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Alternate Names : Bipolar Affective
Disorder, Manic Depression
Definition
Bipolar disorder is distinguished by episodes of
excitability (mania) alternating with cycles of depression.
The "mood swings" between mania and depression are often
very sudden.
Overview, Causes, & Risk Factors
Bipolar disorder results from instability in the sections
of the brain that regulate mood. During manic periods, an
individual with bipolar disorder may be overly impulsive and
energetic, with an overstated sense of self. The depressed
stage brings overpowering feelings of anxiety, low
self-respect, and suicidal thoughts.
There are two principal types of bipolar disorder.
Individuals with bipolar disorder I have had at least one
fully manic episode with episodes of major depression. (At
one time, bipolar disorder I was called manic depression).
Individuals with bipolar disorder II rarely suffer
full-fledged mania. Instead they suffer periods of hypomania
(increased levels of energy and impulsiveness that are not
as extreme as the symptoms of mania). These hypomanic
episodes alternate with episodes of major depression.
A mild form of bipolar disorder called cyclothymia
entails periods of hypomania and mild depression, with less
severe mood swings. Individuals with bipolar disorder II or
cyclothymia may be misdiagnosed as having depression alone.
Bipolar disorder affects men and women equally and
usually appears between the ages of 15 and 25. The precise
cause is unknown, but it occurs more often in relatives of
individuals with bipolar disorder.
Bipolar Disorder Symptoms & Signs
The manic phase may last from days to months and include
the following symptoms:
- Elevated mood
- Racing thoughts
- Hyperactivity
- Increased energy
- Lack of self-control
- Inflated self-esteem (delusions of grandeur, false
beliefs in special abilities)
- Over-involvement in activities
- Reckless behavior
- Spending sprees
- Binge eating, drinking, and/or drug use
- Sexual promiscuity
- Tendency to be easily distracted
- Little need for sleep
- Easily agitated or irritated
- Poor temper control
These symptoms of mania are seen with bipolar disorder I.
In people with bipolar disorder II, hypomanic episodes
involve similar symptoms that are less intense.
The depressed phase of both types of bipolar disorder
involves very serious symptoms of major depression:
- Persistent sadness
- Fatigue or listlessness
- Sleep disturbances
- Excessive sleepiness
- Inability to sleep
- Eating disturbances
- Loss of appetite and weight loss
- Overeating and weight gain
- Loss of self-esteem
- Feelings of worthlessness, hopelessness and/or guilt
- Difficulty concentrating, remembering, or making
decisions
- Withdrawal from friends
- Withdrawal from activities that were once enjoyed
- Persistent thoughts of death
There is a high risk of suicide with bipolar disorder.
While in either phase, patients may abuse alcohol or other
substances, which can worsen the symptoms.
Sometimes there is an overlap between the two phases.
Manic and depressive symptoms may occur simultaneously or in
quick succession in what is called a mixed state.
Bipolar Disorder Diagnosis & Tests
A diagnosis of bipolar disorder involves consideration of
many factors. The health care provider may do some or all of
the following:
- Observe your behavior and mood
- Obtain your medical history, including any medical
problems you have and any medications you take.
- Ask about your recent mood swings and how long
you've experienced them
- Ask about your family medical history, particularly
whether anyone has or had bipolar disorder
- Perform a physical examination to identify or rule
out physical causes for the symptoms
- Request laboratory tests to check for thyroid
problems or drug levels
- Speak with your family members to discuss their
observations about your behavior
Note: Use of recreational drugs may
be responsible for some symptoms, though this does not rule
out bipolar affective disorder. Drug abuse may itself be a
symptom of bipolar disorder.
Bipolar Disorder Treatment
Bipolar disorder is often treated with mood-stabilizing
medications such as valproic acid, lithium, and
carbamazepine. These are effective for treating both the
manic and depressive phases, as well as avoiding future
symptoms.
Antidepressant drugs may be useful throughout the
depressive phase IF the antidepressants are used with a mood
stabilizer. Mood stabilizers are significant in individuals
with bipolar disorder. Without a mood stabilizer,
antidepressants may trigger mania in individuals with
bipolar disorder. (Keep in mind that individuals with
bipolar disorder II may be misdiagnosed with depression only
because they do not experience full-fledged mania. If these
patients take antidepressants without mood stabilizers, it
can trigger a manic episode.)
Anti-psychotic drugs can help an individual who has lost
touch with reality. Anti-anxiety drugs, such as
benzodiazepines, may also help. The patient may need to stay
in a hospital until his or her mood has stabilized and
symptoms are under control.
Electroconvulsive therapy (ECT) may be used to treat
bipolar disorder. ECT is a psychiatric treatment that uses
an electrical current to cause a brief seizure of the
central nervous system while the individual is under
anesthesia. Studies have repeatedly found that ECT is the
most effective treatment for depression that is not relieved
with medications.
Getting enough sleep helps keep a stable mood in some
patients. Psychotherapy may be a helpful option during the
depressive phase. Joining a support group may be
exceptionally helpful for bipolar disorder individuals and
their loved ones.
Bipolar Disorder Prognosis (Expectations)
Mood-stabilizing medication can help control the symptoms
of bipolar disorder. However, patients often need help and
support to take medicine properly and to ensure that any
episodes of mania and depression are treated as early as
possible.
Some people stop taking the medication as soon as they
feel better or because they want to experience the
productivity and creativity associated with mania. Although
these early manic states may feel good, discontinuing
medication may have very negative consequences.
Suicide is a very real risk during both mania and
depression. Suicidal thoughts, ideas, and gestures in people
with bipolar affective disorder require immediate emergency
attention.
Bipolar Disorder Complications
Stopping or improperly taking medication can lead to
symptoms coming back and the following complications:
- Alcohol and/or drug abuse may be used as a strategy
to "self-medicate."
- Personal relationships, work, and finances may
suffer as a result of mood swings.
- Suicidal thoughts and behaviors are a very real
complication of bipolar disorder.
- This illness is challenging to treat. Patients and
their friends and family must be aware of the risks of
neglecting to treat bipolar disorder.
Bipolar Treatment
If you or someone you know would like to talk with one of
our trained staff to discuss treatment options for Bipolar
treatment please contact us 24 hours a day, 7 days a week at
our t oll free number: 1-866-874-9774. You will receive a
free consultation. |
