The term “bipolar mood disorders” shows already that this does not concern uniform clinical picture. The disorder is shown in various forms and can be very individually different. The phases come irregularly, are sometimes short, sometimes long, they can last only a few days but also months or even last years. Left untreated, each phase lasts around six to twelve weeks. Knowledge of these phases can help persons afflicted recognise new episodes at an early stage and accordingly adapt themselves to the disorder.
Model for the better understanding of the bipolar mood disorder
Bipolar I disorders are characterized by distinct manias and depressions. The person afflicted had one or several phases lasting at least one week in which the criteria for a mania are fulfilled (ICD-10: F30 and 31)
The bipolar II disorder is characterized by less distinct and accordingly shorter lasting manias, the so-called hypomanias, and often serious depressive episodes. This form of the bipolar mood disorder is very important is also very difficult to grasp since in retrospect the hypomanias are often not considered as classifiable as an illness or remembered. (ICD-10: F31.8)
“Rapid Cycling means a quick change of the episodes. In this special form of bipolar mood disorder at least four (or more) episodes of the mania, hypomania or depression occur within twelve months. Three types are distinguished:
Rapid cycling (ICD 10: F31.8) At least four phases per year (in ca. 20% of cases).
Ultra rapid cycling (ICD 10: F31.8) change of phase within weeks or days, more than four episodes per month.
Ultradian cycling (ICD 10: F31.8) Change of phase within one day on more than four days a week. (ICD-10: F31.8)
In the mixed episodes the symptoms of mania and depression occur in rapid rotation to each another or exist at the same time. The inhibition (depression) classically moving in the same direction or excitement (mania) of emotional, cognitive and psychomotor processes no longer exist in the mixed states. Thus, for example rapid thought and speech (like in mania) can occur at the same time as the anxious-depressive mood. A mixed state is an extraordinarily multiform, a clinical picture that is partly difficult to diagnose and treat. (ICD-10: F31.6)
A weakened form of bipolar mood disorder is the so-called cyclothymia or cyclothymic disorder. In these persons often mood swings of a strong degree of characterization take place continually over a period or at least two years, whereby the criteria for a depression or mania in detail are not fulfilled and which often occur independently of external influences. The transitions are however very fluent so that in people who come into a clinic or outpatients department with the suspected diagnosis cyclothymia often a bipolar (II) disorder can be determined. (ICD-10: F34)