Bipolar disorder, also known as manic depression, is an illness involving one or more episodes of serious mania and depression. The illness causes a person’s mood to swing from excessively “high” and/or irritable to sad and hopeless, with periods of a normal mood in between. More than 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.
Bipolar disorder can be extremely distressing and disruptive for those who have this disease, their spouses, family members, friends and employers. Although there is no known cure, bipolar disorder is treatable, and recovery is possible. Individuals with bipolar disorder have successful relationships and meaningful jobs. The combination of medications and psychotherapy helps the vast majority of people return to productive, fulfilling lives.
Although a specific genetic link to bipolar disorder has not been found, studies show that 80 to 90 percent of those who suffer from bipolar disorder have relatives with some form of depression.
It is also possible that people may inherit a tendency to develop the illness, which can then be triggered by environmental factors such as distressing life events.
The presence of bipolar disorder indicates a biochemical imbalance which alters a person’s moods. This imbalance is thought to be caused by irregular hormone production or to a problem with certain chemicals in the brain, called neurotransmitters that act as messengers to our nerve cells.
Bipolar disorder is often difficult to recognize and diagnose. It causes 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 a person, which may lead to denial that there is a problem.
Another reason bipolar disorder is difficult to diagnose is that its symptoms may appear to be part of another illness or attributed to other problems such as substance abuse, poor school performance, or trouble in the workplace.
Symptoms of mania
The symptoms of mania, which can last up to three months if untreated, include:
- Excessive energy, activity, restlessness, racing thoughts and rapid talking.
- Denial that anything is wrong.
- Extreme “high” or euphoric feelings—a person may feel “on top of the world” and nothing, including bad news or tragic events, can change this “happiness”.
- Easily irritated or distracted.
- Decreased need for sleep—an individual may last for days with little or no sleep without feeling tired.
- Unrealistic beliefs in one’s ability and powers—a person may experience feelings of exaggerated confidence or unwarranted optimism. This can lead to over ambitious work plans and the belief that nothing can stop him or her from accomplishing any task.
- Uncharacteristically poor judgment—a person may make poor decisions which may lead to unrealistic involvement in activities, meetings and deadlines, reckless driving, spending sprees and foolish business ventures.
- Sustained period of behavior that is different from usual —a person may dress and/or act differently than he or she usually does, become a collector of various items, become indifferent to personal grooming, become obsessed with writing, or experience delusions.
- Unusual sexual drive.
- Abuse of drugs, particularly cocaine, alcohol or sleeping medications.
Provocative, intrusive, or aggressive behavior—a person may become enraged or paranoid if his or her grand ideas are stopped or excessive social plans are refused.
Symptoms of Depression
Some people experience periods of normal mood and behavior following a manic phase, however, the depressive phase will eventually appear. Symptoms of depression include:
- Persistent sad, anxious, or empty mood.
- Sleeping too much or too little, middle-of-the-night or early morning waking.
- Reduced appetite and weight loss or increased appetite and weight gain.
- Loss of interest or pleasure in activities, including sex.
- Irritability or restlessness.
- Difficulty concentrating, remembering or making decisions.
- Fatigue or loss of energy.
- Persistent physical symptoms that don’t respond to treatment (such as chronic pain or digestive disorders).
- Thoughts of death or suicide, including suicide attempts.
- Feeling guilty, hopeless or worthless.
Treatment is critical for recovery. A combination of medication, professional help and support from family, friends and peers help individuals with bipolar disorder stabilize their emotions and behavior.
Most people with bipolar disorder can be treated with medication. A common medication, Lithium, is effective in controlling mania in 60% of individuals with bipolar disorder. Olanzapine (Zyprexa), an antipsychotic, is a new treatment for bipolar disorder, Carbomazepine (Tegratol) and divalproex sodium (Depakote), which are mood-stabilizers and anticonvulsants, are some of the other medications used. In addition, benzodiazepines are sometimes prescribed for insomnia and thyroid medication can also be helpful.
It is suggested that those with bipolar disorder receive guidance, education and support from a mental health professional to help deal with personal relationships, maintain a healthy self-image and ensure compliance with his or her treatment.
Support and self-help groups are also an invaluable resource for learning coping skills, feeling acceptance and avoiding social isolation. Friends and family may want to join a support group to better understand the illness so that they can continue to offer encouragement and support to their loves ones.
Download Do You Have a Mood Disorder?
Download the NIMH brochure on Bipolar Disorder.
Download the NIMH brochure on Bipolar Disorder in Children & Teens.
If you or someone you know is in immediate crisis , call 9-1-1.
National Suicide Prevention Lifeline
Call 1-800-273-TALK (8255) 24 hours a day to be connected to a skilled, trained counselor at a crisis center in your area. suicidepreventionlifeline.org
Depression and Bipolar Support Alliance (DBSA)
730 N. Franklin Street, Suite 501
Chicago, IL 60610
National Institute of Mental Health
National Foundation for Depressive Illness