Bipolar Disorder
Also known as: Manic-depressive
disorder
What is it?
Bipolar disorder is a serious mental
illness marked by mood shifts and episodes of
depression and mania. The Diagnostic and
Statistical Manual of Mental Disorders lists four
separate categories of bipolar disorder: bipolar
I, bipolar II, cyclothymia, and bipolar
not-otherwise-specified (NOS).
Bipolar I is marked by manic episodes followed
by periods of depression that may not be severe.
In contrast, Bipolar II is marked by major
depressive episodes and hypomanic periods, or
milder episodes of mania. Cyclothymia is defined
as episodes of hypomania and depressive periods
that do not reach major depressive proportions.
Bipolar NOS means that the bipolar state does not
fit into the other categories.
Who gets it?
Both children and adults may develop bipolar
disorder but most commonly, the disorder develops
from adolescence through the early twenties.
Studies have shown that people who have family
members with emotional disorders may be more
susceptible to bipolar disorder. Many patients
with bipolar disorder have a history of substance
abuse. A possible biological cause is the presence
of calcium build-up in the cells of bipolar
patients. Bipolar disorder is just as prevalent
among women as men although their symptoms may
vary.
What causes it?
There is no clear cause of bipolar disorder. It
may be genetic, the result of substance abuse –
especially cocaine – or caused by the presence of
calcium build-up in the cells.
What are the symptoms?
An adult with bipolar disorder will have
unusual or extreme shifts in mood, energy and
behavior that could interfere significantly with
normal life.
Manic symptoms include: extreme irritability or
silliness, very high self-esteem, increased
energy, decreased need for sleep, talking quickly
and allowing no interruptions, hypersexuality,
increased goal-directed activity, risk-taking, and
distraction.
Depressive symptoms include: persistent sadness
or irritability, loss of interest, significant
change in appetite or body weight, difficulty
sleeping or excessive sleeping, loss of energy,
feelings of worthlessness or inappropriate guilt,
difficulty concentrating, suicidal thoughts.
Some bipolar patients’ episodes may coincide
with seasonal changes, having manic episodes in
spring and summer months and depressive episodes
in fall and winter.
Diagnosis
A psychiatrist or psychologist usually
diagnoses bipolar disorder. Interviews and tests
may be used and, because of the complexity of the
disorder, it may take several visits, and
sometimes months or years, to definitively
diagnose a patient with bipolar disorder.
Treatment
Bipolar disorder is treated with medications
including a combination of mood stabilizing
agents, anti-depressants, anti-psychotics and
anticonvulsants. An individualized combination of
the medications is determined in order to regulate
the patient’s manic and depressive episodes.
Psychotherapy and counseling may be used in
combination with medications.
Electroconvulsive therapy can be used as a
treatment for unipolar and bipolar depression and
mania. Because of the stigma attached to ECT, it
is often used after medication options are
explored. ECT is given under anesthesia and muscle
relaxants are used to prevent convulsions. The
exact reasons ECT works is unknown, but it seems
that the electrical currents sent to the brain
alter the electrochemical processes of the brain
and, consequently, relieve depression.
Whereas many patients respond to medications,
ECT and psychotherapy, a small number of those
suffering with bipolar disorder don’t respond to
any treatments. Generally, bipolar disorder
requires lifelong treatment.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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