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Understanding Bipolar disorder
Bipolar Disorder, previously known as Manic Depression is a mental health condition characterised by extreme mood swings ranging from feeling very high (mania, hypomania) to being in a very low mood (depression) occasionally accompanied by symptoms of psychosis. Some symptoms of manic episodes are a high degree of excitement, and energy, a reduced need for sleep, and reduced inhibitions. Depressive episodes make one feel sad, hopeless, lethargic, and withdrawn from life. The episodes may last for several weeks at a time and normal mood prevails in the period between them.
The Difference Between Bipolar 1 and Bipolar 2 Disorder
Bipolar I disorder and Bipolar II disorder are subtypes of bipolar disorder, each with its own distinct characteristics, including the nature of depressive episodes:
Bipolar I Disorder:
Manic Episodes: Individuals with Bipolar I experience at least one manic episode, which is a distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting for at least one week. Some may also experience mixed episodes, where symptoms of both mania and depression occur simultaneously.
Severity: Manic episodes in Bipolar I are severe and can significantly impair daily functioning. Depressive episodes in Bipolar I are similar to those in major depressive disorder (unipolar depression).
Bipolar II Disorder:
Hypomanic Episodes: Bipolar II involves at least one hypomanic episode and one major depressive episode. Hypomania is a milder form of mania, with symptoms that are less severe and shorter in duration compared to full-blown manic episodes.
Depressive Episodes: Depressive episodes in Bipolar II are similar to those in Bipolar I and major depressive disorder (unipolar depression), involving persistent low mood, anhedonia, and other depressive symptoms.
Difference in Depression:
Bipolar I Depression: Individuals with Bipolar I experience depressive episodes that are similar to those in unipolar depression (major depressive disorder) but occur within the context of the larger bipolar disorder, which includes manic or mixed episodes.
·Bipolar II Depression: In Bipolar II, the depressive episodes are more consistent with those in unipolar depression or Bipolar I, without the severity and duration of full manic episodes.
Both Bipolar I and II involve depressive episodes, but the distinction lies in the presence and nature of manic or hypomanic episodes. Bipolar I features full-blown manic episodes, while Bipolar II involves hypomanic episodes, which are less severe but still distinct from a person's usual mood. Accurate diagnosis and treatment planning by a mental health professional are crucial for individuals experiencing symptoms of bipolar disorder.
Yoga: Where Mind and Body Meet
Yoga for Bipolar disorder
Yoga's potential impact on the brain in managing bipolar disorder involves various mechanisms that can influence mental health positively. While research in this area is ongoing and findings are still evolving, here are some ways yoga might affect the brain and potentially help manage bipolar disorder:
- Neuroplasticity: Yoga practices, including meditation and mindful movement, may promote neuroplastic changes in the brain. Regular practice might contribute to structural and functional alterations in areas related to mood regulation, potentially aiding in emotional stability.
- Stress Response Regulation: Yoga techniques, such as deep breathing and relaxation exercises, can influence the body's stress response. Chronic stress is a known trigger for mood episodes in bipolar disorder. Yoga may help regulate the stress response systems in the brain, potentially reducing the impact of stress on mood fluctuations.
- Enhanced Emotional Regulation: Mindfulness practices within yoga can foster better emotional regulation by encouraging non-judgmental awareness of thoughts and feelings. This heightened awareness might help individuals recognize and manage mood shifts more effectively.
- Neurochemical Changes: Some studies suggest that yoga practices can influence neurotransmitter levels, including serotonin and gamma-aminobutyric acid (GABA), which play roles in mood regulation. Yoga might modulate these neurotransmitters, contributing to improved mood stability.
- Cognitive Function and Focus: Yoga's emphasis on mindfulness and concentration practices could potentially enhance cognitive function and attention regulation. Improved cognitive control might aid individuals in managing symptoms and coping with mood fluctuations.
However, it's important to note that while yoga can offer potential benefits, it should be approached as a complementary practice alongside other evidence-based treatments prescribed by healthcare professionals for bipolar disorder. Consulting with a healthcare provider before starting any new exercise or yoga routine is crucial, especially for individuals with mental health conditions like bipolar disorder. The practice should be adapted to individual needs and limitations, and any poses or practices that exacerbate symptoms should be avoided.
