Bipolar Disorder: The Facts
WHAT IS BIPOLAR DISORDER?
Bipolar disorder, or manic depression, is a serious brain disorder that causes extreme shifts in mood, energy or functioning that can range from episodes of mania, or “highs”, to episodes of depression or “lows”. These changes in mood or can last for hours, days, weeks, or even months.
Although the true cause is unknown, scientists believe that Bipolar disorder may be caused by a combination of biological and psychological factors. Most commonly the onset of this disorder can be linked to stressful life events.
MANIFESTATION OF BIPOLAR DISORDER
Bipolar disorder most commonly manifests itself by depression, mania and a mixed state of depression and mania.
Depression: Symptoms include a persistent sad mood, a loss of interest or pleasure in activities that were once enjoyed, significant changes in appetite and sleep patterns, irritability, anger, worry, agitation, anxiety, pessimism, loss of energy, feelings of guilt, worthlessness, inability to concentrate, social withdraw, unexplained aches and pains and recurring thoughts of death and suicide.
Mania: Symptoms include a decreased need for sleep, heightened mood, exaggerated optimism and self-confidence, grandiose delusions, inflated sense of self-importance, excessive irritability, aggressive behavior, increased physical, mental activity, racing speech, flight of ideas, impulsiveness, poor judgment, easily distracted, difficulty concentrating, reckless behavior without concern for consequences, such as spending sprees, rash business decisions, erratic driving and sexual indiscretions. In severe cases of Mania, auditory hallucinations (hearing voices) or delusions (strong convictions about things that aren’t true).
DIAGNOSIS
Bipolar Disorder can be difficult to detect. Some people go as long as 10 yeas or more before being correctly diagnosed. The reason is because when someone is feeling manic they feel good. They are “high on life” and because they feel good they don’t seek treatment. On the other hand when they are depressive they are more likely to seek treatment. Then they only describe the depressive symptoms and are misdiagnosed with depression. Bipolar disorder also shares many symptoms with other psychiatric illnesses such as anxiety disorders and schizophrenia.
No laboratory test can detect Bipolar disorder. The Mood Disorder Questionnaire is given to patients to help the doctor’s determine if they have common symptoms as the disorder.
In order to make a correct diagnosis a complete psychiatric history is needed not only for current and past symptoms but also those of the immediate family. Bipolar Disorder is genetic. A complete medical history is also needed to rule out any physical illnesses that could be producing or mimicking the symptoms of the disorder.
A diagnosis of Bipolar disorder is made when all other illnesses and disorders are ruled out and when person has experienced at least one episode of severe mania.
TREATMENT
Treatment for Bipolar disorder is life-long. It includes therapy with a mood-stabilizer such as lithium, carbamazepine or divalproex/ valproic acid. Often this is in combination with an antipsychotic medication. For the most part treatment decreases suffering and reduces the risk of suicide. For mania, an antipsychotic medication and /or benzodiazepine medication is often added to the mood-stabilizer. For depression, an antidepressant medication and /or lamotrigine is often added to the mood-stabilizer. Antidepressant medication can trigger mania, so this medication should always be combined with a mood-stabilizer or antipsychotic medication to prevent mania.
Treatment for Bipolar Disorder must be life-long but many patients are noncompliant and stop their medication after one year. Usually less than 50% of patients have a good overall outcome.
The best recoveries are achieved when individuals with Bipolar disorder get the correct diagnosis and get effective treatment and faithfully stay on it for a lifetime. Regular visits to a supportive physician who is knowledgeable about psychiatric management of this disorder and adopting a healthy lifestyle is essential.
IMPORTANT FACTS
Bipolar disorder appears to run in families. More than two-thirds of people with Bipolar Disorder have as least one close relative with the disorder.
Those with Bipolar disorder are about twice as likely to commit suicide as those suffering from major depression.
The rate of prevalence of Bipolar disorder is roughly equal in men and women. Approximately 2.3 million American adults or about 1.2 percent of the U.S population age 18 and older are affected by Bipolar Disorder in a given year. The average age for a first manic episode is the early twenties.
The number of people affected by Bipolar Disorder will steadily rise in the United States in the coming years. There is no known cause and no cure, but with the proper treatment this disorder can be controlled. If you or if you suspect that a loved one is showing signs of this disorder seek medical help immediately. Proper diagnosis is the first step to a normal life.
