Bipolarism is a psychiatric illness characterized by mood swings that can go from a euphoric to a depressive stage. Therefore, due to this ambivalence, the syndrome was also called “maniacodepressive psychopathy”.
In fact, the patient manifests frenetic moments in which he feels charged and with ideas of grandeur, but also agitated and irritable. But the “manic” phase is replaced by the “depressive” one in which the subject is sad and devoid of strength and interests. And the two conditions can alternate, in succession, or occur simultaneously, but in any case they upset the patient’s life.
There are many famous characters indicated as evidence of this tragic duality: in the past, the painter Vincent Van Gogh and the writer Ernest Hemingway; today the actors Simona Izzo and Mel Gibson.
Some psychiatrists believe that, in the manic phase, the person is more active, creative and productive. Instead, other specialists point out that many artists are not bipolar, while the disease has led many celebrities to suicide.
The first signs of this disorder manifest themselves with exasperated attitudes, fast and often incomprehensible way of speaking, altered or evasive thoughts, emotions expressed in a pushed way or, on the contrary, withheld. The most suitable therapy for bipolarity is above all pharmacological but completed by psychological treatment.
Bipolarity: what is it?
It is a psychiatric disease in which a person undergoes episodes of euphoria and then others of deep depression. During the condition, the patient in some periods may feel full of energy and creativity, pervaded by delusions of grandeur.
Instead, at other times the affected person may be despondent, unable to do simple activities and uninterested in all things.
Thus, Bipolar Disorder, or DB, comprises a series of signs and symptoms centered on pathological mood swings.
In most cases, the agitation or “mania” phase alternates with the depressive phase, although sometimes the condition is more nuanced. In fact, in the past, bipolar disorder was called “manic-depressive psychopathy,” because of this duality.
But sometimes mania and depression occur at the same time or in rapid succession. In borderline situations, the “ups” and “downs” of the symptoms can last for many weeks.
Test for bipolarity
There are several bipolar tests with different specifications, some can even be done online. However, in no case can a self-administered test replace the medical evaluation, it remains only a general indication.
Therefore, in addition to the clinical interview, structured interviews, personality and/or psychometric tests can be used. However, diagnostic tests to verify the presence of physiological causes related to possible pathologies in progress are not excluded.
The Young Mania Rating Scale (YMRS), for example, is one of the most widely used rating scales to analyze symptoms related to bipolar disorder. Then there is the Mood Disorder Questionnaire, a quick self-assessment test which is divided into four subscales (Activation, Perceived conflict, Well-being and Depression).
The Temperament Evaluation Memphis (TEMPS-A) is also a self-administered test, in the form of a questionnaire for the study of temperament and is one of the most accredited and used tools in research.
What are the tests for?
The point is that alone it is not always possible to correctly recognize the symptoms, therefore, without the presence of a specialist, purely indicative checks remain.
Another important tool used for assessing temperament is the TCI-R, Temperament and Character Inventory.
It is used to plan personalized treatments of a pharmacological nature for the temperament, and of a psychotherapeutic nature for the character.
The scores obtained in the test are discussed with the subject to identify his automatic behavioral reactions (temperament) and the cognitive representations he has of himself and of others (character).
The tests for bipolarity are therefore used both in the research field and in the clinic, to grasp the different expressions of the symptomatological manifestations in the most detailed way possible.
Many international studies show that this pathology is not easily diagnosed and distinguishable from cases of major depression or schizophrenia.
Taking this difficulty into account, the first in vitro blood test, EDIT-B™, was recently born, which would be able to diagnose bipolar disorder, differentiating it from unipolar depression.
The test measures the RNA editing of specific markers in the blood of the subjects, exploiting a new generation technology combined with algorithms developed through artificial intelligence.
The use of this test would make it possible to reduce diagnostic times from years to a few days, allowing specialists to opt for the most appropriate therapeutic treatment.
Often the euphoric crisis of Bipolar Disorder comes back in the same way and starts in 3 steps.
The first alarming disorder is the quality of sleep which is greatly reduced in the subject. The interested party is not sleepless but has less need to sleep, does not perceive tiredness and just a few hours of sleep.
This signal is considered “premonitory” and can even precede the full-blown syndrome by a few months.
The second revealing aspect of the arrival of the manic phase is irritability which is however mistaken for great energy. In fact, the person is in the throes of a sense of total well-being, is talkative, works hard and is highly uninhibited.
The third moment, which evolves into the euphoric crisis, involves severe psychotic symptoms, up to delirium. Pervaded by ideas of greatness, the bipolar with skyrocketing mood considers himself the only bearer of truth and exceptional knowledge.
Convinced that he has superpowers, the sufferer is determined to give his infallible solutions to the world’s problems, such as war.
For his plans, the subject does not spare initiatives and would also go to speak with the Pope or the Great of the world. However, such hallucinatory behavior is however typical of the most severe cases of DB, while it usually remains more circumscribed.
Therefore some people with DB may suffer from psychosis during an episode, with hallucinations or delusions.
Symptoms euphoric phase
So in general, in the euphoric phase, the patient can feel excited and present some characteristic conditions of his state:
- The person concerned demonstrates a lot of energy.
- It has periods of greater activity, in many sectors.
- Talk quickly about many things, perhaps changing the subject quickly during conversations.
- He feels a strange sensation, as if thoughts are running out of his head.
- Has a tendency to take risks, even large ones.
- Has difficulty sleeping.
- He feels strong and is always hyperactive.
- He is pervaded by a sense of agitation and strong irritability.
Bipolarity: symptoms in the depressive phase
In the depressive phase, the bipolar has symptoms of hopelessness and engages in negative behaviors:
- The subject experiences sadness and a sense of emptiness.
- You feel lack of energy.
- Experiences periods of reduced activity or productivity.
- He perceives his impossibility to enjoy anything.
- Emotionally you feel numb or drained.
- Has trouble concentrating and forgets things.
- He sleeps too much or, conversely, too little and does not fall asleep easily.
- He has a tired feeling.
- Eat too much or not enough.
- Warns thoughts of death.
Generally in the mixed form, the manic and depressive phases follow each other without an interval. Instead, in some cases, between one and the other, the patient enjoys a period of stable mood, or euthymia.
In the state called hypomanic, episodes of major depression alternate with those similar to mania, but of less intensity. Finally, mood is altered in a consecutive and chronic way in cyclothymic disorder, with hypomanic and then mildly depressive periods.
In summary, the disease can proceed by different courses and have different repercussions in terms of quality and quantity.
Some patients go more easily “from top to bottom”, ie from a manic phase to a depressive one.
Other bipolars have a trend from a less marked manic peak to low, so they are called hypomanic. In some the DB is discontinuous given that after an episode there is a period of well-being followed by more or less intense crises.
However, according to psychiatric analyses, in a large majority of bipolars the depressive phases exceed the manic ones.
Types of bipolarity
The syndrome can present itself with various manifestations, more or less important, of a relapsing nature.
There are 4 categories of bipolar disorder, each of which includes both features of mania and depression. But the factors that distinguish the different types from each other are:
- Variability of the two phases.
Bipolar I disorder means that the patient has had at least one major manic episode, lasting at least 1 week. Therefore, the bipolar I can only experience depressive moments or with both symptoms.
Bipolar II disorder is marked by “hypomania,” a less severe mania accompanied by at least one major depressive episode. But to make this diagnosis, the specialist must ascertain that the patient has not had a severe manic moment.
In fact, hypomania is often misdiagnosed as depression because it is confused with it and not thought to be a rush…