Possible causes of bipolar disorder
It is not clearly understood what causes bipolar disorder. Research shows that it may be caused by either genetic, physical, environmental, or social factors or a complex combination of these factors.
Genetics - Scientific studies have concluded that a large percentage of people with bipolar disorders have a genetic link to a first-degree relative with bipolar disorder. It has been observed that if one parent has bipolar disorder then the child has a 10% chance of developing it. If both parents have bipolar disorder then the chance increases to 40%. However, no single gene has been identified as being the cause of bipolar disorder to manifest.
Chemical imbalance in the brain - The brain chemicals responsible for communication between the nerve cells are called neurotransmitters. The three main neurotransmitters - norepinephrine, serotonin, and dopamine - play a vital role in regulating our emotions, memory, alertness, sleep, and reward pathways. Hence, any major deviation from the norm in the levels of these neurotransmitters in the brain can cause major mood upheavals which may be expressed as bipolar disorder.
Life Events and Environment -
Growing up in an emotionally negative environment with parents or close family who may have mental health issues, indulge in substance or alcohol abuse, or neglect and mistreat a child can increase the chances of developing bipolar disorder. Also, adverse life events such as the breakdown of a relationship, the death of a loved one, and difficulty in coping with everyday challenges of life such as work, managing finances, and personal responsibilities can become a trigger for developing bipolar disorder.
Feelings an individual may have when experiencing bipolar disorder
Depression - during the depressive phase an individual may feel extreme sadness, gloom, hopelessness, a sense of worthlessness, and suicidal at times (a person with bipolar disorder has a 20 to 30 times higher chance of suicide compared to a normal person). These feelings may last for several or more at a time and they don't have a predictable pattern of occurrence.
Mania - during the manic phase the person can feel super excited and optimistic, flow of creativity, and high energy, be sleepless, or barely sleep during the entire episode which may last for a week or longer. The person also acts impulsively, speaks rapidly, feels all over the place with their thoughts jumping from one thing to another, and may indulge in risky behaviour, for instance, extravagant spending on unnecessary things, as they don't have inhibitions or a sense of normal reality.
Psychosis - during the manic phase some individuals may feel symptoms of psychosis such as delusions and hallucinations, feeling grandiose, or they may feel they have special powers and identity (for instance, they may identify as being the president of the universe or a country).
It has been observed that for 45-50% of their timeline, people with bipolar disorder have stable moods.
Effects of bipolar disorder an the individual and their life
The emotional ups and downs experienced by an individual with bipolar disorder and their unpredictable episodes and not knowing how they last can catch them off guard and unable to function normally as others who don't suffer from it.
Affect on relationship - During the manic phase, the person may spend extravagantly on things that are not needed causing financial stress. The person acts impulsively and aggressively, making others wary around them. During the depressive phase, they lose interest in everything and life in general, and other people may be very concerned about them. This can put a huge stress on a relationship and makes it challenging for it to last long.
Affect on Work/ Studies - Bipolar disorder is considered to be a disability when the symptoms last over 12 months. This reflects how much it can affect employment, business, or studies. The extreme fluctuation of emotions can make it difficult to maintain focus, creativity, interpersonal dynamics with colleagues, and reliability in delivering time-bound tasks. Psychotic symptoms may cause a person to be suspicious of and harbour false beliefs about their boss and or colleagues. This may affect their work efficiency and stunt career growth or drop out of academics.
Effect of bipolar disorder on the individual's family and friends
The emotional ups and downs experienced by an individual with bipolar disorder and their unpredictable episodes and not knowing how they last can catch them off guard and unable to function normally as others who don't suffer from it.
Affect on relationship - During the manic phase, the person may spend extravagantly on things that are not needed causing financial stress. The person acts impulsively and aggressively, making others wary around them. During the depressive phase, they lose interest in everything and life in general, and other people may be very concerned about them. This can put a huge stress on a relationship and makes it challenging for it to last long.
