Bipolar Disorder

Text 1 by : John M.Grohol, Psy.D.

What is Bipolar Disorder?

Bipolar disorder, also known in some parts of the world by its older name of “manic depression,” is a mental disorder that is characterized by serious and significant mood swings. A person with this condition experiences alternating “highs” (what clinicians call “mania“) and “lows” (also known as depression).

Both the manic and depressive periods can be brief, from just a few hours to a few days. Or the cycles can be much longer, lasting up to several weeks or even months. The periods of mania and depression vary from person to person — many people may only experience very brief periods of these intense moods, and may not even be aware that they have the disorder.

A depressive episode is characterized by extreme sadness, a lack of energy or interest in things, an inability to enjoy normally pleasurable activities and feelings of helplessness and hopelessness. On average, someone with this condition may have up to three years of normal mood between episodes of mania or depression.A manic episode is characterized by extreme happiness, extreme irritability, hyperactivity, little need for sleep and/or racing thoughts, which may lead to rapid speech. People in a manic episode feel like they can do anything, make plans to try and do all those things, and believe that nothing can stop them.

How is Bipolar Disorder Treated?

According to researchers at the National Institute of Mental Health (NIMH), the exact cause of bipolar disorder is not yet known — but it can still be effectively treated.

Like most mental disorders, this condition is readily treated with psychotherapy combined with psychiatric medications (most people benefit more quickly from combined treatment). Treatment for this condition is effective and helps most people keep a balanced mood throughout their day, most days of the month. One of the biggest challenges of treatment is helping a person find and keep a treatment routine that works best for them over the long-term. Most people with this condition benefit from medications for much of their life, but it can be a challenge to stick with the medications
when all seems well years down the road.

Text 2 by :Steve Bressert, Ph.D.

Bipolar disorder (“manic depression”) is a mental disorder that is characterized by constantly changing moods between depression and mania. The mood swings are significant, and the experiences of the highs of mania and the lows of depression are usually extreme. The new mood can last anywhere from a few days to a few weeks, or even months (see the Bipolar Cycling section below). The mood swings are usually experienced intensely by a person with this condition.

A manic episode is characterized by extreme happiness, hyperactivity, little need for sleep and racing thoughts, which may lead to rapid speech. A depressive episode is characterized by extreme sadness, a lack of energy or interest in things, an inability to enjoy normally pleasurable activities and feelings of helplessness and hopelessness. On average, someone with bipolar disorder may have up to three years of normal mood between episodes of mania or depression.

Bipolar disorder is recurrent, meaning that more than 90 percent of the individuals who have a single manic episode will go on to experience future episodes. Roughly 70 percent of manic episodes in bipolar disorder occur immediately before or after a depressive episode. Treatment seeks to reduce the feelings of mania and depression associated with the disorder and restore balance to the person’s mood.

Those with bipolar disorder often describe their experience as being on an emotional roller coaster. Cycling up and down between strong emotions can keep a person from having a “normal” life. The emotions, thoughts and behavior of a person with bipolar disorder are often experienced as beyond one’s control. Friends, co-workers and family may sometimes intervene to try and help protect their interests and health. This makes the condition exhausting not only for the sufferer, but for those in contact with her or him as well.

Bipolar cycling can either be rapid or slow over time. Those who experience rapid cycling can go between depression and mania as often as a few times a week (some even cycle within the same day). Most people with bipolar disorder are of the slow cycling type — they experience long periods of being up (“high” or manic phase) and of being down (“low” or depressive phase). Researchers do not yet understand why some people cycle more quickly than others.

Living with bipolar disorder can be challenging in maintaining a regular lifestyle. Manic episodes can lead to family conflict or financial problems, especially when the person with bipolar disorder appears to behave erratically and irresponsibly without reason. During the manic phase, people often become impulsive and act aggressively. This can result in high-risk behavior, such as repeated intoxication, extravagant spending and risky sexual behavior.

During severe manic or depressed episodes, some people with bipolar disorder may have symptoms that overwhelm their ability to deal with everyday life, and even reality. This inability to distinguish reality from unreality results in psychotic symptoms such as hearing voices, paranoia, visual hallucinations, and false beliefs of special powers or identity. They may have distressing periods of great sadness alternating with euphoric optimism (a “natural high”) and/or rage that is not typical of the person during periods of wellness. These abrupt shifts of mood interfere with reason, logic and perception to such a drastic degree that those affected may be unaware of the need for help. However, if left untreated, bipolar disorder can seriously affect nearly every aspect of a person’s life.

Identifying the first episode of mania or depression and receiving early treatment is essential to managing bipolar disorder. In most cases, a depressive episode occurs before a manic episode, and many patients are treated initially as if they have major depression. Usually, the first recognized episode of bipolar disorder is a manic episode. Once a manic episode occurs, it becomes clearer that the person is suffering from an illness characterized by alternating moods. Because of this difficulty with diagnosis, family history of similar illness or episodes is particularly important. People who first seek treatment as a result of a depressed episode may continue to be treated as someone with unipolar depression until a manic episode develops. Ironically, treating depressed bipolar patients with antidepressants can trigger a manic episode in some patients.