Mood Swings and Bipolar Disorder

Bipolar disorder is a mental illness characterized by extreme mood disturbances. These include changes in energy level, activity, sleep, behaviors, and judgement. Bipolar disorder is one of the psychiatric disorders with a complex and multifactorial heritage.

According to Bipolar disorder: Implications for nursing practice (2017), the age for bipolar diagnosis begins at 18 and it can be diagnosed at any time in a person's life. Studies reveal that the prevalence of bipolar disorder is 0.5% to 1.5% amongst the general population, that the disease is generally diagnosed between 18 and 30 years of age, and that its prevalence in men and women is similar (Bipolar disorder: Implications for nursing practice, 2017). Individuals who experienced bipolar spectrum disorder symptoms for lifetime was about 2.4% of the general population, with a prevalence of 0.6% of Bipolar disorder Type I and 0.4% of Bipolar type II (Rowland & Marwaha, 2018). The prevalence of Bipolar Type I in US is 1%, which is slightly higher than other countries. Some data suggest that females are at greater risk for depression and rapid mood shifts, while males have a greater risk for mania (Bipolar Disorder, 2016). There are multiple risk factors that contribute to the development of bipolar disorder (BD). The National Institute of Mental Health (NIMH) describes bipolar disorder in adults as possibly due to genetics, or brain variations in structure or function. According to Amini, Najafi-Vosough, Ghaleiha, and Mahjub (2017), almost 60% and 75% of patients experience relapse within 2 and 5 years. According to World Health Organization reports, bipolar disorder is the sixth leading cause of life-long disability worldwide.

Amini et al. (2017) state that BD is a serious and chronic disorder, which is ongoing with recoveries and relapses and causes significant morbidity and mortality. There are no definitive blood tests or brain scans to diagnose this condition. However, brains of people with bipolar disorder show different patterns than the brains of healthy people or people with other mental disorders. Diagnosis is done by a psychiatrist through diagnostic tests, family history assessment, and history of symptoms.

Because of the overlapping symptoms with certain conditions like major depression, attention deficit hyperactivity disorder(ADHD), and anxiety, BD is commonly misdiagnosed. Bipolar disorder exists along with other illnesses, such as anxiety disorder, substance abuse, or eating disorders. Patients tend to seek treatment when depressed. An accurate diagnosis of bipolar disorder is essential to develop an effective plan of treatment. It is necessary to run a complete physical exam to eliminate other diseases causing mood fluctuations. Also necessary to study is a complete medical history, as well as family and social history that might be influencing changes in mood. Providers should screen for depression to differentiate between unipolar and bipolar. People with BD are at risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses.

Nonadherence to medication therapy results in relapses. Manic episodes can be described as over exhibition of joy, more energy than usual, belief in ability to do many things simultaneously, irritability, racing thoughts, risky behaviors, unusual sexual activity, and overspending of money. Depressive episodes consist of feelings of sadness and hopelessness, loss of interest in activities, trouble concentrating, forgetfulness, over- or under-eating, trouble sleeping, and suicidal thoughts. Bipolar I Disorder is characterized by manic episodes that last at least 7 days or severe manic symptoms that require hospitalization, as well as depressive episodes lasting at least 2 weeks. Bipolar II Disorder is defined by a mixture of depressive episodes and hypomanic episodes, but not the true manic episodes. Cyclothymic Disorder incorporates numerous periods of hypomania and depression lasting for at least 2 years (1 year in children and adolescents). Other Specified and Unspecified Bipolar and Related Disorder is defined by bipolar disorder symptoms that do not match the three categories listed above (National Institute of Mental Health, 2018).

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