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 swings in mood.

These extreme mood swings can include increased vitality, energy, euphoria, known as 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 the manic and depressive pole, which is known as mixed episodes. Some people with more severe symptoms may present psychotic symptoms, such as loss of reality judgment and hallucinations.

Most people with bipolar disorder have no symptoms between episodes and can virtually lead a normal life with proper treatment. Said treatment includes medications that stabilize mood to effectively stop the 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 a first episode include:

-Having a blood relative (such as a 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.
-Growing up in environments lacking support networks.

Other factors include the use of substances such as alcohol, cocaine and cannabis. In these cases, and for people with a diagnosis of Bipolar Affective Disorder (TAB), it has been seen that the prevalence of suicide risk is higher. In addition, they are more likely to have mixed episodes and more likely to require hospitalizations over the course of the disease. Comorbidity with substance abuse is one of the main variables that has been associated with greater severity of manic episodes. It has been observed that there is worse global functioning and a lower occupational status, as well as worse adherence to treatment.

At first, bipolar symptoms are commonly confused with attention deficit disorder, depression, anxiety, borderline personality disorder, or borderlines and, in its most serious manifestations, with schizophrenia. This is because the early symptoms of this disorder are unusually varied. Only over time does the pattern of alternating between high and low moods become clear. That is why it is important to seek specialized help, not to go to any therapist or psychiatrist, and to consider that without treatment, bipolar episodes generally last from several weeks to several months. Periods between episodes, without symptoms of mania or depression, can last weeks, months, or years. Therefore, not consulting can generate more 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 manic and depressive episodes have been observed to decrease; the state of negative emotions is recognized and helps reduce anxiety symptoms. Cognitive-behavioral therapy has also been shown to have effects in reducing the number and duration of depressive episodes, residual or interepisode 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 of getting everyone at home involved and reducing the level of stress at home.

Ultimately, bipolar disorder is not the same as a “changing” 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 adulthood, but the peak incidence occurs between 15 and 25 years, with an average age of diagnosis of 21 years.

Finally, it is a disease that has Explicit Health Guarantees, which are a set of benefits guaranteed by law for people affiliated with Fonasa and Isapres. The required guarantees are:

Access: Right by law to health care.
Chance: Maximum waiting times for the granting of benefits.
financial protection: The beneficiary pays only a percentage.
Quality: Granting of benefits by an accredited or certified provider.

Who can access? All people over 15 years of age with diagnostic confirmation of altered mood, going through periods of exaltation and low mood quickly, through diagnostic confirmation 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 the periods without help or treatment.

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J. A. Allen

Author, blogger, freelance writer. Hater of spiders. Drinker of wine. Mother of hellions.

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