1. At what age does bipolar disorder typically surface, and why?
It typically surfaces during early adulthood, usually in the 20s. This is attributed to the natural history of the illness and the real reason is not known.
2. What are symptoms of bipolar disorder, and how are they different from depression? (I understand that bipolar patients experience periods of low moods too, so how to differentiate between the two?)
Patients with Bipolar suffers from episodes of mania or hypomania and depression. The depressive episodes of Bipolar Disorder are indistinguishable from clinical depression. As such patients who have depressive episodes are first diagnosed with clinical depression and the diagnosis will be revised should an episode of mania or hypomania surface.
The symptoms of mania are elevated mood, increased energy, increased self esteem, decreased need for sleep, pressure to keep talking or unusual talkativeness, racing thoughts, distractibility, excessive involvement in harmful activities. The symptoms should last for at least one week. In Hypomania, the symptoms are milder and the duration may be shorter.
3. How quickly can a bipolar patient's mood swing from one extreme to another? What are the triggers for the mood changes?
Most bipolar disorder consists of mood episodes, depressive or manic, that typically last weeks to months if not treated. A typical example will be one month of mania followed by three months of depression and the rest of the year is normal mood. However, there are patients who suffer rapid cycling bipolar disorder who cycle four times of more a year. Whilst some patients are thought to cycle even more frequently than that, ie. days to even within a day, this remains controversial.
Stresses in life, like work stress or family conflict, can sometimes trigger an episode. Sometimes a period of poor sleep, due to exams or work commitments can also lead to episodes.