Understanding Bipolar Disorder


Bipolar disorder is a serious condition in which a person experiences both extremes or "poles" of feelings--mania and depression--in ways that often cause great pain and suffering for the individual, as well as for those who care about them.

Bipolar disorder, also known as manic-depression, is characterized by wide extreme mood swings from severe highs (mania) followed by episodes of distinct lows (depression) and is most often a chronic condition. Sometimes the mood switches are dramatic and rapid, but most often they are gradual. The length of an episode varies from person to person, but each one generally lasts for several weeks. Episodes may be longer at the onset of the illness before treatment has begun. Bipolar disorder usually emerges in late adolescence or early adulthood. At any given time, more than 2 million people in the United States suffer from bipolar disorder.

Most people with bipolar disorder will have at least a year of normal, productive life between episodes. However, about 10% to 30% will develop a pattern of rapid cycling at some time during the course of their illness. Rapid cycling refers to four or more episodes occurring in one year. Unlike a typical episode, episodes which occur during rapid cycling usually last for only a day or two, or in extreme cases, just a few hours.

When one member of a family has bipolar disorder, their condition affects everyone else in the family. When episodes occur, they often feel confused, alienated and helpless. During manic phases, family and friends may watch in disbelief as their loved one transforms into a person they do not know and cannot communicate with. During episodes of depression, everyone can become frustrated as they desperately try to elevate the depressed person's mood. Sometimes a person's moods are so extreme and so unpredictable that family members feel like they're stuck on an out of control roller coaster ride that is impossible to disembark from.

Symptoms of Depression and Mania

A diagnosis of bipolar I is made when a person has experienced at least one episode of severe mania; a diagnosis of bipolar II is made when a person has experienced at least one hypomanic episode but has not met the criteria for a full manic episode.

A person's diagnosis depends on the number of symptoms they have, how strong those symptoms are, and how long they last.

Depression

  • Persistent sad, anxious, or empty mood


  • Feelings of hopelessness, pessimism


  • Feelings of guilt, worthlessness, helplessness


  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex


  • Insomnia, early-morning awakening, or oversleeping


  • Significant change in appetite or body weight


  • Decreased energy, fatigue, feeling "slowed down"


  • Recurrent thoughts of death or suicide; suicide attempts


  • Restlessness, irritability


  • Difficulty concentrating, remembering, making decisions


  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain


Mania

  • Overly inflated self-esteem


  • Inappropriate irritability


  • Decreased need for sleep


  • Grandiose ("larger than life") notions


  • Increased talkativeness


  • Disconnected and racing thoughts


  • Distractibility


  • Increased sexual desire


  • Increased goal-directed activity or physical agitation


  • Excessive involvement in pleasurable activities that have a high potential for painful consequences


  • Inappropriate social behavior


Causes of Bipolar Disorder

Despite extensive investigation, the exact cause of bipolar disorder is still unknown. Some researchers have suggested that the cycles of moods are brought on by a viral infection, but there is yet to be any conclusive support for this theory. Others have suggested that the symptoms of bipolar disorder are triggered by stressful events in one's life.

The most popular theory argues that bipolar disorder is caused by a chemical imbalance in the brain. The brain is made up of nerve cells, called neurons, and chemicals, called neurotransmitters. According to this theory, an imbalance of one neurotransmitter, norepinephrine, is thought to cause the symptoms of bipolar disorder. It seems there are unusually high levels of norepinephrine in a person's brain during manic episodes, and markedly low levels during depressive episodes.

Family history is another factor when determining the cause for bipolar disorder. Studies show that between 4% to 24% of those who have a relative with bipolar I will also develop the disorder. The rates for bipolar II are a bit lower; individuals who have a parent or sibling diagnosed with bipolar II have only about a 1% to 5% chance of developing the disorder. It's important to note that, while those who have biological family members with bipolar disorder are at greater risk of getting the disorder, it does not mean they absolutely will get it.

Treating Bipolar Disorder

Bipolar disorder is usually a life-long condition. Left untreated, the periods of mania and depression can occur over and over again and episodes can progressively become more frequent and more severe. The good news is that effective treatment is available. Treatment is vital to decreasing the suffering that accompanies the disorder and preventing future episodes. Basic ways to treat bipolar disorder are therapy, medication, and a combination of the two.

Therapy

There are therapists who are especially skilled and experienced at helping people who are suffering from bipolar disorder. Therapy provides a safe, comforting, and confidential setting in which to receive the kind of help and understanding that can best assist in first relieving the symptoms, then recovering, and ultimately protecting the patient from future recurrences. It can take as few as one to two weeks to receive relief from the symptoms of bipolar disorder.

Medication

Medication is often used to alleviate the symptoms of bipolar disorder. Mood stabilizing medications, such as Depakote, Lithium, Tegretol, are most commonly used to treat bipolar disorder. During periods of depression, antidepressant medications may be prescribed.

Combination of Therapy and Medication

For those who suffer from bipolar disorder, a treatment plan of both therapy and medication can be the most effective in relieving symptoms and preventing future episodes.

Conscientious changes in lifestyle can be extremely helpful for the management of bipolar disorder. The therapist can suggest coping strategies that are particularly tailored to the daily life patterns of the individual. Some common suggestions may include:

  • Communicate openly with the therapist


  • Maintain medication treatment


  • Keep stress as manageable as possible


  • Maintain consistent patterns of activity


  • Make sure to get proper sleep and rest. Try to go to bed and get up at the same time each day. It's important to tell the therapist if insomnia occurs, or if waking up becomes difficult


  • Stay open to feedback from family and friends who may be the first to recognize symptoms of episodes


  • Avoid alcohol or mood-altering drugs


It is important to remember that even very small amounts of alcohol, caffeine, or some over-the-counter medications can disrupt sleep and ultimately affect mood quality.

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