A serious mental illness, also known as manic-depressive disorder, characterized by severe changes in mood, energy, activity and ability to perform everyday tasks, varying from manic episodes to depressive ones. Symptoms are usually severe in nature and are different from the normal fluctuations in one’s emotional state. It results in severely altering one’s quality of life, affecting relationship patterns, the ability to keep a job or perform well in school, while in extreme forms, patients experience recurring suicidal thoughts and tendencies.

 

There are four types of bipolarism – bipolar I disorder (at least one manic, recurring depressive episodes, possible trigger of psychosis), bipolar II disorder (at least one major depressive episode lasting for more than two weeks and at least one hypomanic episode lasting for about four days, but never had a manic episode), cyclothymic disorder (at least two years of numerous periods of hypomania symptoms and periods of depressive symptoms, and bipolar disorder not otherwise specified (BP-NOS), which is diagnosed when manifesting symptoms of the illness are severe enough to disrupt one’s daily life, but are not classifiable in neither type I nor type II

Causes

There are multiple risk factors contributing to the possible onset of the illness

 

Genetics seems to have a large role in determining one’s predisposition to developing the disease, in many cases bipolar disorder appearing to run in the family

 

Functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have also suggested that unusual brain mappings may also be responsible for causing bipolar disorder – it seems that the prefrontal-cortex in bipolar adults is smaller in size and functions less well; the prefrontal cortex is usually relegated the role of managing problems and making decision, this specific part of the brain maturing within adolescence, and so it may account for the reason why the disorder typically develops during a person’s teen years

 

An imbalance of naturally occurring brain chemicals (neurotransmitters) also plays a significant part in developing this particular disorder

Symptoms and signs

Patients suffering from this illness typically experience unusually intense emotional episodes that occur in distinct alternating periods called ‘mood episodes’

 

Each mood episode represents a departure from the person’s usual state of being, the overly joyful and active state being dubbed as the ‘manic episode’, while the extremely sad and mostly lethargic state being dubbed as the ‘depressive episode’

 

Mania:

Mood changes: a long period of feeling extremely happy and excited, intensely outgoing, paired with extreme irritability

 

Behavioral changes: inflated self-esteem or grandiosity, decreased need for sleep, unusual talkativeness, a feeling of thoughts racing through one’s mind, agitation, engaging in potentially harmful behavior, increased goal-activity, sleeping little or not being tired

 

Behaving impulsively and engaging in pleasurable, yet risky behavior

 

Depression:

Mood changes: overly long period of feeling excessively sad and hopeless, paired with a loss of interest in formerly enjoyed activities, including sex

 

Behavioral changes: feeling tired or ‘slowed down’, insomnia or excessive sleeping, significant weight loss in the absence of dieting, restlessness or alternatively slowed behavior, indecisiveness, loss of energy, decreased ability to think and concentrate

 

Recurring suicidal thoughts and actual attempts

Advice

Keeping a daily life chart to make notes on one’s daily symptoms, sleeping and eating patterns, and activities can be extremely helpful when formulating a therapeutic plan with the help of one’s doctor

 

Medications:

Mood stabilizers (usually the first choice of medications – Lithium)

 

Anticonvulsants as a popular alternative to Lithium – valproic acid, lamotrigine, topiramate and oxcarbazepine

 

Atypical antipsychotics – olanzapine, aripiprazole, quetiapine and others

 

Antidepressants, among which Zoloft and Prozac are the most popular ones

 

Unfortunately, many of these medications have a plethora of side effects

 

Psychotherapy:

Cognitive behavioral therapy

 

Family-focused therapy, involving family members to enhance coping strategies

 

Interpersonal and social rhythm therapy which is mainly used for aiding patients in regulating their daily routines

 

Psychoeducation for helping patients recognizing early signs of impending episodes

 

Electroconvulsive therapy

 

Sleep medications

 

Herbal supplements

MISCONCEPTIONS
  • That being bipolar is not a ‘real illness’

     

    That all subsequent mood changes are attributable to the disorder

     

    That symptoms necessarily appear exuberant and uncontrollable to outsiders

Statistics

Bipolar disorder usually develops in a person’s late teen or early adult years, at least half the cases developing before the age of 25

 

According to the World Health Organization, bipolar disorder is the sixth leading cause of disability in the world

 

According to NIMH bipolar disorder affects approximately 5.7 million American adults or approximately 2.6% of the U.S. population aged 18 or older

 

More than two-thirds of patients have reported having at least one close relative suffering from either the illness or unipolar major depression

 

According to the Surgeon General Report for Mental Health, success rates of 70 to 85% were once expected with lithium for the acute phase treatment of mania, however, lithium response rates of only 40 to 50% are now commonplace

 

According to the Depression and Bipolar Support Alliance (2000), there exists a gender bias in the diagnosis of bipolar disorder: women are far more likely to be misdiagnosed with depression and men are far more likely to be misdiagnosed with schizophrenia

 

According to the DBSA (1999), 9 out of 10 people with bipolar disorder are satisfied with their treatment, though side effects remain a problem

Did you know?

A severe form of the illness is called Rapid-cycling Bipolar Disorder and it occurs when one experiences at least four major depression episodes, mania, hypomania, or mixed states all within the course of just one year, studies having found that it seems to occur in people who have had their first episode during mid-teen years, it is more prevalent in women than men and it may ‘come and go’

 

For an effective diagnosis, signs of both manic and depressive episodes must be severe enough to cause a noticeable change in daily activities, work, and relationship management

 

Scientists are now stating that most children born from bipolar parents will not develop the illness

 

Famous personalities diagnosed (or believed to have been suffering from) bipolar disorder count: Ernest Hemmingway, Edvard Munch, Friedrich Nietzsche, Virginia Woolf,  Marilyn Monroe, Kurt Cobain, Amy Winehouse, Sinead O’Connor, Robin Williams, Catherine Zeta-Jones, Stephen Fry, Jim Carrey