BIPOLAR MOOD DISORDER

What is Bipolar Mood Disorder?

Introduction

Bipolar Mood Disorder, commonly known in English as Bipolar Disorder, is a prevalent psychiatric illness. Approximately 0.5% to 5% of the general population suffers from this condition. Broadly speaking, this disorder consists of two extreme emotional poles—mania (excessive euphoria) and depression (extreme sadness).

Feelings of happiness and sadness are natural human emotions, just like anxiety, worry, fear, relief, and others. These emotions are essential in life. For instance, you may feel sad today because your spouse reprimanded you harshly, your boss overloaded you with work, or your child was disciplined at school. However, the next day, you may feel happy when your spouse surprises you with a thoughtful gift. Such emotional fluctuations happen to all normal individuals—this is not Bipolar Mood Disorder.

Symptoms

Mania (Extreme Emotional Highs)
Mania makes an individual feel excessively euphoric, irritable, or easily angered. However, it is not just about feeling happy—it must also be accompanied by several other symptoms, including:

1. Elevated self-esteem – An extreme increase in self-confidence.

2. Grandiosity – A belief that they are a special individual with extraordinary abilities, often unrealistic.

3. Reduced need for sleep – Feeling energized despite sleeping very little.

4. Talkative and rapid speech – Speaking excessively fast and continuously.

5. Flight of ideas – Jumping from one idea to another, making it hard for others to follow.

6. Easily distracted – Difficulty maintaining focus.

7. Increased goal-directed activity or psychomotor agitation – Excessively planning or engaging in various activities.

8. Risky pleasurable activities – Engaging in activities like:

   • Promiscuous sexual behavior due to heightened libido.

   • Reckless spending or investments despite financial struggles.

These symptoms typically last for at least a week and significantly disrupt daily functioning.

Impact on Daily Life:

• Students may fail to complete assignments, skip classes, or lose focus in lessons.

• Workers may neglect job responsibilities.

• Parents or family members may ignore their financial duties or become constantly irritable and short-tempered.

• Social Relationships may deteriorate due to aggressive and provocative behavior.

Diagnosing mental illness is not easy, but unfortunately, many people ignore these conditions due to stigma, denial, or shame. Some believe these symptoms are caused by supernatural forces, black magic, or possession by spirits instead of recognizing them as medical conditions requiring psychiatric treatment.

Examples of Bipolar Disorder Manifestations:

📌 A middle-aged man suddenly gets an idea to help the poor and becomes obsessed with building a charity foundation, despite having no financial resources. He attempts to take a bank loan and shares his plans with everyone, while neglecting his family’s financial needs—even forgetting to buy milk for his child.

📌 A teenager who failed their SPM (high school exam) becomes depressed for a while but then suddenly announces their desire to conquer Mount Everest. Initially, the family is not suspicious. However, they later notice the teenager becoming obsessed with the idea—spending hours researching online but failing to train physically. One day, without any preparation, the teenager impulsively buys a plane ticket to Nepal.

Causes & Treatment

Like many mental illnesses, Bipolar Disorder is a chronic condition caused by multiple factors. Its treatment requires a holistic approach, combining biological, psychological, social, and spiritual elements.

The primary biological treatment for Bipolar Disorder is Mood Stabilizers. These medications have been proven effective in controlling mood instability, which is not the same as daily mood swings experienced by most people.

Examples of Mood Stabilizers:

• Lithium

• Sodium Valproate

• Lamotrigine

• Carbamazepine

• Quetiapine

• Olanzapine

• Aripiprazole

These medications can only be prescribed by a certified medical doctor with specialized training in psychiatry.

Complications of Untreated Bipolar Disorder

If left untreated, Bipolar Disorder can lead to severe complications, not only endangering the individual but also disrupting their social and functional life.

🔴 Suicide Risk – Individuals with Bipolar Disorder are 20-30 times more likely to attempt suicide than the general population (Pompili et al., 2013).

🔴 Substance Abuse – Higher likelihood of drug and alcohol addiction.

🔴 Social Issues – Increased unemployment and violence are commonly observed in untreated Bipolar Disorder patients.

🔴 Aggressive Behavior – Bipolar patients not receiving treatment tend to be more impulsive and aggressive (Perroud et al., 2011).

Like other mental illnesses, untreated Bipolar Disorder not only burdens family members emotionally and physically but also impacts society and national productivity in the long run.

Dr. Zul Azlin Razali
Psychiatry Specialist
Specialist Clinic, Universiti Sains Islam Malaysia (USIM)