Generally it is considered that bipolar affective disorder is a condition in which there is ongoing mood swings. On the contrary, bipolar affective disorder, has an episodic course of illness in which there may be an episodes of mania/hypomania and/ or episodes of depression.
Patient with bipolar affective disorder generally experience one to two episodes of either mania or depression in one year, each lasting for a minimal period of 1-2 weeks or it may persist for even longer period like 6 months. In few individual patient may experience 4 episode per year in which it is called as Rapid Cycler.
During Manic episode there is a change in a person thinking pattern and behaviour which is noticed by people around him or by patient himself. Patient may experience following changes in behaviour in episode of hypo/ mania.
- Decreased sleep but still alert and active.
- Excessive talk with loud volume
- Increased planning and risky behaviour
- Disinhibited & authoritative behaviour increased sexual desire.
- Increased socialization,
- Increased spending & charity
- Change in religiosity
- Increased confidence and Grandiosity
- Changes of increased smoking or use of street drugs
Above symptoms must last for atleast 1 week to confirm diagnosis of Manic Episode.
In depressive episode patient will experience totally opposite of above as mentioned already in depressive disorder.
Whenever a patient present with a specific episode, either mania or depression, first step is to manage that particular episode. Once that episode is over; depending on his previous episodes, medicines are adjusted in a manner that chances of further episodes are reduced.