The mood changes suddenly. How to live with bipolar?

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Bipolar disorder is increasingly seen in films, books and in culture at large. For example, the TV series “Shameless” gave us the word “Bipolar.” If you've noticed mood swings and are starting to worry whether it's bipolar, try taking these questionnaires, they will help you better determine whether there is a reason to see a doctor. Remember that the diagnosis is still made by a psychiatrist. Bipolar affective disorder is a complex disease, and even an experienced doctor will rarely make a diagnosis right away.

We've put together a series of tests to help you determine whether you have symptoms of bipolar disorder or not.

Test for bipolar affective disorder and hypomania

Bipolar disorder differs from depression and other disorders in that with bipolar disorder there are periods of elevated mood, so determining whether you have had such episodes is very important for diagnosis. Hypomania test HCL-32 is a validated Russian version for identifying the possible presence of bipolar disorder.
Used to identify type 2 bipolar disorder among patients with recurrent depressive disorder. The test describes the symptoms of hypomania. Take the online test

Clinical picture

Manic-depressive syndrome is manifested by significant mood swings - from unusually “good” to irritation, sadness and even hopelessness. Such fluctuations can be repeated cyclically. An episode of “elevated” mood is called mania, while an episode of sad mood is characterized by depression.

Symptoms of manic syndrome:

• unusually good, high spirits;
• increased energy, activity, restlessness;
• significant irritation;
• very fast thinking and speech, “jumping” from one thought to another;
• impaired concentration;
• low need for sleep;
• unrealistic ideas about your abilities;
• excessive material costs;
• increased sexual need;
• use of drugs, alcohol;
• provocative and aggressive behavior;
• denial, not accepting any refusal.

Manic tendencies exist if an excessively good mood in combination with at least 3 other symptoms persists for a week (at least).

Cyclothymia test

Cyclothymia is a relatively “mild” form of bipolar disorder.
The symptoms of this disease are very similar to manic-depressive psychosis, but are much less pronounced, so they first attract attention. Go to test

Read about what bipolar disorder is and the severity of depression.

Causes and etiology of the disease

To date, the exact cause of manic syndrome has not been determined.
Most often, a complex of factors is involved in the development of mania, which together form a picture of the disease. Most often, manic syndrome manifests itself as part of bipolar disorder (the so-called manic-depressive syndrome or psychosis), which is characterized by recurrence in the family history, so there is most likely a genetic predisposition to this disease.

In this regard, suggestions have been made regarding the existence of genes for bipolar disorder. However, if manic disorder were caused solely by genetic factors, then among identical twins, one of whom suffers from the disorder, the other twin would inevitably also be affected. But this fact has not been confirmed by medical research.

On the other hand, the likelihood of disease in such cases increases significantly.

Research shows that, as with other mental disorders, mania (and bipolar disorder) is the result of damage not to one gene, but to a combination of genes that, together with environmental factors (drugs and medications, surgery, physical illness, etc.) .) and cause the development of mania.

Risk factors

In addition to genetic predisposition, there are other factors that can cause a manic state. These include:

• strong emotions (shock, sadness, mental anguish, fear, etc.);
• physical and mental exhaustion;
• season;
• taking certain medications (antidepressants, corticosteroids, etc.);
• drug use (cocaine, hallucinogenic substances, opiates).

Beck Depression Inventory

The Beck Depression Inventory was developed by him in 1961 and is still one of the most relevant scales for determining depression.

The questions are based on the most common symptoms and complaints among patients.

Take the test

Only a psychiatrist or psychotherapist can make a diagnosis and prescribe treatment, and of course, no questionnaires can replace it. The psychiatrist looks at you, how you speak, how you behave, nothing can replace a face-to-face meeting. But tests can strengthen your desire to go to the doctor, because deciding to go to one can be difficult.

There are mental illnesses that have some (or many) symptoms similar to bipolar affective disorder. Psychiatrists sometimes make mistakes in diagnosis, failing to distinguish one from the other. Below we provide tests for diseases that are most often confused with bipolar disorder. Please note that there are times when one person has both bipolar disorder and another mental disorder, such as borderline personality disorder.

