A mental health illness which is generally explained as having periods of severe mood disturbances. This episodes affects a persons mood, thoughts and even his or her behaviour. Bipolar disorder is a mental health condition defined by periods (better known as episodes) of extreme mood disturbances. Bipolar disorders include sever moods swings which incorporate emotional highs (mania or hypomania) and lows (depression).

There are two main types of bipolar disorders: bipolar I and bipolar II. According to the Diagnostic and Statistical Manual of Mental Disorders, bipolar I disorder involves episodes of severe mania and often depression. Bipolar II disorder involves a less severe form of mania called hypomania.

Types of Illness.

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The American Psychiatric Association describe four categories of bipolar disorder: bipolar I disorder, bipolar II disorder, cyclothymic disorder, and bipolar disorder due to some other medical or substance abuse disorder.

Bipolar I Disorder

Bipolar I disorder is diagnosed with manic episodes which can go on for at least seven days and are accompanied by psychotic features or the manic symptoms are severe enough to require immediate hospitalisation in order to avoid harm to self and or others. Sometime there are could also be Depressive episodes, which may last up to at least two weeks. Some people also experience manic episodes with some depressive features or depressive episodes with some manic features

Bipolar II disorder‍

People diagnosed with bipolar II disorder do not experience mania but they do get into recurring episodes of major depression and hypomania, which is a milder mania. There needs to be at least one hypomanic episode and one major depressive episode in a life time to be diagnosed with bipolar II disorder. In bipolar I disorder, a major depressive episode (one or more) usually occurs, but it is not required. Bipolar II disorder involves one or more major depressive episodes. Some of the common common symptoms that occur in a major depressive episode include:

Insomnia or hypersomnia
Unexplained or uncontrollable crying
Severe fatigue
Loss of interest in things the person typically enjoys
Recurring thoughts of death or suicide

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Cyclothymic disorder.

‍Cyclothymia comprises cyclic moods swings and is a milder form of bipolar disorder. The highs and lows are generally not extreme enough to be classified as either mania or a severe depression.

Cyclothymic disorders are found mostly among adolescents who are able to function normally but present as being 'moody'. This group of people are known not to seek treatment as they don't see a need but there is a risk of developing bipolar disorder.

Bipolar disorder due to another medical or substance abuse disorder‍

Not all bipolar disorders have a clear pattern and they don't match the other three disorders but they do meet the criteria for abnormal mood shifting. Sometimes the mild depressive or hypomanic symptoms last for less then two years required to be diagnosed with cyclothymia.

For example, a person may experience mild depressive or hypomanic symptoms that last less than the two years specified for cyclothymia. Another example is if a person has depressive episodes, but their symptoms of mood elevation are too mild or brief to be diagnosed as mania or hypomania.

With bipolar I disorders, a major depressive disorders may not necessarily appear while people suffering from bipolar II will experience at least one or two major depressive episodes. Symptoms of a depressive episode include:

• Fatigue
• Loss of interest in things normally enjoyed
• Loss of apetite
• Insomnia or hypersomnia
• Suicidal ideation

Mania can last up to a week or so and sometimes people do engage in risky behaviour. Common symptoms are:

• Disconnected and very fast (racing) thoughts.
• Grandiose beliefs.
• Inappropriate elation or euphoria.
• Inappropriate irritability.
• Inappropriate social behavior.
• Increased sexual desire.
• Increased talking speed or volume.
  
• Markedly increased energy.

Hypomania symptoms are milder and may not require hospitalisation. Those experiencing hypomania may actually enjoy and it with more energy to do things. Common symptoms include:

- Overconfident

- Irritable and rude behaviour

- Higher energy levels

- Feeing well. both physically and mentally

- More talkative and sociable than usual.

Treatment is customised to specific needs of each individual depending on the severity. A combination of psychophamarcology and therapy is works best .

As bipolar is a chronic illness, treatment is normally on going and people are able to live enriching lives.

Medications are used normally to treat bipolar disorders and may include mood stabilizers, antipsychotics (possible with bipolar I disorders) and antidepressant. It is important to meet the doctor regularly to review the medications and its impact on the symptoms. It is possible for doctors to change the dosages or medications to identify what works best for the patient.

Therapy is an important component to work with bipolar disorders. Identifying triggers and symptoms and managing the triggers with the right coping skills becomes crucial to maintain long term recovery. There are various tehniques in therapy which are employed.

Cognitive behavioral therapy, Solution Focused Therapy, Family therapy and Psychoeducation are some of the common techniques employed when working with bipolar disorders. Patients will work closely with their doctors and clinicians and come up with a long term treatment plan which needs to be reviewed regularly in order to monitor and track treatment outcomes and progress.