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Bipolar Disorder, What is it?

Bipolar Disorder, What is it?

06 Oct 2017 dr. Rini Siallagan Articles 39

The first week of October calls for World Mental Health Week.  As we know in life, your health is defined by both physical and mental health.  Whilst the stigma of mental disorders is still quite a challenge in Indonesia, we hope by educating the public that gradually we will end the stigma.  In this article, we will be discussing bipolar disorder, a mental condition that is gaining popularity lately.


Star Wars’ favorite Carrie Fischer and legendary painter Vincent van Gogh are known to have suffered from bipolar disorder. Bipolar disorder is characterized by episodes of mania and depression.  This results in unusual shift in mood, energy, activity levels, and the ability to carry out day-to-day tasks.  This is different from schizophrenia, where patients may hallucinate.


Manic and depressive episodes are what characterize bipolar patients.  The shift between manic and depressive episodes could be anywhere between weeks, months to years.


Manic episodes are characterized by:

  • Feeling euphoric

  • Increased energy, needing less sleep

  • Irritable, easily angered

  • Excessively talking

  • Racing thoughts

  • Increased self-esteem

  • Impulsiveness and recklessness (shopping sprees, promiscuous sex)


Depressive episodes are characterized by:

  • Depressed mood, feeling sad, helpless, and hopelessness

  • Feeling lonely, anxious, guilty

  • Low energy levels and apathy

  • Slow speech and fatigue

  • Insomnia or oversleeping. Hard to get out of bed.

  • Suicidal thoughts

  • Poor concentration and memory

  • Lack of interest or pleasure in usual hobbies and activities


Bipolar disorders are characterized into Bipolar I and Bipolar II.  In Bipolar I the shift between manic and depressive episodes are extreme.  

Whereas in Bipolar II, the shifts and the episodes are not as extreme.  The term “hypomanic” is a manic phase with less intensity.  The patient may be in a better mood, productive, and everything goes well, however family and friends may notice that there is a change in mood and activity.


Though not fully understood, there are certain theories and risk factors of developing bipolar disorder.  Neural structures, genetics and family history are significant risk factors.


Generally speaking, patients are diagnosed when they come to their psychiatrist or doctor during a depressive episode rather than a hypomanic or manic phase.  Patients may pose harm to themselves and others when they have depressive or manic phase.  Depressive phase may affect their social and work life, and in severe cases suicide.  Manic phase may also affect their social and work life, spending sprees may hurt their financial life, and impulsiveness may also harm those around them.


Patients are managed by medication and psychotherapy.  Medications may differ according to the episodes and the effectiveness of the medicine on the particular patient.  Medications have to be tightly monitored as doses may differ between patients.


Psychotherapy provides support, education and guidance to patients and their families.
Bipolar disorder is a lifelong illness, and manic and depressive episodes typically come and go.  Being compliant and routinely meeting with your doctor or psychiatrist will help control the polarity of mood swings.  Support of family, friends, and the community are as important as medications in order for a bipolar patient to feel better.