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Bipolar disorder, formerly known as manic depression, is a mental health disorder characterized by significant mood swings between "mania" and "depression." These are not the sort of mood swings that everyone experiences from time to time, but severe, disruptive changes that interfere with daily life and functioning. The National Institute of Mental Health reports that the lifetime incidence of bipolar among American adults is 3.9 percent, and that the average age at diagnosis is about 25 years.
Cause
As with other mental illnesses, a specific cause has not been pinpointed. Bipolar disorder does, however, run in families, suggesting a strong genetic basis. Although anyone can inherit a predisposition to bipolar disorder, not everyone will develop it. Certain events seem to be potential triggers of the disease, including recreational drug use; periods of sleeplessness; major stressful life changes -- particularly childbirth, with its many hormonal changes and sleep disruptions; and the use of certain prescription drugs, such as steroids.
Symptoms
Mania is characterized by euphoria, increased energy, restlessness, insomnia, reckless behavior and rapid speech. From a health-care perspective, the biggest problem with mania is that the person with mania feels wonderful and is often reluctant to seek medical attention. Meanwhile, people with mania often engage in behaviors than can harm themselves or their families, such as spending sprees, gambling sprees, indiscriminate sexual behavior, or binge drinking. Depending on the severity of the illness, people with mania might even have delusions, such as believing that they are invincible or famous, or trouble communicating, with speech that wanders from topic to topic such that others have trouble understanding them.
Some of the symptoms of depression include a sad or blue mood, crying spells, hopelessness, decreased motivation and decreased attention span. In severe cases, the person in the depressive phase might have delusions that he is evil or unworthy of being alive.
People in both phases, manic and depressive, are at risk for suicide.
Treatment
Treatment of bipolar disorder is usually managed by a psychiatrist, because prescription medication is necessary for these patients. Common drugs prescribed for the condition include the mood stabilizers lithium, carbamazepine and valproic acid. If these don't work, sometimes a doctor will try antipsychotic drugs as well. Regular antidepressants are often not indicated, even in the depressive phase, because they are often associated with triggering a manic state.
Psychotherapy is also an integral part of treatment for many patients. Living with a chronic and often disruptive disease can pose a lot of practical and emotional challenges. Often people with bipolar need assistance maintaining good relationships with family, friends and coworkers. They may also need help for substance abuse, and they may need practical help with such tasks as finding and keeping a job.
Sometimes during a severe manic or depressive phase, hospitalization is required until the patient's mood and behavior can be stabilized.
Prognosis
Most people with bipolar disorder will struggle with it off and on their whole lives -- there is no "cure." However, some people have frequent strong fluctuations in mood, whereas others have milder or less frequent fluctuations. According to The University of Maryland Medical Center, a person with bipolar disorder will experience an average of eight to ten manic or depressive episodes in her lifetime, and in general, depressive episodes are more common than manic episodes. As with most health problems, early diagnosis and treatment are beneficial.
