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Module 1: Overview of Bipolar Disorder
Overview of Bipolar Disorder
The Diagnosis of Bipolar Disorder
Correctly identifying an illness can help you begin to explore the various treatment options available to you
so that you can better manage your illness. As such, having an accurate diagnosis is the beginning of
becoming well. Remember that a proper diagnosis should only be made by your general practitioner or
psychiatrist, or a trained mental health practitioner. The information provided below is not enough for an
accurate diagnosis to be made by anyone who is not a trained mental health professional or physician.
The following diagnoses are based on the definitions and criteria used in the Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV) by the American Psychiatric Association, 1994.
Bipolar I Disorder is the most common and prevalent of the different bipolar mood disorders. It is
characterised by the experience of full-blown manic episodes and severe depressive episodes. The patterns
of abnormal mood states are very varied and different individuals may experience a different course of the
illness. Many physicians refer to bipolar I disorder as a relapsing and remitting illness, where symptoms
come and go. It is therefore, important to ensure that treatment is continued even if the symptoms are no
longer present, to prevent an episode relapse.
Bipolar II Disorder is characterised by the experience of full-blown episodes of depression and episodes
of hypomania (i.e., with mild manic symptoms) that almost never developed into full-fledged mania.
Cyclothymic Disorder is characterised by frequent short periods of mild depressive symptoms and
hypomania, mixed in with short periods of normal mood. Though a patient with cyclothymic disorder does
not experience major depression or mania, they may go on to develop bipolar I or II disorder.
Patients with bipolar I or bipolar II may experience frequent mood cycling. Patients who experience more
than four episodes of hypomania, mania, and/or depression in a year are said to experience Rapid Cycling.
These patients tend to alternate between extreme mood states separated by short periods of being well, if
What Causes Bipolar Disorder?
No one factor has been identified to cause bipolar disorder, that is, it is not caused by a person, event, or
experience. There are a number of factors that interact with each other that may contribute to the
development of this disorder in some people. In this section, we present to you a way of understanding
how all these factors come together to trigger the onset of this illness – called a stress vulnerability model.
First, we begin by looking at three key factors in this model, namely: genetic vulnerability, biological
vulnerability and socioenvironmental stress (or life stress).
Bipolar disorder tends to run in families. First degree relatives of people with bipolar disorder have an
increased risk of developing bipolar disorder. Children of bipolar patients face an 8% risk of getting the
illness versus 1% in the population. Children of bipolar patients also face an increased risk (12%) of getting
unipolar depression (i.e., depression only, without mania). Identical twins are also more likely to both
develop this disorder than fraternal twins. While these results indicate to some extent that this disorder is
genetically inherited, they also suggest that there are other factors that may contribute to its development.
This refers to possible biochemical imbalances in the brain that makes a person vulnerable to experiencing
mood episodes. An imbalance of brain chemicals or an inability for them to function properly may lead to
episodes of “high” or “low” moods.