Bipolar disorder: complex but surmountable by early diagnosis, Pg 22

• Bipolar disorder involves pathological mood fluctuations from mania (high energy, impulsiveness) to depression (sadness, hopelessness).

• Often misdiagnosed or diagnosed late due to symptom overlap and lack of awareness.

Causes & Risk Factors

• Highly heritable (6085%), but also influenced by:

• Gene-environment interactions

• Childhood trauma, maltreatment

• Stressors like bereavement, unemployment

• Dysfunction in HPA axis and circadian clock linked to recurrence.

Environmental & Social Determinants

• Negative life events can trigger relapses.

• Early childhood adversity significantly increases vulnerability.

• Societal awareness, early screening, and diagnosis are key to improved outcomes.

Diagnosis & Challenges

• Diagnosis may be delayed for years, with depressive symptoms preceding manic episodes.

• Hypomania is often underreported, causing further delay.

Analysis & Way Forward

• Mental disorders like bipolar disorder need multi-pronged intervention, combining early diagnosis, psychotherapy, and public education.

• Government should ensure community mental health outreach, as advocated in the National Mental Health Survey.

Mains Mock Question:

"Mood disorders, including bipolar disorder, are often misunderstood and misdiagnosed in India. Examine the causes and propose strategies to improve early detection and care of mental health conditions."