Depression Bipolar Disorder Bipolar disorder, also known as manic depression, is a mental illness involving episodes of serious mania and depression. The person’s mood swings from excessively "high" and irritable to sad and hopeless and then back again, with periods of the person’s normal mood in between. At least 2 million Americans suffer from bipolar disorder. Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as an illness and people who have it may suffer needlessly for years or even decades. Bipolar illness has been diagnosed in children under age 12, although it is not common in this age bracket. It can be confused with attention-deficit /hyperactivity disorder, so careful diagnosis is necessary. For those afflicted with the illness, it is extremely distressing and disruptive. Like other serious illnesses, bipolar disorder is also hard on spouses, family members, friends and employers. Family members of people with bipolar disorder often have to cope with serious behavioral problems (such as wild spending sprees) and the lasting consequences of these behaviors. Though bipolar disorder can become disabling, it is also one of the most treatable mental illnesses. The combination of medications and psychotherapy helps a vast majority of people with this illness return to happy, fulfilling lives. What Causes Bipolar Disorder? Although a specific genetic link to bipolar disorder has not been determined, studies show that 80 to 90 percent of people who suffer from this illness have relatives who have some form of depression. It is also possible that people may inherit a vulnerability to the illness, which may then be triggered by environmental factors. Other research suggests the illness may be caused by a biochemical imbalance which alters a person’s moods. This imbalance may be due to irregular hormone production or to a problem with certain neurotransmitters. What Are The Symptoms Of Bipolar Disorder? Bipolar disorder is often difficult to recognize and diagnose. One reason is because of hypomania, which is an early sign of manic depression. Hypomania may cause a person to have a high level of energy, unrealistically expansive thoughts or ideas and impulsive or reckless behavior. These symptoms may feel good to the person, which may lead to denial that there is a problem. Another reason for the lack of recognition may be that bipolar disorder may appear to be symptoms of other illnesses or may occur with other problems such as substance abuse, poor school performance, or trouble in the workplace. Symptoms of mania: Increased energy, activity, restlessness, racing thoughts and rapid talking Denial that anything is wrong Excessive "high" or euphoric feelings Extreme irritability and distractibility Decreased need for sleep Unrealistic beliefs in one’s ability and powers Uncharacteristically poor judgment A sustained period of behavior that is different from the person’s usual behavior Increased sexual drive Abuse of drugs, particularly cocaine, alcohol and sleeping medications Provocative, intrusive, or aggressive behavior Symptoms of Depression: Persistent sad, anxious, or empty moods Feelings of hopelessness or pessimism Feelings of guilt, worthlessness, or helplessness Loss of interest or pleasure in ordinary activities, including sex Decreased energy, a feeling of fatigue or of being "slowed down" Difficulty concentrating, remembering, or making decisions Restlessness or irritability Sleep disturbances Loss of appetite and weight, or weight gain Chronic pain or other persistent bodily symptoms that are not caused by physical disease Thoughts of death or suicide; including suicide attempts Treatment Anyone suffering from bipolar disorder should be under psychiatric care; however, he or she may need help and encouragement from friends and family in recognizing the problem and seeking help. If the person is in the midst of an episode, he or she may refuse to get help. In this situation, it may be necessary to have the person hospitalized for his or her own protection in order to receive much needed treatment, particularly if the person is considering suicide. Most people with bipolar disorder can be helped with medication. Lithium, which is effective in controlling mania; and carbamazepine and valproate, which are mood-stabilizers and anticonvulsants, are some of the medications which are used. In addition, benzodiazepines are sometimes prescribed for insomnia and thyroid medication may also be helpful. It is often suggested that people with bipolar disorder also receive guidance, education and support from a psychotherapist. A therapist can help the person to deal with personal relationships, maintain a healthy self-image and ensure that the person complies with his or her treatment. Psychotherapy can also assist the person in coping with the side-effects of the medications. Ongoing encouragement and support from friends and family are also very important. It may be helpful to join a self-help or support group to help those coping with this illness. This publication is supported by an educational grant from the William H. Donner Foundation. This brochure was reviewed by Dr. James Maddox, professor of Psychiatry at the George Mason University, Alexandria, VA. Copyright 1997. Return