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Bipolar disorder, a leading cause of global disability, disrupts relationships, careers and daily life while shortening lifespans by over a decade. Dr. Sneha Sharma, a consultant psychiatrist and drug de-addiction specialist at Aakash Healthcare, unpacks the complexities of this condition—from recognising manic and depressive episodes to addressing stigma and the critical role of early intervention.
Excerpts:
The daily toll of bipolar disorder
Dr. Sharma: Bipolar disorder is one of the biggest causes of disability globally. It strains relationships, creates challenges in education or work, and complicates daily activities. The condition also raises suicide risks and increases vulnerability to anxiety, substance abuse, and physical health issues like cardiovascular disease. Tragically, people with bipolar disorder die 10 years earlier on average due to barriers to healthcare access and comorbid conditions.
Spotting the signs: Mania, depression and beyond
Dr. Sharma: Bipolar disorder is a mental health condition marked by significant mood fluctuations. During a manic episode, a person is in a very high mood and full of energy. They may experience euphoria, mood swings, or outbursts of emotion.
In manic episodes, the changes in mood and activities are accompanied by other characteristic symptoms like a highly inflated sense of self-worth or self-esteem, decreased need for sleep, and reckless or risk-taking behavior, such as overspending, risky sexual activity, drinking, or harming oneself or others
During a depressive episode, however, a person has a depressed mood (feeling sad, angry, and empty). They may lose interest or pleasure in activities they once enjoyed. Other symptoms may include impaired focus, feelings of overwhelming guilt or low self-worth, changes in eating or weight, feeling extremely exhausted or depleted of energy, etc.
A depressive episode differs from the mood changes that most people experience in that the symptoms continue for the majority of the day, almost every day, for at least two weeks. Manic and depressed episodes can cause considerable problems in all areas of life, including at home, work, and school. They may require specific care to keep them from causing harm to themselves or others.
Can bipolar disorder be managed effectively?
Dr. Sharma: Absolutely. With a combination of medications, psychiatric therapy, and psychosocial support, individuals can lead meaningful lives. Medication alone isn’t enough—patients must be actively involved in their care decisions, balancing treatment efficacy, side effects, and personal preferences.
Bipolar I vs. II: A critical distinction
Dr. Sharma: The primary distinction between bipolar 1 and bipolar 2 is in the mania stage of bipolar illness, a mental health condition characterised by mood and energy changes. Bipolar 1 patients experience manic episodes, which are characterised by profound changes in mood and activity.
The bipolar 2 state is usually linked with milder hypomanic symptoms. Remember that every person diagnosed with bipolar disorder is affected differently. The kind of bipolar diagnosis is determined by the duration and intensity of manic, hypomanic or depressed episodes.
Triggers and treatment: Pathways to stability
Dr. Sharma: Although bipolar disorder can be unpredictable, mood swings can be made more likely by specific triggers. Some of the typical triggers include:
Stress – Significant life transitions, professional demands, or interpersonal disputes may set off episodes.
Lack of Sleep – Mood instability can result from sleep disturbances.
Substance Use – Drugs or alcohol can exacerbate symptoms.
Medication Changes – Skipping or adjusting medication without medical advice can be risky.
Seasonal Changes – Weather and daylight variations can affect mood.
Stability can be preserved by managing these triggers with **self-care and medical support.
Stigma and systemic gaps
Dr. Sharma: People suffering from bipolar disorder have limited access to treatment worldwide. Both men and women are frequently misdiagnosed. Many people lack access to services and suggested interventions, particularly in low- and middle-income countries (LMICs).
People with bipolar disorder face stigma and discrimination in both their communities and in health-care settings. This can jeopardize access to healthcare. It also contributes to social marginalization and can reduce possibilities for education, work, and housing.
Helping your child manage bipolar disorder
Dr. Sharma: Children and teenagers with bipolar disorder may experience manic, depressed, or “mixed” episodes. A mixed episode combines manic and depressed symptoms. These mood swings generate symptoms that might endure for days or weeks. During an episode, symptoms arise daily and continue for most of the day. These mood and activity changes differ significantly from the child’s typical behaviour and that of healthy children and adolescents.
To assist your child with bipolar disorder, here are some basic things you can do:
* Be patient.
* Encourage and listen to your child when they speak.
*Monitor your child’s mood and be vigilant for any significant changes.
* Develop techniques to manage high emotions and impatience.
* Ensure your child has fun.
* Stick to the treatment plan to help your child improve and maintain their health over time.
Importance of early intervention & family support
Dr. Sharma: People with risk factors for bipolar disorders (BD) or modest prodromal symptoms may benefit from early detection and intervention, improving the illness course and preventing negative long-term repercussions.
Following early and adequate discovery, the prevention of sickness development becomes critical. As a result, significant research efforts are being directed toward the development and evaluation of early selective and recommended therapies. Choosing the right remedy necessitates a careful balance of risks and rewards in a collaborative decision-making process.
Family-centered psychotherapy targeted to the needs of young at-risk individuals was related to a reduction in depressive symptoms, an increase in psychosocial functioning, and a longer period in remission.
What role does therapy play in treatment?
Dr. Sharma: Psychotherapy helps patients reframe harmful thoughts, rebuild relationships, and manage emotions. It provides families with education and coping strategies, complementing medication to ensure holistic care.