Better Understanding of Bipolar Disorder from Clinical Expression to Therapeutic Strategies

Bipolar disorder is a psychiatric disease that involves profound changes in mood accompanied by severe changes in feelings, thoughts and behaviors: emotions can move quickly from a deep depression to excessive excitement, without some apparent reason. BD is usually a chronic condition and may last for life with recurring episodes that often occur during adolescence or early adulthood, sometimes during childhood and usually requires treatment for life. In the manic phase the disorder typically occurs in forms of exasperated disinhibition and manic symptoms may include: an euphoric mood or irritable, angry and reactive state of mind; increased activity and feelings of strength and energy; ambitious and grandiose aspirations; poor self-criticism; greater interest in sexual activity and reduction in hours of sleep and need for sleep. On the other hand, depressive phases may be so serious that can also lead to episodes of self-harm. Depressive symptomatology may include: depressed or apathetic mood; reduced strength in activities, thinking and talking; feeling of being hopeless and helpless; pessimistic approach to reality, sometimes, with suicidal thoughts; alteration in the rhythm of appetite and in sleep patterns. Although it is not known a definitive cure, BD is a very treatable disease that can be kept under control. Drugs play a key role in the care of persons affected by BD, in particular medications commonly used to treat the manic episodes of bipolar disorder are mood stabilizers. During depressive episodes, people with bipolar disorder can be treated with antidepressants by evaluating administration and dosage with extreme caution because of the risk to switch to a manic phase. In addition to medications psychotherapy and psychoeducational approaches are essential for individuals suffering from bipolar disorder. At present BD is considered a multifactorial etiology condition in which many physiopathogenetic factors are involved, thus researchers have identified several causes such as biological differences, imbalance of neurotransmitters and hormones, genetic predisposition, traumatic life events, stress and environmental factors.