Bipolar Disorder

  
 
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Bipolar disorder, sometimes called manic-depressive disorder, causes mood swings. The elevated moods are clinically referred to as mania or, if milder, hypomania.  Individuals who experience manic episodes also commonly experience depressive episodes, or symptoms, or mixed episodes in which features of both mania and depression are present at the same time. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy.

Mood shifts may only occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time. These episodes are usually separated by periods of "normal" mood; but, in some individuals, depression and mania may rapidly alternate, which is known as rapid cycling. Extreme manic episodes can sometimes lead to such psychotic symptoms as delusions and hallucinations. The disorder has been subdivided into bipolar I, bipolar II, cyclothymia, and other types, based on the nature and severity of mood episodes experienced; the range is often described as the bipolar spectrum.
  • Bipolar I disorder. Mood swings with bipolar I cause significant difficulty in your job, school or relationships. Manic episodes can be severe and dangerous.
  • Bipolar II disorder. Bipolar II is less severe than bipolar I. You may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine. Instead of full-blown mania, you have hypomania, a less severe form of mania. In bipolar II, periods of depression typically last longer than periods of hypomania.
  • Cyclothymia. Cyclothymia is a mild form of bipolar disorder. With cyclothymia, hypomania and depression can be disruptive, but the highs and lows are not as severe as they are with other types of bipolar disorder.
Bipolar disorder also affects your energy level, judgment, memory, concentration, appetite, sleep patterns, sex drive, and self-esteem. Additionally, bipolar disorder has been linked to anxiety, substance abuse, and health problems such as diabetes, heart disease, migraines, and high blood pressure. The causes of bipolar disorder aren’t completely understood, but it often runs in families. The symptoms can be subtle and confusing, so many people with bipolar disorder are overlooked or misdiagnosed, resulting in unnecessary suffering. But with proper treatment and support, you can lead a rich and fulfilling life.

Bipolar disorder can run in families. It usually starts in late adolescence or early adulthood. It usually appears between the ages of 15 to 25. If you think you may have it, tell your health care provider. A medical checkup can rule out other illnesses that might cause your mood changes.

Bipolar disorder can look very different in different people. The symptoms vary widely in their pattern, severity, and frequency. Some people are more prone to either mania or depression, while others alternate equally between the two types of episodes. Some have frequent mood disruptions, while others experience only a few over a lifetime.

Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.

A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home.

Manic Episodes include:
Mood Changes
  • A long period of feeling "high," or an overly happy or outgoing mood
  • Extremely irritable mood, agitation, feeling "jumpy" or "wired."
Behavioral Changes
  • Talking very fast, jumping from one idea to another, having racing thoughts
  • Being easily distracted
  • Increasing goal-directed activities, such as taking on new projects
  • Being restless
  • Sleeping little
  • Having an unrealistic belief in one's abilities
  • Behaving impulsively and taking part in a lot of pleasurable,
    high-risk behaviors, such as spending sprees, impulsive sex, and impulsive business investments.
Depressive Episodes include:
Mood Changes
  • A long period of feeling worried or empty
  • Loss of interest in activities once enjoyed, including sex.
Behavioral Changes
  • Feeling tired or "slowed down"
  • Having problems concentrating, remembering, and making decisions
  • Being restless or irritable
  • Changing eating, sleeping, or other habits
  • Thinking of death or suicide, or attempting suicide
Sometimes, a person with severe episodes of mania or depression has psychotic symptoms too, such as hallucinations or delusions. The psychotic symptoms tend to reflect the person's extreme mood. For example, psychotic symptoms for a person having a manic episode may include believing he or she is famous, has a lot of money, or has special powers. In the same way, a person having a depressive episode may believe he or she is ruined and penniless, or has committed a crime. As a result, people with bipolar disorder who have psychotic symptoms are sometimes wrongly diagnosed as having schizophrenia, another severe mental illness that is linked with hallucinations and delusions.

To date, there is no cure for bipolar disorder. But proper treatment helps most people with bipolar disorder gain better control of their mood swings and related symptoms. Because bipolar disorder is a lifelong and recurrent illness, people with the disorder need long-term treatment to maintain control of bipolar symptoms. An effective maintenance treatment plan includes medication and psychotherapy for preventing relapse and reducing symptom severity. Keeping a chart of daily mood symptoms, treatments, sleep patterns, and life events can help the doctor track and treat the illness most effectively. Sometimes this is called a daily life chart. If a person's symptoms change or if side effects become serious, the doctor may switch or add medications. Not everyone responds to medications in the same way. Several different medications may need to be tried before the best course of treatment is found.

 

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