Are you feeling high or low? Are you on a roller coaster? You may be ill...

Expert of this article: Zhao Wei, deputy chief physician of Department of Neurology and Sleep Medicine Center, Tianjin University Teda Hospital

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Sometimes I feel very excited, full of energy and never feel tired; but sometimes I feel depressed, exhausted and just not feeling good at all...Have you ever had this feeling?

”

Recently, the term #bipolar disorder# became a hot search, instantly attracting the attention of many netizens.

Weibo screenshot

So what exactly is bipolar disorder? How is it different from depression? How can you tell if you have it? Let's take a look.

What is bipolar disorder?

Bipolar disorder, also known as manic-depressive illness, refers to a type of mental illness that presents both depression and mania.

Bipolar disorder mainly includes bipolar type I (depression + mania), bipolar type II (depression + hypomania), etc., and its symptoms include depression and mania/hypomania.

Symptoms of depression

Depressed mood, significant changes in weight or appetite, insomnia or excessive sleeping, psychomotor agitation or retardation, low self-esteem or excessive self-blame, indecisiveness or difficulty concentrating, suicidal thoughts or behaviors.

Symptoms of mania/hypomania

Psychotic symptoms include elevated mood, high energy or irritability, increased goal-oriented activities (working without sleep, frequent socializing, etc.) and psychomotor agitation (restlessness, etc.), impulsive and risky behavior (uncontrolled shopping, hasty investments, etc.), decreased need for sleep, inattention, hallucinations, delusions, etc.

The symptoms of mania and hypomania are basically the same. The difference is that mania symptoms last longer (7 days), the degree of functional impairment is more serious, psychotic symptoms are often present, and hospitalization is required.

How to diagnose bipolar disorder?

These symptoms often indicate bipolar disorder:

Early age of onset;

Frequent short-term depression;

Family history of bipolar disorder;

Depression with psychotic features (e.g., hallucinations, delusions);

depression with atypical features (such as excessive sleeping and excessive eating);

Emotional instability;

Sleep disturbance;

antidepressant-induced mood elevation;

Full of energy.

It should be noted that if one is in high spirits for a long period of time, has a reduced need for sleep, is full of ideas and opinions, and works day and night, it may also be hypomania, which is more common in successful people and workaholics.

How to distinguish bipolar disorder from depression?

Bipolar disorder can be thought of as depression “plus” and is characterized by recurring or alternating cycles of depression and mania.

The mood of bipolar disorder is like a "seesaw" or "roller coaster", while the core symptoms of depression are depressed mood or loss of interest/pleasure. The diagnosis of depression requires the exclusion of manic or hypomanic episodes.

Most bipolar disorder patients first present with a depressive episode and most of the time they experience a manic episode, so even psychiatrists sometimes have difficulty distinguishing between bipolar disorder and depression. Up to 70% of bipolar disorder cases are initially misdiagnosed as unipolar depression, and antidepressant drugs can induce manic episodes.

The depressive episodes of bipolar disorder are slightly different from major depression: depression in patients with bipolar disorder often starts acutely or resolves rapidly, with frequent episodes, accompanied by mood instability, hallucinations or delusions, and atypical symptoms (excessive sleeping and excessive eating).

Is bipolar disorder worse than depression?

First, bipolar disorder develops at an earlier age, usually before the age of 20, while the average age of onset of depression is 32.

Second, compared with depression, bipolar disorder is more likely to lead to more destructive behaviors, such as self-harm and harming others.

Third, the suicide risk of bipolar disorder patients is 10 times that of ordinary people. Patients with bipolar disorder are at higher risk of co-occurring other physical and mental illnesses.

Fourth, bipolar disorder is easily missed and misdiagnosed.

The average delay from onset to diagnosis of bipolar disorder is 5-10 years. Hypomanic patients generally do not take the initiative to seek medical treatment. Most patients seek medical treatment for depression, and if the doctor does not pay attention to asking for medical history, it is easy to miss the diagnosis. Low mood is easily misdiagnosed as depression, emotional instability is easily misdiagnosed as borderline personality, and excessive activity is easily misdiagnosed as attention deficit hyperactivity disorder or conduct disorder.

Fifth, compared with other mental illnesses, the recurrence rate of bipolar disorder is extremely high.

Do people with bipolar disorder have higher IQs?

Many people believe that people with bipolar disorder have higher IQs than the average person.

Great geniuses all have a crazy side. For example, famous writers Hemingway and Balzac, painter Van Gogh, poet Whitman, presidents Lincoln and Roosevelt, British Prime Minister Churchill, Russian composer Tchaikovsky, Hollywood star Catherine Zeta-Jones and others are all patients with bipolar disorder.

This makes sense. When people with bipolar disorder enter a manic phase, their energy levels rise, more ideas come to mind, and their creativity increases.

Studies have found that there is extensive genetic overlap between bipolar disorder and intelligence. People who carry these genes have stronger information processing and thinking abilities, but are also at high risk of developing bipolar disorder.

Psychologists have found that higher IQs are associated with bipolar disorder traits, leading some to call it the "genius disorder."

How to prevent it?

Bipolar disorder is the result of the combined effects of genetics, social and psychological factors. There is no effective prevention method, but the following points should be noted:

Parents and society should create a healthy and safe growth environment for young people;

Maintain a healthy lifestyle and good sleeping habits, do appropriate physical exercise, do not drink alcohol, do not stay up late, and do not consume excessive caffeine;

Learn to manage stress and emotions, face life's setbacks correctly, be the master of your emotions, and don't let them control you.

More attention should be paid to young patients with mood swings, anxiety and depression, especially those whose parents have a history of bipolar disorder;

Antidepressants increase the risk of manic episodes. Antidepressants should not be taken without a doctor's evaluation. Patients who are taking antidepressants should seek medical attention if they experience symptoms such as high spirits and high energy.

Bipolar disorder is a chronic disease that, like hypertension and diabetes, requires long-term management. Patients with bipolar disorder should take medication regularly and should not stop taking medication without authorization.

If there is someone around

Suffering from bipolar disorder

Please don't discriminate against them.

Create a

Relaxed working or living environment

Lead them to accept

Formal psychological and drug treatment

Avoid irritating the patient

Try to be caring and listen

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