Borderline Personality Disorder Test

Bipolar disorder can be confused with borderline personality disorder. The two disorders have similar symptoms. Borderline personality disorder is also characterized by mood swings, an unstable connection with reality, high anxiety and a strong level of desocialization.

Take the test

The mood changes suddenly. How to live with bipolar?

Kim Kardashian's husband, rapper Kanye West, spoke well about this disease. On the cover of his album he wrote: "I hate being bipolar, it's amazing." You can't say it more precisely. Our expert is a psychiatrist of the highest category, corresponding member of the Russian Academy of Sciences, professor, head of the department of psychiatry and narcology, director of the Institute of Electronic Medical Education of the First Moscow State Medical University named after I.M. Sechenov, Doctor of Medical Sciences Marina Kinkulkina.

The essence of mental illness, abbreviated as bipolar affective disorder (BD), is the radically sudden and causeless mood swings that occur throughout a person’s life. Previously, this disease was called manic-depressive psychosis.

Life at different poles

We are talking not just about alternating sadness or joy, as is often the case with emotional people, but about extreme degrees of either despair or euphoria. A change in these moods can occur either gradually or suddenly, and for no apparent reason.

Many celebrities in the past are believed to have suffered from bipolar disorder. This illness, however, like other mental disorders, is attributed to Byron and Hemingway, Virginia Woolf and Edgar Allan Poe, Van Gogh, Schumann, Vivien Leigh and many others. There is an assumption that even “our everything” suffered from a mild degree of bipolar disorder - in any case, contemporaries often mentioned Alexander Sergeevich’s mood swings.

Many modern stars openly admit to having this mental disorder. In particular, Britney Spears, Miley Cyrus, Selena Gomez, Mariah Carey, Mel Gibson and others admitted this.

Genetics or lifestyle?

Men also suffer from bipolar disorder, but the weaker sex is more likely to suffer from it. This disorder can appear at any age: in both a teenager and an elderly person.

The main risk factor is genetics. However, a specific gene that would be responsible for the development of bipolar disorder has not been identified. This is a polygenic disorder, so taking tests to find out how great the risk of getting sick does not make sense yet. Moreover, genetic predisposition is not a death sentence. This was proven by studies on identical twins, one of whom developed bipolar disorder over the years, and the other did not. Probably, some predisposing factors have an influence. Some of them are known. It is believed that living at the limit of one's capabilities, with constant deadlines, stress and chronic lack of sleep, as well as night shift work, frequent flights with significant changes in hour-long flights and, of course, the use of psychoactive substances contribute to the development of the disease. Therefore, you should try to avoid all this. But scientists have yet to find out how the lockdown and pandemic, as well as other stresses of the ill-fated 2021, affect the psyche. Although probably not in the best way.

You won't get bored

According to various estimates, bipolar disorder affects from a fraction of a percent to several percent of the population. Recently, the proportion of affective disorders has increased significantly, which may be explained by improved diagnosis (as well as an increase in the number of stresses).

At first glance, BAR does not look like something scary or dangerous. To many, this disorder even seems attractive - sometimes it’s sad, sometimes it’s fun, in general, you won’t get bored. Besides, being different from everyone else is fashionable these days. And then, it is believed that people with bipolar disorder have higher intelligence and creative abilities than the “gray masses”. But even if this is so, then none of those who suffer from it will definitely call bipolar disorder a pleasant thing. It is especially difficult for those patients who do not seek medical help on time. Without treatment, both phases of bipolar disorder can last for months (although sometimes the disorder occurs with frequently changing phases). Moreover, it is impossible to say which period of the disease is more severe - manic or depressive.

It's hard when you feel bad

Those who have experienced depression say that it is the worst thing that can happen. The whole world appears in black, not only mood, but also self-esteem is greatly reduced, the meaning of existence itself is lost. Life is perceived as a chain of tragic mistakes, the patient constantly blames himself for all troubles and sins, even those that are not even traced. In addition to mental suffering, physical suffering often occurs: a person moves as if in a dream, with difficulty, as if there were weights on the legs and arms, or as if he were swimming against the current. In addition, pain and tension are felt throughout the body. With moderate depression, the stomach often hurts. People go to doctors about this, but a diagnosis cannot be made. And the daily pain continues. Psychiatrists call this somatoform symptoms. With severe depression, many people experience so-called “pre-cardiac melancholy”: pain and heaviness in the chest, “a stone on the heart.” But even an in-depth examination does not reveal cardiac problems.

