Bipolar Disorder, formerly known as "manic depression", is aExtreme mood swingsA psychological disorder characterized by mania (or hypomania) and depression. Patients experience mood swings between extremes of euphoria and self-confidence to extreme depression and helplessness. These intense and recurring mood swings not only impact patients' psychological experiences but also often severely interfere with their daily lives, interpersonal relationships, and academic and work performance.

1. Two core states of bipolar disorder

1. Manic Episode
   • It manifests as high spirits, overflowing self-confidence, high energy, racing thoughts, and accelerated speech, accompanied by exaggerated self-evaluation, irritability, decreased need for sleep, and reckless and impulsive behavior (such as spending money recklessly, sexual impulses, quitting jobs, taking risks, etc.).
   • Patients may feel that they are "capable of doing anything", but in reality their judgment is impaired and they have difficulty assessing consequences, which may lead to serious financial, legal, and emotional problems.
2. Depressive Episode
   • Symptoms include depression, loss of interest, slow thinking, self-denial, lack of energy, appetite and sleep disorders, and in severe cases, thoughts of self-harm and suicide.
   • The depressive phase often lasts for weeks to months, and many patients are first seen by a doctor during this phase.

Classification of bipolar disorder

Bipolar disorder is divided into several main types, depending on the severity and type of symptoms:

1. Bipolar I Disorder
   • At least one clear-cut manic episode has occurred, with or without a depressive episode.
   • Mania can be severe and often requires hospitalization.
2. Bipolar II Disorder
   • At least one depressive episode and one hypomanic episode have occurred, but the patient has not developed into a full-blown manic episode.
   • The symptoms of hypomania are milder, shorter-lasting, and do not necessarily seriously interfere with function. They are often mistaken for "improved mood" or "being in a good state."
3. Cyclothymic Disorder
   • Mood swings are mild but do not meet the diagnostic criteria for full-blown mania or depression.
   • It usually lasts at least two years and is considered a subtype of bipolar disorder.

The difference between bipolar disorder and ordinary mood swings

Everyone experiences mood swings in life; this is a normal human psychological response. However, the mood swings seen in bipolar disorder have the following distinct characteristics:

• Extremes: Emotional fluctuations far exceed what most people understand as "happy or sad."
• Periodicity: Emotional states occur periodically on a daily, weekly, or monthly basis, with a certain regularity.
• Impaired function: Fluctuations can significantly affect work, school, and interpersonal relationships, and may even lead to uncontrolled behavior.
• Not directly triggered by external events: Sometimes mood swings have no obvious triggers, and even if there are, they are far beyond common sense reactions.

Pathogenesis and Predisposing Factors

The occurrence of bipolar disorder is generally considered to be the comprehensive result of the "biopsychosocial model":

• Biological factors: including dysfunction of neurotransmitters (such as dopamine and serotonin), genetic susceptibility (the incidence rate is higher in those with a family history), and abnormal function of the brain's emotion regulation areas (such as the prefrontal lobe, limbic system, etc.).
• Psychological factors: early emotional trauma, personality fragility, extreme self-evaluation, etc.
• Social factors: Sudden changes in life (such as unemployment, heartbreak, death of a loved one), accumulated stress, interpersonal conflicts, sleep deprivation, etc. may all trigger an attack.

5. Treatment and Adjustment Methods

1. Drug treatment:
   • Commonly used mood stabilizers (such as lithium salts), anti-epileptic mood stabilizers (such as sodium valproate), antidepressants, antipsychotics, etc.
   • Medications must be prescribed and adjusted by a professional psychiatrist. Do not stop or change medications on your own.
2. Psychotherapy:
   • Cognitive behavioral therapy (CBT): helps patients identify cognitive biases and emotional triggers and trains coping strategies.
   • Family therapy: Relieve family conflicts and improve family members’ understanding and support of the disease.
   • Social rhythm therapy: Reduce the probability of seizures through regular work and rest schedules and stable social rhythms.
3. Daily self-management:
   • Maintain a stable sleep and diet
   • Record mood changes and track fluctuation cycles
   • Reduce stimuli and stressful situations
   • Say no to drug abuse and excessive drinking
   • Build a support system (family, friends, counseling)

6. Misunderstandings and Social Prejudice

Because bipolar disorder is often associated with extreme behavior and emotional instability, patients are often misunderstood as having personality problems, being emotional, or being unreasonable, even with derogatory labels. This misconception only exacerbates self-stigma and feelings of isolation. In reality, many individuals with bipolar disorder possess exceptional sensitivity, creativity, and insight, but simply have imbalances in their emotional regulation systems. With appropriate treatment and support, they can achieve stable lives and continued growth.

VII. Conclusion

Bipolar disorder is a complex but treatable mental disorder. It's not simply a case of mood swings, but rather a deeper imbalance in the emotional regulation system. Early identification, proactive treatment, and social understanding are key to helping patients navigate the emotional turmoil and regain vitality. For anyone facing this emotional storm, accepting oneself and seeking help is a courageous act worthy of respect and the first step toward recovery.