Bipolar Disorder

What is Bipolar Disorder?

Bipolar disease is caused by a biochemical alteration, in many cases of hereditary origin, which influences mood and causes periods of depression and others of mania. Although in phases of stability (euthymia) the patient can function normally, being the same more durable when the patient is under treatment

In short, bipolar disorder is a mood regulation disorder characterized by its recurrent course in the form of various combinations of manic, hypomanic, depressive, and mixed episodes. Early diagnosis of bipolar disorder is key to correct treatment and a good prognosis. Psychotic mania is frequently confused with schizophrenia, and hypomanic and mixed symptoms with behavioral disorders derived from personality disorders or the use of toxic substances.

A correct differential diagnosis and the detection of associated pathologies are critical for proper management of the disease.

Types of bipolar disorder

Bipolar Disorder Type I

A person with type I bipolar disorder may experience four different types of episodes throughout their illness: manic episodes, hypomanic episodes, depressive episodes, and mixed episodes. Although, with treatment, the longest period of time is stable (euthymia). It is quite common for those affected by type I to require hospitalization at some point due to the strong intensity with which the symptoms occur in the manic phases. This internment in the hospital involves medical supervision that allows establishing an adequate treatment for the person, which will mean the beginning of their recovery.

People with type I bipolar disorder typically experience manic relapses and depressions that vary in frequency and intensity from person to person. Sometimes after a manic phase a depressive phase can occur and this is usually of proportional intensity to that of the mania. In other words, "the higher we climb, the harder the fall will be". Hence the importance of detecting "high" phases in time in order to stop them; This way we don't let the symptoms of mania get worse and we also prevent the subsequent depressive period.

Type II Bipolar Disorder

A person affected by type II bipolar disorder can have two types of episodes throughout their illness: hypomanic episodes and depressive episodes. However, although the symptoms of hypomanic episodes are less severe than those of manic phases, the depressions of type II bipolar disorder can be just as severe as those of type I bipolar disorder.

The disorder Type II bipolar is usually more difficult to diagnose than type I, since people who suffer from it do not usually identify the phases of hypomania as something pathological and, therefore, do not usually report these periods in consultation. For this reason, recurrent depression is sometimes misdiagnosed in people who actually have bipolar II disorder.


A person diagnosed with cyclothymia may experience euphoric phases and mild depression throughout their lives. Let's call it the "milder" form of bipolar disorder. However, precisely because of the low intensity of the symptoms, people with cyclothymia do not usually seek professional help and attribute the instability to their own character, ignoring that it is a disease. Although cyclothymia is the least severe form of bipolar disorder, it can cause interference in the social, family and work life of people who suffer from it, so it is also important to consult a professional to seek appropriate treatment.

FAQs - Questions and answers

In our center, we combine psychiatric medical help and psychotherapy along with healthy lifestyle activities aimed at seeking emotional stability.

If you are interested in receiving information about our treatments and therapies for any type of disorder, contact us by completing the form and we will provide you with all the necessary information from one of our psychiatrists.

Basically it is a disease that alternates episodes of mania with others of depression. In manic episodes, the patient feels euphoric, is highly active, loses the need for sleep, becomes hypersociable, sometimes promiscuous, and spends excessively. His thinking becomes accelerated and he often jumps from one idea to another without finishing developing it (it is what we call ideofugitive thinking). Delusions of grandeur can sometimes appear and the patient sometimes faces projects that are totally out of step with his reality.</ P>

The manic phase of bipolar disorder is one of the few mental disorders in which the person does not suffer from their symptoms and cannot understand why others are trying to stop their condition, because the patient feels very good, full of energy. Critical capacity is almost nullified, no risks are foreseen and there is hardly any impulse control. Naturally, they are not usually aware of the disease and are patients who generally have to be admitted with judicial authorization.

In episodes of depression the opposite happens, since sadness, feelings of guilt, apathy, asthenia and anhedonia predominate. They often have anxiety, lose their appetite and have sleep disturbances. Suicidal thoughts are common. Self-esteem always very low. There are cognitive complaints. They lose their sexual appetite. Sometimes they may present delusions congruent with their state of mind.

In bipolar disorderses Genetic vulnerability factors are combined with environmental exposure factors, which lead to the onset of the disease, generally around adolescence, and a recurrent course in which the episodes become less and less dependent on environmental triggers. Current theories about the causes of bipolar disorder are grouped into a biopsychosocial vulnerability-stress model. Genetic factors are fundamental but they explain only part of the risk of developing the disease, being important environmental factors of a biological type (brain injuries, drugs, drugs, hormonal changes), psychological (stressful events, social support) and even meteorological (changes seasonal).

Genetic studies have shown that heredity plays a major role, not only in the etiology of the disorder, but also in its clinical expression and course. On the other hand, among the biological factors involved in the origin of bipolar disorder, there are various neurotransmitters, hormones, and alterations in the clinical pattern of sleep. In addition, the so-called “life events” (life events or circumstances in which a person is subjected to significant stress) appear to be involved in the appearance of the disease in genetically vulnerable subjects, and may influence the triggering of successive relapses. Finally, it should be added that up to 20% of bipolar patients present a seasonal pattern of relapses, which consists of a peak in admissions for depression in spring and autumn, while the manic phases seem to be mainly concentrated in summer, seeming likely, for so much so that luminosity is the most relevant variable in this sense. The identification of a seasonal pattern is clearly relevant at the level of prognosis and treatment, since in times of risk medical visits and doses of prophylactic treatment may increase.

Bipolar disorder needs to be treated long-term. The treatment of bipolar disorder lies in calming or stabilizing drugs in both phases (lithium carbonate salts and valproic acid, among others). In the depressive phase, antidepressant drugs are also managed, while in the manic phase, neuroleptic drugs.

In our clinic, we treat this disorder in an interdisciplinary way, adding to the pharmacological treatment personalized psychotherapeutic interventions, essential when it comes to preventing the so frequent relapses. The treatment is, therefore, psychosocial, with a marked psychoeducational orientation, both for patients and family members, with the aim of:

  • Improve medication compliance, removing obstacles that interfere with medication adherence.
  • Facilitate the early identification of relapse symptoms, teaching them methods to record the occurrence, severity and course of manic and depressive symptoms that allow early intervention if these worsen.
  • Cope with the psychosocial consequences of previous episodes and prevent future ones, teaching them adequate coping skills.
  • Provide patients with strategies to cope with stressful social and interpersonal situations that may be triggers or exacerbators of symptom manifestations.
  • Provide patients with non-pharmacological strategies to cope with behavioral and cognitive symptoms of mania and depression.

In short, we try to provide patients and relatives with skills in managing the disease, providing them with information about the disorder, its maintenance and the frequent difficulties associated with it.



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