Bipolar disorder, also called manic-depression, is a type of mental illness involving intense fluctuations in mood. Manic-depressives experience highs and lows to the extreme and are unable to control the severity, frequency, duration or stability of these emotions. Periods of mania and depression can last weeks and cause marked impairment in social and occupational functioning.
Bipolar I Disorder
The criteria for bipolar I disorder includes the presence of one or more manic or mixed episode for a period of at least one week. A manic episode is characterized by an abnormally elevated or irritable mood accompanied by an increased involvement in pleasurable activities, increased self-esteem, racing thoughts and a decreased need for sleep. A mixed episode is a period of time during which the criteria for both a manic episode and a major depressive episode are met. A major depressive episode includes a depressed mood and loss of interest as well as fatigue, cognitive difficulties and changes in sleeping and eating.
Bipolar II Disorder
Bipolar II disorder is diagnosed when one or more major depressive episodes, as described above, as well as one or more hypomanic episode are present. Hypomanic episodes have the same symptoms as the manic episodes in bipolar I disorder. The only difference between manic and hypomanic episodes is the duration. Whereas manic episodes must last a minimum of a week, hypomanic episodes need last only four days to meet the criteria for bipolar II disorder.
Genetics
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), bipolar disorder has a strong genetic component. In fact, the DSM-IV states that first-degree biological relatives of an individual with bipolar I disorder have a 4 percent to 24 percent chance of suffering from bipolar I or major depressive disorder. Their chance of having bipolar II disorder is 1 percent to 5 percent. Individuals with a first-degree biological relative with bipolar II disorder are at an increased risk for bipolar I, bipolar II and major depressive disorder.
Suicide
According to Suicide.org, an estimated 25 percent to 50 percent of people with a bipolar disorder diagnosis attempt suicide. The DSM-IV-TR states that approximately 10 percent to 15 percent of those with bipolar I and bipolar II disorders commit suicide. However, the University of Maryland Medical Center suggests that bipolar II disorder may put individuals at a greater risk for suicide than those with either bipolar I disorder or manic depressive disorder. This may be because suicidal thoughts and attempts are more likely to occur during a depressive or mixed episode.
Medications
According to the National Institute of Mental Health, mood stabilizers, atypical antipsychotic medications and anti-depressants are the three types of medication prescribed to treat bipolar disorder. Mood stabilizers, such as lithium and divalproex sodium, which are both approved by the Food and Drug Administration to treat mania, are most commonly prescribed for the treatment of bipolar disorder. Atypical antipsychotic medications such as ziprasidone HCl, risperidone and olanzapine are usually taken with other medications as they do not treat all of the symptoms of bipolar disorder. Anti-depressants, such as sertraline, paroxetine, fluoxetine and bupropion may be prescribed along with a mood stabilizer to treat depressive symptoms of bipolar disorder.
References
- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR); American Psychiatric Association; 2000
- National Institue of Mental Health: How Bipolar Disorder is Treated
- Suicide.org: Untreated Bipolar Disorder Can Cause Suicide