Often, with depression, patients (especially older ones) complain of difficulty thinking and memory impairment. Doctors suspect they have dementia, but in fact, mood disorders do not affect the intellect, and with treatment, when the mood stabilizes, thinking abilities are restored.

But the worst consequence of depression is suicide. Most suicide attempts are made in this state. Sometimes people in very severe depression, believing that they have done something irreparable, and believing that the consequences of their actions can harm loved ones, decide on extended suicides, in which they settle scores not only with their own lives, but also take their loved ones with them ( more often children).

It's bad when it's too good

The manic stage of bipolar disorder is subjectively more pleasant. Patients are in a great mood: they love the whole world and themselves in it. The reflection in the mirror pleases, there is not the slightest doubt in one’s own talents and intelligence, there is more than enough strength and energy, the bonus is accelerated mental activity. Many patients in this stage sleep for an hour a day, but do not experience fatigue. Sometimes they are on their feet for days and at least they are as energetic as an Energizer. It seems great. But no. During the manic phase, desires and ideas arise too quickly, so a person grabs onto every new task, but, as a rule, does not complete anything. So productivity at this stage is low. But it would be okay if that was only the case/

The main danger of mania is that a person has no criticism at this moment and he can commit actions that he will later greatly regret. For example, he can give away all his property to others (sometimes unfamiliar people or scammers). Or, say, he will take out loans to go on a trip to the other side of the world. Maybe even steal something - for example, to give an expensive gift. Many patients at these moments enter into hasty intimate relationships, mistaking a chance meeting for the love of their life (while completely “forgetting” that a wife and four children are waiting at home). Finally, often with mania, people, experiencing euphoria, ignore their severe somatic symptoms, as a result, do not consult a doctor for a long time and thus trigger a serious illness (pneumonia, for example, or COVID-19).

In addition, not all patients in the manic stage are “darlings”. They often show unreasonable aggression if, for example, others do not agree with their “brilliant” ideas. As a result of “angry mania,” conflicts and even situations arise that require the intervention of law enforcement agencies and involuntary hospitalization of the patient.

With good intentions

The worst thing that relatives and friends of a person with bipolar disorder can do is ignore the problem, devalue the suffering, while blaming the patient himself and appealing to his conscience. For example, they urge a depressed person to “pull himself together, don’t lose heart,” they say that he is “out of his mind,” and so on. A patient at the stage of mania is most often accused of immorality, frivolity, irresponsibility, promiscuity, etc. However, doing this is the same as blaming a person with diabetes for not being able to eat sweet cake, or blaming a patient with heart failure for not running a marathon.

BAR is a disease like many others. And she needs to be treated. The sooner proper therapy is started, the faster the patient’s condition can be stabilized and the better the future prognosis.

How to treat"?

On the Internet you can not only test yourself for any mental disorder, but also find out how to “cure”. Doctors strongly advise against doing this. The least harm of self-medication is that it will not help, but it can also worsen the condition. For example, inadequate use of antidepressants for bipolar disorder can plunge a person from a depressive phase into a severe manic state, from which it will then be difficult to get out.

Only a psychiatrist (and not a psychologist, neurologist or doctor of any other profile) can identify bipolar disorder and choose the right treatment. Treatment must be strictly individual; it is selected based on the characteristics of a particular patient and taking into account the moment in the course of the disease. The goal of therapy is not only to equalize the patient’s mood, but also to prevent repeated episodes.

