Bipolar disorder

Clinic

• Previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood
• If the elevated mood is severe or associated with psychosis, it is called mania; if it is less severe, it is called hypomania.
• During mania, an individual behaves or feels abnormally energetic, happy or irritable, and they often make impulsive decisions with little regard for the consequences. There is usually also a reduced need for sleep during manic phases.
• Late adolescence and early adulthood are peak years for the onset of bipolar disorder
• Bipolar disorder occurs in approximately 1% of the global population
• Exact mechanism underlying the disorder remains unclear

Signs / Symptoms

• Depression: Crying, Negative outlook on life, Poor eye contact, Slowed movements
• Mania:
  • An increase in energy of psychomotor activity / Decreased need for sleep / Constant fidgeting
  • High risk of suicide
  • Euphoria or dysphoria, Irritability
  • Increased self-esteem or grandiosity
  • Racing thoughts
  • Pressured speech that is difficult to interrupt
  • Disinhibited social behavior
  • Increased goal-oriented activities
  • Impaired judgement, Impulsive or high-risk behaviors such as hypersexuality, Excessive spending.
• Psychosis: Delusions (Grandiose), Hallucinations

Related states

Hypomania

• Hypomania is the milder form of mania, defined as at least four days of the same criteria as mania, but which does not cause a significant decrease in the individual's ability to socialize or work,
• It lacks psychotic features such as delusions or hallucinations, and does not require psychiatric hospitalization.

Mixed affective episodes

• In bipolar disorder, a mixed state is an episode during which symptoms of both mania and depression occur simultaneously.
• Individuals experiencing a mixed state may have manic symptoms such as grandiose thoughts while simultaneously experiencing depressive symptoms such as excessive guilt or feeling suicidal.
• They are considered to have a higher risk for suicidal behavior as depressive emotions such as hopelessness are often paired with mood swings or difficulties with impulse control.
• Anxiety disorders occur more frequently as a comorbidity in mixed bipolar episodes than in non-mixed bipolar depression or mania.
• Substance (including alcohol) use also follows this trend, thereby appearing to depict bipolar symptoms as no more than a consequence of substance use.

Comorbid conditions

• Anxiety (71%)
• Substance abuse (56%)
• Personality disorders (36%)
• Attention deficit hyperactivity disorder (10–20%)

• Metabolic syndrome (37%)
• Migraine headaches (35%)
• Obesity (21%)
• Type 2 diabetes (14%)

Entities / Miasms

	GSS	STLE	TBE
Emotional lability	+++	+++	+++
Hallucinations / Delusions		+++	+++
Depression	+++	+++
Psychosis	+++

Research

• CMV and Bipolar disease.

Remedies

Depression stage

• Anac
• Sep
• Naja

Manic stage

• Bell
• Stram
• Hyos
• Tarant
• Syph