Bipolar Disorder

Abstract

Bipolar Disorder is a mental illness in which a person's mood alternates between extreme mania and depression. Bipolar disorder is also called manic-depressive illness. In a related disorder called cyclothymic disorder (sometimes called Bipolar III), a person's mood alternates between mild depression and mild mania. Some people with cyclothymic disorder later develop full-blown bipolar disorder. Rates of bipolar disorder are similar throughout the world. At least fifteen percent of people with bipolar disorder commit suicide. Bipolar disorder is much less common than depression. Many people with bipolar disorder function normally between episodes. Medications known as "mood stabilizers" are usually prescribed by psychiatrists to help control bipolar disorder. In general, people with bipolar disorder continue treatment with mood stabilizers for extended periods of time. One of the most important thing family and friends can do for a person with bipolar disorder is learn about the illness. Never ignore remarks about suicide. It is important to note that most people with bipolar disorderÐ'--even those with the most severe forms can achieve substantial stabilization of their mood swings and related symptoms with proper treatment.

Bipolar Disorder is a mental illness in which a person's mood alternates between extreme mania and depression. Bipolar disorder is also called manic-depressive illness. When manic, individuals with bipolar disorder feel intensely elated, self-important, energetic, and irritable. When depressed, these individuals experience painful sadness, negative thinking, and indifference to things that used to bring them happiness

Bipolar disorder is much less common than depression. In North America and Europe, about one percent of people experience bipolar disorder during their lives (J). Rates of bipolar disorder are similar throughout the world. In comparison, at least eight percent of people experience serious depression during their lives. Bipolar disorder affects men and women about equally and is somewhat more common in higher socioeconomic classes. At least fifteen percent of people with bipolar disorder commit suicide. This rate roughly equals the rate for people with major depression, the most severe form of depression (E).

Some research suggests that highly creative peopleÐ'--such as artists, composers, writers, and poetsÐ'--show unusually high rates of bipolar disorder, and that periods of mania fuel their creativity. Famous artists and writers who probably suffered from bipolar disorder include poets Lord Byron and Anne Sexton, novelists Virginia Woolf and Ernest Hemingway, composers Peter Ilyich Tchaikovsky and Sergey Rachmaninoff, and painters Amedeo Modigliani and Jackson Pollock. Critics of this research note that many creative people do not suffer from bipolar disorder, and that most people with bipolar disorder are not especially creative (E).

SYMPTOMS

Bipolar disorder usually begins in a person's late teens or twenties. Men usually experience mania as the first mood episode, whereas women typically experience depression first (E). Episodes of mania and depression usually last from several weeks to several months. On average, people with untreated bipolar disorder experience four episodes of mania or depression over any ten-year period. Many people with bipolar disorder function normally between episodes. In rapid-cycling bipolar disorder, however, which represents five to fifteen percent of all cases, a person experiences four or more mood episodes within a year and may have little or no normal functioning in between episodes (H). In rare cases, swings between mania and depression can occur over a period of days or hours. The term ultra-rapid cycling may be applied to those who cycle through episodes within a month or less. If this pattern is demonstrated within a twenty-four hour period, the person's diagnosis could possibly be phrased ultra-ultra-rapid cycling or ultradian. Ultradian cycling is often difficult to differentiate from a mixed state, when a person experiences aspects of both depression and mania or hypomania at the same time. Sometimes mania is prominent, sometimes depression (A).

Bipolar I can have some very frightening characteristics of psychosis (loss of contact with reality). These may include: hallucinations (hearing or seeing things that are not there), delusions (persistent beliefs in things that are not true), and paranoia (believing that a person or group is actively working to harm you, without any basis in fact). These psychotic features are also characteristic of schizophrenia, a mental illness where the patient is out of touch with reality, but without mood swings. Bridging the space between bipolar disorder and schizophrenia is schizoaffective disorder. What distinguishes schizoaffective disorder from Bipolar I with psychotic features is that sometimes (for at least two weeks) the patient has only psychotic symptoms, without mania or depression (A).

In another type of bipolar disorder (Bipolar II), a person experiences major depression and hypomanic episodes, or episodes of milder mania. In a related disorder called cyclothymic disorder (sometimes called Bipolar III), a person's mood alternates between mild depression and mild mania. Some people with cyclothymic disorder later develop full-blown bipolar disorder. Bipolar disorder may also follow a seasonal pattern (Seasonal Affective Disorder), with a person typically experiencing depression in the fall and winter and mania in the spring or summer (A).

People in the depressive phase of bipolar disorder feel intensely sad or profoundly indifferent to work, activities, and people that once brought them pleasure. They think slowly, concentrate poorly, feel tired, and experience changesÐ'--usually an increaseÐ'--in their appetite and sleep. They often feel a sense of worthlessness or helplessness. In addition, they may feel pessimistic or hopeless about the future and may think about or attempt suicide.

In the manic phase of bipolar disorder, people feel intensely and inappropriately happy, self-important, and irritable. In this highly energized state they sleep less, have racing thoughts, and talk in rapid-fire speech that goes off in many directions. They have inflated self-esteem and confidence and may even have delusions of grandeur. Mania may make people impatient and abrasive, and when frustrated, physically abusive. They often behave in socially inappropriate ways, think irrationally, and show impaired judgment. For example, they may take airplane trips all over the country,