Bipolar Disorder (also known as manic depression) causes serious shifts in mood, energy, thinking, and behavior–from the highs of mania on one extreme, to the lows of depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with your ability to function.
A mood disorder sometimes called manic-depressive illness or manic-depression that characteristically involves cycles ofdepression and elation or mania. Sometimes the mood switches from high to low and back again are dramatic and rapid, but more often they are gradual and slow, and intervals of normal mood may occur between the high (manic) and low (depressive) phases of the condition. The symptoms of both the depressive and manic cycles may be severe and often lead to impaired functioning.
Both phases of the disease are deleterious. Mania affects thinking, judgment, and social behavior in ways that may cause serious problems and embarrassment. For example, unwise business or financial decisions may be made when an individual is in a manic phase. Depression can also affect thinking, judgment, and social behavior in ways that may cause grave problems. For example, it elevates the risk of suicide. About 5.7 million American adults, or about 2.6 percent of the population aged 18 and older, have bipolar disorder.
Although bipolar disorder often worsens over time if untreated, most people with bipolar disorder can achieve stabilization of their mood swings and reduction of symptoms with proper treatment. Treatment usually consists of medications known as "mood stabilizers."
During a manic episode, a person might impulsively quit a job, charge up huge amounts on credit cards, or feel rested after sleeping two hours. During a depressive episode, the same person might be too tired to get out of bed and full of self-loathing and hopelessness over being unemployed and in debt.
The causes of bipolar disorder aren’t completely understood, but it often runs in families. The first manic or depressive episode of bipolar disorder usually occurs in the teenage years or early adulthood. 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.
Causes and symptoms
Although the source of bipolar disorder has not been clearly identified, a number of genetic and environmental factors appear to be involved in triggering episodes. Bipolar disorder has an inherited component; children who have at least one parent with bipolar disorder are more likely to develop the disorder. They are also more likely to be diagnosed with other psychiatric disorders such as attention deficit/hyperactivity disorder (ADHD).
Several studies have uncovered possible genetic connections to the predisposition for bipolar disorder. A large study done in Sweden reported in 2009 that schizophrenia and bipolar disorder appeared to share similar genetic causes. Brain imaging studies suggest that there are physical changes in the brains of people with bipolar disorder. It is hypothesized that dopamine and other neurotransmitters involved in mood may be involved. The possible role of hormonal imbalances in bipolar disorder is another area of investigation. Investigators are also researching what, if any, environmental factors may trigger the disorder.
People with bipolar disorder tend to have other psychiatric disorders. Oppositional defiant disorder (ODD) and ADHD are among the most common. Over one-half of patients diagnosed with bipolar disorder have a history of substance abuse. A high rate of association exists between cocaine abuse and bipolar disorder. The emotional and physical highs and lows of cocaine use correspond to the manic depression cycle of the bipolar patient, making the disorder difficult to diagnosis.
For some bipolar patients, manic and depressive episodes coincide with seasonal changes. Depressive episodes are typical during winter and fall, and manic episodes are more probable in the spring and summer months.
Symptoms of bipolar depressive episodes include low energy levels, feelings of despair, difficulty concentrating, extreme fatigue, and psychomotor retardation (slowed mental and physical capabilities).
Manic episodes are characterized by feelings of euphoria, lack of inhibitions, racing thoughts, diminished need for sleep, talkativeness, increased risk taking, and irritability. In extreme cases, mania can induce hallucinations and other psychotic symptoms such as grandiose illusions.
Treatment
Medication is the most effective treatment for bipolar disorder. A combination of mood stabilizing agents with antidepressants, antipsychotics, and anticonvulsants may be used to regulate manic and depressive episodes.
Mood stabilizing agents are the most commonly prescribed drugs to treat bipolar disorder. Their function is to regulate the manic highs and lows of bipolar disorder. The following drugs are commonly used:
Lithium (Cibalith-S, Eskalith, Lithane, Lithobid, Lithonate, Lithotabs) is one of the oldest and most frequently prescribed drugs available for the treatment of bipolar mania and depression. Because the drug takes four to ten days to reach a therapeutic level in the bloodstream, it sometimes is prescribed in conjunction with neuroleptics and/or benzodiazepines to provide more immediate relief of a manic episode. Lithium also has been shown to be effective in regulating bipolar depression, but is not recommended for mixed mania. Lithium may not be an effective long-term treatment option for rapid cyclers, who typically develop a tolerance for it or may not respond to it. Possible side effects of the drug include weight gain, thirst, nausea, and hand tremors. Prolonged lithium use also may cause hyperthyroidism (a disorder in which the thyroid is overactive, which may cause heart palpitations, nervousness, the presence of goiter, sweating, and a wide array of other symptoms.)
Carbamazepine (Tegretol, Atretol) is an anticonvulsant drug often prescribed in conjunction with other mood stabilizing agents. The drug may be used to treat bipolar patients who have not responded well to lithium therapy. Blurred vision and abnormal eye movement are two possible side effects of carbamazepine therapy.
Valproate (divalproex sodium, or Depakote; valproic acid, or Depakene) is one of the few drugs available that has been proven effective in treating rapid cycling bipolar and mixed states patients. Valproate is prescribed alone or in combination with carbamazepine and/or lithium. Stomach cramps, indigestion, diarrhea, hair loss, appetite loss, nausea, and unusual weight loss or gain are some of the common side effects of valproate.
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