Bipolar disorder, or manic-depressive disorder, is a form of depression interrupted by at least one period of mania. Most individuals with bipolar disorder alternate between periods of deep depression and severe mania. Both phases can be equally disabling and can interfere with the individual's ability to perform optimally in school, at work or at home. In some individuals, the manic phases inspire high levels of productivity, but the ability to make rational decisions during these periods is normally severely impaired.
Symptoms
According to "Selecting Effective Treatments: A Comprehensive, Systematic Guide to Treating Mental Disorders," the main symptoms during depressed phases in bipolar disorder are a low level of energy, an increased need for sleep, a lack of motivation and creativity, a feeling of worthlessness and a lack of interest in continuing to live. During manic episodes, the symptoms can be the exact opposite. Some individuals experience heightened energy levels, little need for sleep, extreme motivation, grandiosity, hyper-sexuality, obsession, goal-directed activity and creativity. For others, the manic episodes give rise to negative feelings such as irritability and anger.
Misconceptions
Those not familiar with bipolar disorder may think that it would be a gift to have frequent manic episodes with the accompanying increased energy levels, elevated mood and creative impulses. However, as pointed out in "New Hope for Children and Teens with Bipolar Disorder," manic patients rarely enjoy their manic episodes. Even those who are euphoric during a manic episode are often driven to make bad impulsive decisions that they later regret. Creativity also tends to decline at later stages of the disease, where getting easily distracted becomes a more dominant symptom.
Types
As outlined in "New Hope For People With Bipolar Disorder," there are at least four different forms of bipolar disorder: bipolar I, bipolar II, cyclothymic disorder and mixed bipolar disorder. The first three have similar patterns of mood swings but vary in intensity, with the most intense mood changes occurring in bipolar I. In mixed bipolar disorder, mania and depression occur simultaneously. This is usually considered the most dangerous form of bipolar, because during these episodes the individual has lost their desire to go on living, while also having the motivation to do something about it.
Misdiagnosis
Approximate 56 percent of patients diagnosed with bipolar disorder are misdiagnosed, according to a study published in the July 2009 issue of "The Journal of Clinical Psychiatry." The researchers found that 40 percent of patients misdiagnosed with bipolar disorder suffered from borderline personality disorder. The remaining misdiagnosed patients suffered from a variety of different conditions, including major depression, ADHD, post-traumatic stress disorder and other anxiety disorders. Mania and anxiety are easily distinguishable neurobiologically. In mania, the levels of serotonin, dopamine and the stress hormone norepinephrine are increased. Anxiety disorders also give rise to surges of stress hormones. But in anxiety disorders, serotonin levels are significantly lower than normal.
Interference with Work
According to a longitudinal study published in the December 2005 issue of "Archives of General Psychiatry," both manic and depressive episodes can interfere with an individual's ability to work. Manic episodes can lead to bad impulsive decision-making and anger outbursts, and depressive episodes can lead to a complete lack of motivation. Some bipolar patients in the early stages of the disease rely on their manic episodes for their work. Artists, writers and other people in creative lines of work diagnosed with bipolar disorder often cannot work at all, except during their manic episodes. But the heightened levels of creativity rarely extend into the later stages of the disease.
References
- "Selecting Effective Treatments: A Comprehensive, Systematic Guide to Treating Mental Disorders"; Linda Seligman and Lourie W. Reichenberg; 2007
- "New Hope for Children and Teens with Bipolar Disorder"; Boris Birmaher; 2010
- "New Hope For People With Bipolar Disorder"; Jan Fawcett, et al.; 2010
- "The Journal of Clinical Psychiatry"; Psychiatric Diagnoses in Patients Previously Overdiagnosed With Bipolar Disorder; Mark Zimmerman, et al.; July 2009
- "Archives of General Psychiatry"; Psychosocial Disability in the Course of Bipolar I and II Disorders: A Prospective, Comparative, Longitudinal Study; L. L. Judd, et al.; December 2005