Affect on Work/ Studies - Bipolar disorder is considered to be a disability when the symptoms last over 12 months. This reflects how much it can affect employment, business, or studies. The extreme fluctuation of emotions can make it difficult to maintain focus, creativity, interpersonal dynamics with colleagues, and reliability in delivering time-bound tasks. Psychotic symptoms may cause a person to be suspicious of and harbour false beliefs about their boss and or colleagues. This may affect their work efficiency and stunt career growth or drop out of academics.
Demands of daily life and how they influence symptoms of bipolar disorder
Relationship issues such as having a difference of opinions causing clashes, abuse be it emotional or otherwise, living separate lives, and bereavement can influence symptoms of bipolar disorder
Such issues can have a very negative influence on the person causing them distress and are likely to trigger depressive symptoms as they may find it very difficult to cope with them.
Demands and pressures of work or studies, dynamics of the workplace, and equations with colleagues and superiors can all play out in ways that can trigger a person's bipolar symptoms.
Depending on how a person and their performance is viewed at the workplace, they can either move ahead in their career or be deprived of opportunities to do well. This may manifest manic or depressive symptoms depending on the positive or negative experience of the person with bipolar disorder.
Financial issues such as debt, lack of money, and impulsive overspending without the means to pay back are likely to influence bipolar disorder symptoms. These demands of daily life can make a person with bipolar disorder feel either very elated or very low depending on how they view or handle the situation.
While these demands can influence the symptoms of bipolar disorder, some of these demands come into play because of a person's behaviour during manic episodes when they indulge in extravagant spending or not realising what they are up to when they commit such actions but later when they are feeling normal their actions can haunt them and trigger their symptoms forming a vicious cycle.
Medical interventions for bipolar disorder
Drugs and medication - Most individuals with bipolar disorder are given medications to manage their symptoms and function normally. The medications used are Lithium to manage episodes of mania, Ketamine for depressive episodes, anticonvulsants, mood stabilisers, and antipsychotics.
Talking treatments or Psychological treatments - These involve treatments such as psychotherapy, counseling, and cognitive behaviourial treatment and aim to help the person to help themselves by making them develop a better understanding of their condition so they are more in charge of it and minimise any negative impact it may have on the person.
Electroconvulsive Therapy (ECT) - For people who do not respond well to medications and alternative treatments such as talk treatments, ECT may be considered.
Hospital admission - A person experiencing severe manic or depressive episodes may have to be hospitalised for proper assessment, to reduce risk, and relieve those caring for the person affected.
Strategies for an individual to manage bipolar disorder when entering manic/ depressive episode
An individual can be more organised when they are in normal moods and should have a strategy in place with family and friends to minimise the impact of bipolar highs and lows.
When entering a manic phase the person should hand over finances including credit cards if any to a trusted loved one or a reliable friend to keep from any impulsive and unnecessary spending and reduce the risk of debt and financial stress.
Recognise mood changes - The person suffering from bipolar disorder and their family and friends must learn as much as they can about the condition so they can notice the mood shifts at the onset to enable better support for the person affected.
Eat and sleep regularly - Bipolar disorder can cause a wild fluctuation in a person's appetite, and eating and sleeping pattern. Disturbed sleep can trigger and worsen the symptoms of bipolar as can consuming unhealthy food and drinks such as high sugar high fat refined or processed foods, alcohol, and caffeine. Eating wholesome nourishing food regularly in tandem with good sleep may also help as a mood stabiliser.
How family and friends can help the individual with bipolar disorder to manage their illness.
An individual can be more organised when they are in normal moods and should have a strategy in place with family and friends to minimise the impact of bipolar highs and lows.
When entering a manic phase the person should hand over finances including credit cards if any to a trusted loved one or a reliable friend to keep from any impulsive and unnecessary spending and reduce the risk of debt and financial stress.
Recognise mood changes - The person suffering from bipolar disorder and their family and friends must learn as much as they can about the condition so they can notice the mood shifts at the onset to enable better support for the person affected.
Eat and sleep regularly - Bipolar disorder can cause a wild fluctuation in a person's appetite, and eating and sleeping pattern. Disturbed sleep can trigger and worsen the symptoms of bipolar as can consuming unhealthy food and drinks such as high sugar high fat refined or processed foods, alcohol, and caffeine. Eating wholesome nourishing food regularly in tandem with good sleep may also help as a mood stabiliser.