware about it indetail ... Do share

                                   Rajesh, 24 year old young boy, sat in the chair in an inclined pose similar to Amitabh Bachchan. He told me very confidently that he will be starting a showroom of Ford in the coming month and later on he would be starting the company Ford. He added that he has accounts in every reputed bank and these accounts have crores of rupees in it. He also mentioned that all the big leaders of all the political parties knew him very well. He not only talked but also sang abruptly. He wore colourful shirt and goggles. His family was quiet when he was telling all of this. I made him sit someplace else and tried to get more information from his father. His father mentioned that he has been bluffing since last few  days. He doesn’t sleep at night, he gets up at 3 o’clock and exercises and says he wants to be a bodybuilder, but in 2-3 hours he does something entirely different. He keeps saying senseless things to all the people who come and go. He purchases things that we already have. He drives rashly. Based on this information, he was diagnosed with Bipolar Mood disorder and having mania at present. After giving proper consultation and medication, he showed a lot of improvement in about 15-20 days and then he was advised to continue the pills for a month or two.

                  Most of the times we meet people who are very motivated, driven and heroic. Their dreams are unbelievably big. We appreciate them and we encourage them. But not everyone who talks like this is normal. Sometimes you realize that this person doesn’t always talk like this. In fact, sometimes such people are so fickle minded. There goals change by day or by hour. They showcase over confidence and bluff so much that we realize that there is something fishy here. Sometimes the same person acts so negatively as if he has lost all hope of living a good life. They don’t feel like doing anything. They lose confidence and faith. These are extreme ends of behaviour. Such person may be suffering from bipolar mood disorder. 30th March is celebrated to create awareness among the people about bipolar mood disorder. Various events and activities are organized to create awareness. 30th March was the birthday of world-renowned fine artist Vincent van Gogh. Vincent van Gogh suffered from bipolar mood disorder. Therefore, his birthday, March 30th, is observed as Bipolar Mood Disorder Day. Bipolar disorder is a very common disease. It is important to dispel misconceptions and stigma about the disease. Even today, many people associate the treatment of this disease with devilish acts, black magic and instead of treating it, they take the patient to people like Bhagat, Gurav, priest and spend a significant amount of crucial time on it. That is why it is a need to create awareness about this disease.

What is bipolar mood disorder?

Bipolar mood disorder, (bi means two, polar means poles i.e. two opposite ends), is a disease in which the mood, action and communication show extremities. To put it simply, I quote Kabhi Khushi Kabhi Gam. This means that there are extreme changes in the mood, energy level, physical activity, the way person talks and daily activities of the person with the disease. These episodic changes can occur over the years, months, or even weeks. Sometimes such changes are too drastic and frequent and progress instantly. Two sorts of episodes that may occur in a patient. Manic episodes are when a person’s mood and energy is high or excessive. When a person’s mood and energy level is low, it is called depressive episode.

                     In a State of Mania, a person feels overly happy. A person thinks big about himself. Considers himself great. He bluffs by saying I am God, I am a hero, I have a lot of money and so on. Sleep is reduced. (Less sleep, no need for sleep, little sleep is enough), he Talks more than usual, chats more with strangers, keep talking. Continues to speak in English. Constantly changes the subject of discussion because of which others don’t understand what he is talking about. Excessive planning, Foolish actions which involves investing money in business unknown to him, spending money unnecessarily, squanders money. Suddenly starts social service. Increase in the speed of mental thoughts and physical activities, starts dancing, singing. Gets involved in dangerous actions like consumption of alcohol or other addictions excessively, extramarital affairs, speeding, etc.

Against this, in a State of Depression, the patient is always depressed and sad. The patient becomes irritable by small things. Loses interest from the things like hobbies and choices. The patient does not feel like talking to anyone and prefers staying alone. He avoids mixing with people. Loses appetite, doesn’t feel like eating anything. He feels sleepless most of the times. Keeps tossing and turning through the night. They lose their confidence. At such times, he starts thinking negatively about his life. The feeling of helplessness and uselessness engulf him. He feels that his life is now over, nothing good can happen ( feeling of hopelessness), nobody can help him (feeling of helplessness) and he is of no use to anybody (feeling of worthlessness). Such negative thoughts may lead to extreme behaviour like committing suicide.

Why does bipolar mood disorder occur?

An increase in Dopamine chemicals in the brain leads to mania, while a decrease in  Serotonin, Dopamine, Epinephrine, and Norepinephrine leads to depression. It is also caused by an injury to brain, a brain tumor, a stroke or by excessive addictions (alcohol, charas, marijuana, etc.). Although stress is the main cause of the disease, sometimes it may be heredity. The primary symptoms start appearing probably between 15 and 25 years of age. This disease affects every aspect of that person’s life. It affects everything like his relationships, his work, his daily life. The disease is difficult to be detected in early stages. One in five people with bipolar mood disorder dies because of suicide. Although the symptoms are mild in the early stages, if left untreated, the disease can become severe and endanger one’s own life, the lives of others or damage property.

What are the treatments for this disease?

Treatment includes medication, electro convulsive therapy(ECT), counselling and rehabilitation. Medications like mood stabilizers, anti-psychotics, anti-depressants, etc. are used (not just sleeping pills). The patient can be completely cured if the medication course is completed as soon as possible and if it is taken regularly and on time. First time when patient is diagnosed, he needs to take regular medication for 6 to 8 months, while in the second time, it takes 2 to 5 years. However, many patients and their relatives do not complete the treatment and in such cases, the patient’s illness turns into a chronic illness such as Diabetes, Hypertension and then the patient may have to continue treatment for life. In addition to medication, he may need psychotherapy and counselling. Supporting, educating the patient and relatives about the illness is needed to help them deal it in better way. Counselling is needed to support the patient, educate him about the illness, and guide his family. During depression Psychotherapy, CBT, REBT etc. should be used along with medication.

ECT (electrical therapy) which is simply called shock treatment. This is a very good and effective treatment. ECT treatment should only be used if the patient is not taking medication, is hurting himself or others, or is not benefiting from the medication. Not all patients need it. But even today, there are many misconceptions about this treatment.

How should patients take care of themselves?

1. Take medication regularly.

2. Consult a psychiatrist regularly (at least once every three months). Avoid taking the same Medications without psychiatrists consultation for years together. Self-medication should be avoided.

3. Need to get proper, calm and adequate sleep.

4. Eat a balanced, adequate and timely diet. Do not fast.

5. Learn to control and manage stress properly.

6. Avoid consumption of caffeine, cigarettes and other tobacco products, alcohol and other

drugs.

7. Make a daily schedule.

8. Exercise for at least 30 minutes every day.

Dr. Atul Dhage,

Psychiatrist, sexologist, deaddiction specialist and counsellor.

Mindcare Hospital For Mental & Sexual Health, Ratnagiri