INTRODUCTION

Everyone has a mood. It is a term to describe the emotional tones that color their daily
lives. Moods may be happy or sad; energized or sluggish; embodying various combinations of
emotional states. Moods consist of feelings as well as the thoughts and judgments that give
feelings their meaning. An anxious mood may shift into an excited mood with a simple change
of perspective, and a depressed mood may shift into a happier one upon hearing pleasing news.
Moods are typically transient things that shift from moment to moment or day to day, but they
can be prolonged. While people's moods rise and fall as various life events are experienced, most
moods never become that extreme or feel uncontrollable. As depressed as an average person
might get, it won't take too much for them to recover and start feeling better. Similarly, happy
and excited moods are not easily sustainable either, and tend to regress back to a sort of
average mood. Most people can't stay too depressed or too happy for any length of time.

In contrast to people who experience normal mood fluctuations are people who have
Bipolar Disorder. Bipolar disorder, also known as manic depression or sometimes Bipolar
Affective Disorder, is a serious mental illness in which client experiences dramatic mood swings
between extreme, severe and typically sustained mood states which deeply affect their energy
levels, attitudes, behavior and general ability to function. Bipolar mood swings can damage
relationships, impair job or school performance, and even result in suicide. Family and friends as
well as affected people often become frustrated and upset over the severity of
bipolar mood swings. The up feeling is called mania. The down feeling is depression.

AREA BIPOLAR I BIPOLAR II

• General Mood Persistently elevated, Depressed mood most of the
explosive or irritable mood. day, almost every day.
• Thought: Process and Inflated self-esteem or Feelings of worthlessness, or
Content grandiosity. excessive or inappropriate
guilt.
Flight of ideas, racing
thoughts. Recurrent thoughts of thought.
• Cognition Distractibility Decreased ability to think or
concentrate.
• Behavior Increased goal-directed Psychomotor agitation or
activity. retardation nearly everyday.

Markedly decreased interest in

 More talkative than usual. pleasurable activities.

Excessive involvement in
pleasurable activities.
• Sleep Decreased need for sleep. Insomnia or hypersomnia
nearly everyday.

Fatigue or loss of energy.

• Severity The mood disturbance is The symptoms cause clinically
sufficiently severe to cause significant distress and
marked disturbance in overall impairments in function.
functionality.
• Rule Out The symptoms are not due to The symptoms are not due to
direct physiological effects of direct physiological effects of
a substance or a general a substance or a general
medical condition medical condition: the
symptoms are not accounted
for by bereavement.
Prevalence
Bipolar I Disorder affects both sexes equally in all age groups and its worldwide prevalence is
approximately 3-5%. It can even present in preschoolers. There are no significant differences
among racial groups in the prevalence of this disorder.
The first episode may occur at any age from childhood to old age. The average age at onset is
21. More than 90% of individuals who have a single Manic Episode go on to have future
episodes. Untreated patients with Bipolar I Disorder typically have 8 to 10 episodes of mania
and depression in their lifetime. Often 5 years or more may elapse between the first and second
episode, but thereafter the episodes become more frequent and more severe.
There is significant symptom reduction between episodes, but 25% of patients continue to
display mood instability or mild depression. As many as 60% of patients experience chronic
interpersonal or occupational difficulties between acute episodes. Bipolar I Disorder may
develop psychotic symptoms. The psychotic symptoms in Bipolar I Disorder only occur during
severe manic, mixed or depressive episodes. In contrast, the psychotic symptoms in
Schizophrenia can occur when there is no mania or depression. Poor recovery is more common
after psychosis.
Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median
duration about 4 months). Depressive episodes tend to last longer (median length about 6
months), though rarely for more than a year, except in the elderly.