In?Popular?Psychology?Or ”street”, bipolar disorder has been defined as a disorder in which the person changes his mood more frequently and less moderation than usual (sometimes he is sad and suddenly happy, sometimes angry and in a short time, calm). , this is not entirely correct, and it is necessary to define this condition in more detail and rigor.
There are two forms of bipolar disorder: type I and type II, bipolar disorder type I is characterized primarily by the presence of a manic episode (euphoric state) and type II by the presence of a hypomaniacal episode and major depression. each of these concepts.
- According to the DSM-5 (Diagnostic Manual and Statistics of Mental Disorders).
- A manic episode is characterized by a well-defined period of abnormal and constantly elevated.
- Expansive or irritable mood.
- And an abnormal or persistent increase in activity or energy.
A condition in which the person would be most of the day, almost every day, for a period of at least one week (or whatever the duration if it is so acute that the person should be hospitalized).
Accompanied by at least three additional symptoms (decreased need for sleep, increased self-esteem or feeling of greatness, excessive participation in activities that have a good chance of painful consequences, etc. ).
The mood in a manic episode is often described as euphoric, too cheerful, strong, or “sentimental of the world. “For example, the individual may spontaneously engage in long public conversations with strangers. Thoughts go faster than they can be expressed verbally.
The mood in a manic episode is often described as euphoric, too cheerful, strong, or “sentimental of the world. “
Expansive humor, excessive optimism, grandeur, and poor judgment can lead to reckless activities, such as overspending, donating property, dangerous driving, reckless investment in business, and sexual promiscuity unusual for the individual.
Initiatives that often only cause losses to the individual, either economically or in their social support network.
This episode is severe enough to cause a major deterioration in social or professional functioning, to require hospitalization or because there are psychotic characteristics (delusions, hallucinations, etc. ).
According to DSM-5, a hypomaniacal episode is a well-defined period of abnormal and constantly elevated, expansive or irritable mood, and an abnormal and persistent increase in activity or energy, lasting at least four consecutive days.
Unlike the manic episode, the hypomaniacal episode is not severe enough to cause a major change in social or professional functioning, nor does it require hospitalization, and does not have psychotic characteristics.
Unlike the manic episode, the hypomaniacal episode is not severe enough to require hospitalization.
Depression is a better-known concept of the general population. Do we use the word colloquially?Depression ?, to describe states of sadness, melancholy, lack of energy, drowsiness, slowness, etc. As we have done with mania and hypomania, let’s see what criteria must be met to diagnose an episode of major depression.
To diagnose it, DSM-5 requires the presence of at least five of the following symptoms almost daily and for most of the day, for at least two weeks, in addition to the presence of a depressive mood or loss of interest or pleasure. Necessary.
At least 90% of depressed patients seem sad or despondent, it is important to wonder what is the worst and best time of day, or if there is something that makes the patient feel better, because these aspects are related to melancholy.
It’s about reducing pleasure in everyday activities, so nothing does the person any good (neither going out, nor seeing their grandchildren or nephews, watching a TV show?).
The criterion used is a 5% weight gain in a month compared to the usual weight, although sometimes it can be difficult to assess this symptom.
Insomnia is still considered a depressive symptom, although in hypersomnia there are more doubts, which can become atypical, here it is advisable to explore both the initial and moderate and terminal insomnia, and analyze what the patient’s 24-hour sleepiness looks like, as well as whether the sleep is restful or not, the time spent in bed, etc.
One criterion often used for initial insomnia is to take more than 30 minutes to fall asleep; medium insomnia occurs when the patient wakes up for more than 30 minutes during the night with difficulty falling asleep again; Late insomnia occurs when the patient wakes up 1 to 3 hours earlier than normal and can no longer sleep. There is no established criterion for hypersomnia.
It refers to both delayed and psychomotor agitation, and its diagnosis requires a manifestation of behavior visible to others.
Sometimes respondents say they have no energy, but in fact it is a decrease in interest.
It is often helpful to ask the patient to describe himself and how his acquaintances or relatives would describe him or her.
Here, typical questions try to identify whether the patient is able to follow a conversation or TV show, focus on their work, etc.
Between 60% and 80% of suicides committed occur in patients diagnosed with depression. Depression increases the risk of suicide by about 30 times compared to the general population.
When a person has at least 5 of these symptoms, this does not mean that it is possible to automatically diagnose the presence of a “major depressive state”. In addition, there must be significant psychosocial deterioration and this whole condition cannot be due to the effects of substances or diseases (such as dementia), nor to the effects of a normal bereavement reaction.
Diagnosing a major depressive episode requires the presence of a depressive mood or a loss of interest or pleasure.
As we’ve seen before, type I bipolar disorder is characterized by the presence of a manic episode, before or after there may be hypomaniacal episodes or major depression.
During manic episodes, patients generally do not perceive that they are sick or do not recognize that they need treatment and are strongly reluctant to receive it. They often change the way you dress, make up, or look personal to a more eye-catching or sexually suggestive one. Style.
Some patients may become aggressive and make physical threats; if they are delirious, they can physically attack other people or commit suicide.
Due to judgmental problems, poor awareness of the disease and hyperactivity, the manic episode can have catastrophic consequences.
Mood can vary very quickly to irritation or even depression. During manic episodes, depressive symptoms may appear for minutes, hours, or, more rarely, days.
Type I bipolar disorder is characterized by the presence of a manic episode.
“The lifetime risk of suicide for patients with bipolar disorder is estimated to be 15 times higher than that of the general population. In fact, bipolar disorder accounts for a quarter of all suicides consumed.
As we’ve seen before, bipolar disorder type II is characterized by the presence of a hypomaniacal episode and major depression. The manic episode is an exclusive Feature of Type I. Patients with bipolar II disorder often consult a doctor during a major depressive episode and are unlikely to initially complain of hypomania. Hypomaniacal episodes usually don’t cause dysfunction on their own.
Dysfunction is the result of major depressive episodes or a persistent pattern of unpredictable and fluctuating mood swings, and an unreliable pattern of interpersonal or professional relationships. Patients with bipolar II disorder may not consider hypomaniacal episodes to be pathological or adverse, although the individual’s behavior is erratic. may annoy others.
A common feature of this disorder is impulsivity, which can contribute to suicide attempts and substance use disorders.
Bipolar disorder type II is characterized by the presence of a hypomaniacal episode and major depression.
“The risk of suicide is higher in bipolar DISORDER II. About one-third of patients with bipolar II disorder have a history of suicide attempts. The lethality of attempts, defined by a lower rate of attempts compared to the suicides consumed, is higher in patients with bipolar DISORDER II than in patients with bipolar I disorder. (DSM-5).
Bibliography: American Psychiatry Assiciation, Diagnostic and Statistical Manual of Mental Disorders (DSM-5)