About Bipolar Disorders

Bipolar disorder, or manic-depressive illness, is a physical disorder of the brain that causes fluctuations in a person's energy level, mood, self-awareness and ability to function. The disorder can occur at any age, but generally first develops during the late teens or early 20s. Untreated bipolar disorder can result in serious consequences, including damaged relationships, an inability to work, complete disability or even suicide. Fortunately, a variety of treatment options exist, including medications and electroconvulsive therapy.

Identification

• Bipolar disorders affect an estimated 3 percent of the adult population, with more than 5.5 million American adults being affected at any one time. The disorder tends to develop during adolescence and early adulthood, a time of life that is normally confusing, stressful and emotionally unsettling anyway. This makes bipolar disorder difficult to detect, and can result in long treatment delays and multiple misdiagnoses. Without prompt diagnosis and proper treatment, bipolar disorder can be disabling, resulting in significant damage to professional, personal and social relationships, and often leading to suicide.

Types

• Bipolar disorder is broken down into three main types: bipolar 1 disorder, bipolar 2 disorder, and cyclothymia. All three types of bipolar present with similar symptoms, but differ in the severity and frequency of symptoms experienced. Bipolar 1 is the most severe form of the disorder and is associated with full-blown manic episodes that may involve psychosis. Those with bipolar 2 disorder experience the severe depressions associated with bipolar 1, but experience hypomania instead of mania. Cyclothymics alternate frequently between mild depression and hypomania, and some people with this lesser form of bipolar may rarely experience periods of normal mood.

Characteristics

• Bipolar disorders are characterized by alternating periods of high and low moods. Most people experience periods of normal moods in between, and the severity of the highs and lows depends on the type of bipolar disorder present. High moods, called mania, generally cause symptoms such as increased energy, euphoric or irritable mood, racing thoughts, decreased need for sleep, increased sexual desire, rapid speech, distractibility and unrealistic thoughts. A less severe form of mania, known as hypomania, may cause similar symptoms but does not result in psychosis or an inability to function.
  Symptoms of depression, or low mood, generally include a prolonged sad or empty mood, feelings of guilt and worthlessness, loss of interest in activities that were once enjoyable, difficulty making decisions, feeling restless or irritable, sleeping too much, changes in appetite, and thoughts of death or suicide. When symptoms of depression overlap with symptoms of mania, such as experiencing a depressed mood while also experiencing a decreased need for sleep and racing thoughts, the episode is typically called a "mixed state."

Causes

• According to the National Institute of Mental Health, there is no single cause for bipolar disorder. Studies are currently under way to determine what, if any, specific genes may be responsible for a predisposition to the disorder. A variety of factors are believed to play a role in the development of bipolar disorder, including genetics, altered levels of certain neurotransmitters in the brain and prolonged or acute stress. Brain imaging techniques, such as MRI and PET, have shown that brain activity in those with bipolar disorder differs from those without the disorder. As the causes of bipolar become better understood, treatments can be developed to treat the underlying causes instead of focusing primarily on symptom management.

Prevention/Solution

• The primary method of treating bipolar disorder involves the use of medications. Mania is typically treated with mood-stabilizing medications, or anti-epileptic drugs, such as lithium, Depakote, or Tegretol. Any psychosis associated with the disorder is treated with antipsychotic medications, such as Zyprexa, Risperdal, or Seroquel. Antidepressants may be prescribed to treat depressive episodes, and medications such as Valium may be prescribed to treat insomnia.
  Most people diagnosed with bipolar disorder will need to remain on medication throughout their life. Unfortunately, not all people respond to all medications used to treat bipolar disorder, and it can take years of adjustments in the type and dose of medications before an effective treatment regime is discovered. For those with medication-resistant bipolar disorder, electroconvulsive therapy, or ECT, is a useful treatment for both mania and depression. Like most bipolar medications, ECT may have serious side effects that make it unattractive to many people.