The symptoms and diagnosis of bipolar disorder: a literature review

Ieva Radzevičiūtė1

1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania

Abstract

Bipolar disorder (BD) is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The illness affects about 1-2% of the population. The mean age of onset is 25 years. Scientists believe that BD is caused by multiple genes. Its phenotypic expression is a result of interacting genetic and environmental factors. Life events and chronic stressors are important in precipitating and perpetuating mood episodes. There are several types of BD. Bipolar I disorder involves periods of severe mood episodes from mania to depression. Bipolar II disorder is a milder form of mood elevation, involving milder episodes of hypomania that alternate with periods of severe depression. Manic symptoms: elevated, expansive or irritable mood, increased activity, reduced need of sleep, excessive involvement in pleasurable activities, inflated self esteem or grandiosity, increased or pressured speech, racing thoughts. Hypomania is a milder form of mania. Depressive symptoms: depressed mood, markedly reduced interest in nearly all activities, increased or decreased appetite or weight, insomnia or hypersomnia, psychomotor retardation or agitation, fatigue or loss of energy, feelings of excessive worthlessness or guilt, recurrent thoughts or actions of death or suicide. Cyclothymia refers to a subset of milder disorders with repeated short cycles of hypomania and mildly lowered mood occurring regularly over two or more years. Besides a thorough psychiatric and neurological examination, further clinical tests should be performed in order to exclude differential diagnosis. The key to diagnosis is the presence or history of hypomania or mania. It is important to take a full history of depressive and manic symptoms in current and previous episodes and perform a mental state examination. After all the prognosis of BD is depending on the individual course of the illness

Keywords: bipolar disorder, mania, hypomania, depression