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Hello and welcome to another blog post! In this blog, I will share some information regarding a mental illness that is fairly common, yet greatly misunderstood by many: bipolar disorder.
Bipolar disorder is characterized by recurring and chronic shifts in energy and mood (Grand et al., 2016). Impacting over 1% of the global population, it ranks among the leading causes of disability in young people, often resulting in cognitive and functional impairment and, tragically, an increased risk of mortality due to suicide. Individuals living with bipolar disorder frequently contend with psychiatric and medical comorbidities, making accurate diagnosis and management particularly challenging. Onset typically occurs with a depressive episode, which can mimic unipolar depression. Furthermore, the absence of reliable biomarkers further complicates diagnosis. Differentiating this condition from others often relies on detecting hypomanic periods—characterized by elevated mood and increased motor drive—and long-term observation.
Managing bipolar disorder begins with confirming a diagnosis of mania or hypomania and assessing the patient’s mood state, which is crucial for tailoring therapeutic approaches (Grande et al., 2016). Treatment decisions are influenced by various factors including comorbidities, previous treatments, treatment response, and patient preferences. During acute management, ensuring patient and community safety and achieving clinical stability with minimal adverse effects are paramount. Establishing a therapeutic alliance, especially during the initial episode, is crucial for chronic conditions like bipolar disorder. Long-term management goals include relapse prevention and supporting functional stability during treatment optimization.
Mood stabilizers and antipsychotics are mainstays in managing acute bipolar mania and depression, while the efficacy of antidepressants remains uncertain, and their use as monotherapy is cautioned against (Grande et al., 2016). Electroconvulsive therapy is highly effective for treatment-resistant acute mood episodes, particularly with psychotic or catatonic features. Emerging treatments for acute management include modafinil as a cognitive enhancer and ketamine for treatment-resistant depression.
While periods of remission are common for individuals with bipolar disorder, relapse is expected, especially with poor treatment adherence (Grande et al., 2016). Those experiencing predominantly depressive episodes are at greater risk of suicide attempts, while substance misuse is more prevalent among those with frequent manic episodes.
In contrast to acute symptom management, long-term care ideally integrates pharmacological, psychological, and lifestyle interventions from the outset (Grande et al., 2016). Psychotherapeutic approaches such as psychoeducation, cognitive-behavioral therapy, interpersonal and social rhythm therapy, and family-focused therapy are beneficial.
Despite presenting with normal or superior cognition prior to diagnosis, individuals with bipolar disorder often exhibit neurocognitive deficits across all mood states, even during remission (Duncan, 2024). These deficits may contribute to functional impairment despite symptomatic remission, highlighting the importance of holistic recovery strategies.
A recent study from the University of Toronto found that 43% of previously diagnosed Canadians with bipolar disorder were symptom-free, with 1 in 4 achieving complete mental health (Duncan, 2024). While promising, it’s noteworthy that individuals with a history of bipolar disorder were significantly less likely to attain complete mental health compared to those without such a history. Factors contributing to mental health for individuals with bipolar disorder included having a trusted confidant, spiritual beliefs, and absence of chronic pain. Thus, while there is hope for individuals with bipolar disorder to achieve complete mental health, they require comprehensive support to thrive.
Thank you very much for reading this blog post. I hope that this blog post helped you learn something new, or provided you with a refresher. Wishing everyone a wonderful rest of the day!
References
Duncan, D. (2024, June 11). 1 in 4 people with bipolar disorder achieve complete mental health. Neuroscience News. https://neurosciencenews.com/bipolar-mental-health-26296/
Grande, I., Berk, M., Birmaher, B., & Vieta, E. (2016). Bipolar disorder. The Lancet, 387(10027), 1561-1572. https://doi.org/10.1016/S0140-6736(15)00241-X
Note: The Free Your Mind Mental Health Society is an independent youth-led organization. The contents of this blog are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. In the event of a medical emergency, please call your doctor or 911 or other local emergency numbers immediately.