Bipolar disorder: beyond the changing

It is common to hear phrases such as “hey, you’re bipolar”, “I’m bipolar today”, “my boss is so bipolar”, among others. But do we know what it means? Bipolar affective disorder is a mental illness that causes extreme changes in mood.
These extreme mood swings can include increased vitality, energy, euphoria, which is called mania; or a decrease in activity and vitality, called depression. It can affect health, productivity and personal relationships, and affect cognition, energy and sleep.
In some cases there is a mixture between the symptoms of manic and depressive pole, which are known as mixed episodes. Some people with more severe conditions may have psychotic symptoms, such as loss of judgment and hallucinations.
Most people with bipolar disorder have no symptoms between episodes and can virtually live a normal life with proper treatment. This treatment includes medications that stabilize mood to effectively tackle acute phases and prevent recurrences, in addition to receiving psychosocial and psychoeducational support as central elements.
Factors that may increase the risk of bipolar disorder or may act as triggers for the first episode include:
-Having a blood relative (such as parent or sibling) with bipolar disorder. In people with bipolar disorder the risk of having a child with the disease is about 10%.
-Exposure to physical, psychological or sexual abuse during childhood or adolescence.
Periods of high stress, such as the death of a loved one or other traumatic experiences.
-Grow up in environments lacking support networks.
Among other factors is the consumption of substances such as alcohol, cocaine and cannabis. In these cases, and for people diagnosed with Bipolar Affective Disorder (BAD), it has been seen that the prevalence of suicide risk is higher. In addition, they are more likely to suffer mixed episodes and more likely to require hospitalizations throughout the course of the disease. Comorbidity with substance abuse is one of the main variables that has been linked to increased severity of manic episodes. It has been observed that there is a worse global functioning and a lower occupational status, in addition to worse adherence to treatment.
At first, bipolar symptoms are commonly confused with attention deficit, depression, anxiety, borderline personality disorder and, in its most severe manifestations, schizophrenia. This is because the early symptoms of this disorder are unusually varied. Only with time does the pattern of alternation between high and low moods become clear. That is why it is important to seek specialized help, not to see any therapist or psychiatrist, and to consider that without treatment bipolar episodes usually last from several weeks to several months. Periods between episodes, without symptoms of mania or depression, can last for weeks, months, or years. So not consulting can generate greater suffering than daring to try an intervention with a diagnosis closer to what happens to the person.
In this line, one of the most significant therapeutic interventions in the last 10 years is dialectical-behavioral therapy, in which it has been observed that manic and depressive episodes decrease; It recognizes the state of negative emotions and helps reduce the symptoms of anxiety. Cognitive behavioral therapy has also been shown to have effects in decreasing the number and duration of depressive episodes, residual or interepisodic symptoms, and possible hospitalizations. In the same way, it has an effective impact on psychosocial performance. Finally, in these diagnoses, it is suggested that all therapy involve the family, with the aim that everyone at home is involved and the level of stress at home is reduced.
In short, bipolar disorder is not the same as a “changeable” person. The person suffering from bipolar disorder oscillates between two affective extremes (euphoria and depression). In Chile there is a prevalence of approximately 2.2% within the population: the picture can begin both in childhood and in adult life, but the peak incidence occurs between 15 and 25 years, with an average diagnostic age of 21 years.

Finally, it is a disease that has Guarantees Explicit in Health, which are a set of benefits guaranteed by law for people affiliated to Fonasa and Isapres. The guarantees required are:
-Access: Right by law of health provision.
-Opportunity: Maximum waiting times for the granting of benefits.
-Financial protection: The beneficiary pays only a percentage.
-Quality: Granting of services by an accredited or certified provider.
Who can access? All people over 15 years of age with diagnostic confirmation of mood alteration, going through periods of exaltation and low mood quickly, through diagnostic confirmation performed by a specialist. The latter is not easy, since the high stigma that mental health has in Chile prevents people from consulting on time, lengthening periods without help or treatment.

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The content expressed in this opinion column is the sole responsibility of its author, and does not necessarily reflect the editorial line or position of El Mostrador.

Original source in Spanish

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