In the treatment of bipolar disorder, the main role is played by drugs to stabilize mood - mood stabilizers (lithium salts, some anticonvulsants (anticonvulsants) and new generations of antipsychotics). Modern medications are much better tolerated than their predecessors and have fewer side effects, as they are designed for long-term use over many years. While taking them, women can even become pregnant. For depression within this disorder, antidepressants are prescribed only in exceptional cases, given the danger of changing one phase to another

Bipolar disorder cannot be cured once and for all, so you often have to take medications for years (with periodic visits to the doctor). But often, when the patient begins to feel well thanks to medications (this state - intermission - is completely indistinguishable from full health), he can stop taking the drugs. This is a big mistake that does not allow achieving a stable treatment result. After all, it is long-term use of maintenance therapy recommended by a doctor that allows you to achieve a stable state and feel the joy of life for many years.

Link to publication: Arguments and facts

How dangerous is a maniac for himself and for people?

In about half of the cases, there is an increase in the consumption of alcohol or drugs by the manic person.

Manic syndrome also carries various social risks. A person can cause inconvenience to himself, for example, with inappropriate jokes or arrogant behavior. The public, as a rule, is not sufficiently informed about a person’s mental state, and associates such behavior with the characteristics of his character. This significantly complicates the personal and social life of a manic person.

The significant financial losses that accompany reckless behavior in the manic phase often lead to subsequent social problems, logically related to the partner or marital relationship, which may also be negatively affected by this mental disorder.

Mania is a mental disorder that, unfortunately, cannot be prevented because... such disorders are mainly associated with hereditary transmission.

A healthy lifestyle, sufficient physical activity, avoidance of stressful and emotionally difficult situations and factors, regular and high-quality sleep, avoidance of alcohol and other psychoactive substances (marijuana, LSD, cocaine, methamphetamine, etc.) can bring certain benefits.

Spectrum of disorders

Symptoms of mania can vary in intensity:

• hypomania – mild form; the disorder does not cause significant harm to a person's psychosocial functioning and is characterized by moderately elevated mood that persists for at least 4 consecutive days, increased energy, activity, and a feeling of increased productivity;
• classic mania – elevated mood and agitation lasting more than a week, increased self-esteem, loss of social inhibitions, risky behavior;
• manic disorder with psychotic symptoms often requires hospitalization, the disease is characterized by the presence of delusions and hallucinations; this form affects about 1/3 of patients (manias, usually expansive, religious, erotic, etc.).

Manic syndrome is divided into 3 types:

• euphoric syndrome - a feeling of bliss, contentment without significant hyperactivity;
• stuporous mania – complete absence of psychomotor symptoms;
• resonant mania - irritability, anxiety, sometimes aggression.

Therapy methods

In the treatment of manic syndrome, 2 main groups of medications are used: mood stabilizers and antipsychotics.

The patient may also be prescribed medications that have auxiliary effects, for example, for insomnia, anxiety and restlessness, etc.

The main drugs used in therapy:

1. Mood stabilizers : a group of drugs intended for preventive treatment. Their long-term use reduces the risk of relapse of depression or mania. Drugs in this group are also used in acute cases of mania or depression.
2. Antipsychotics (antipsychotics) : drugs used to treat mania or depression. Some of the newer antipsychotic drugs have also demonstrated effectiveness in long-term, prophylactic use, thus resembling the effects of mood stabilizers.

Additional (auxiliary) drugs:

1. Antidepressants are used to treat depression. It is not recommended to use drugs in this group without a mood stabilizer - this can lead to a worsening of the disease.
2. Sleeping pills and tranquilizers are intended only for short-term use in the treatment of insomnia, anxiety, in cases of tension or excitement.

Diagnostic criteria

The diagnosis is made based on the medical history and interview with the patient. The exact type of mania is determined and appropriate treatment is decided. If necessary, tests are carried out to determine what type of mania the patient has developed.

Rorschach test

The Rorschach test (inkblot test) is one of the psychological methods used to analyze personality. This is a projective test that uses the projection of thinking processes and personal qualities onto undefined objects.

Altman scale

The Altman Scale is a self-report diagnostic scale that can be used to assess the presence and severity of manic and hypomanic symptoms, most commonly in patients suspected of having bipolar disorder.

This scale can assess differences in “normal” or baseline levels from mania in 5 subjective and behavioral areas:

• positive mood;
• self confidence;
• need for sleep;
• speech;
• activity.