Some people experience severe mood swings where they can feel very high with elated mood or very low and depressed. This condition is called bipolar disorder. The period of high mood is referred to as mania or manic. This is why bipolar disorder used to be called Manic Depression. It is estimated that bipolar disorder affects 1 in 100 people. Usually episodes of bipolar disorder can last for weeks or months sometimes with devastating consequences for the patient and people around him. During these episodes patient experience depression, mania or sometimes hypomania (a less severe form of mania). When people suffering from bipolar disorder have a depressive episode they feel low in their mood, lose ability to enjoy things, have loss of interest in life, sleeping problems, hopelessness, helplessness, guilt feeling, feeling of worthlessness, change in appetite, weight loss, poor concentration, feeling tired easily and loss of sexual drive. Sometimes during depressive episodes people can have thoughts of ending their lives. On the other hand during manic episodes people with bipolar disorder experience high mood, feel excited, have excessive energy, talk excessively, make unrealistic plans, starts many projects that they don’t tend to finish, overspend, don’t see the need to sleep, feel that they are of special importance, have special powers or abilities, feel that they are on a special mission, become disinhibited, become more interested in sex, engage in dangerous reckless behaviour, become irritable and they usually lack insight into what they are going through. Patients with bipolar disorder can also have psychotic symptoms when the experience severe mood swings.
Diagnosing and treating bipolar disorder can be challenging. Especially that patients usually present in depressive episodes and not when they are experiencing manic episodes as they quiet often lack insight during these episodes. If the patient does not see a clinician who is experienced in diagnosing, treating and differentiating bipolar disorder from other mental illness that can present in a similar way this can lead to misdiagnosis and delay in recovery. In the acute stage of bipolar disorder the first line treatment is medication. Medication is also used between episodes to protect patients from experiencing further episodes. The choice of which medication to use depends on many factors such as if the patient is feeling low or high and the severity of the condition. Medications used include mood stabilizers, antidepressants and sometimes antipsychotic medication. Besides medication talking therapies that includes psycoeducation and other forms of formal therapy such as Cognitive Behavioral Therapy (CBT) play crucial role in recovery and protecting patients from experiencing further episodes.
Dr Abdelghani is one of two consultant psychiatrists running the Complex Depression, Anxiety and Trauma service (CDAT) in the NHS trust where he works. This is the team responsible for the management of patients suffering with bipolar disorder. He has extensive experience in diagnosing and treating different mood disorders. This includes using medication and working with colleagues from other disciplines, such as psychologists, to deliver a comprehensive and holistic management plan to his patients. Dr Abdelghani developed special interest in treating affective (mood) disorders since early stages of his career. He gained exceptional skills in the field through working in the National Affective Disorders Unit in South London & Maudsley NHS trust during his post-gradual psychiatric training. This was one of only six National Affective Disorders Units in the UK. During his time at the National Affective Disorders Service he took part in assessing and treating patients in the Healthcare Professional Clinic. This is a unique outpatient clinic that treats healthcare professionals (i.e. doctors, nurses, psychologists, occupational therapist … etc) who suffer from mood disorders. The time he spent at the National Affective Disorders unit and outpatient clinic equipped him with clinical skills and excellent experience to manage and treat the most treatment resistant mood disorders. Besides his time with the National Affective Disorders Service he also worked in teams that manage people who suffer from bipolar disorder in different clinical settings such as outpatient, inpatient, inner city London and rural areas.