Bipolar I disorder, or manic depression, is a type of mood disorder with alternating episodes of depression and mania. Bipolar I disorder causes impairment if not treated, and also can cause much distress for those with the condition and their loved ones.
Depression
One identifier of bipolar I disorder is having at least one depressive episode. According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), a depressive episode is marked by depressed mood or decreased interest in pleasurable activities. These indicators are accompanied by sleeping too little or too much, loss of energy, changes in weight or appetite, feeling hopeless or worthless, concentration difficulties, indecisiveness, feelings of guilt, feeling restless or slowed down, or having thoughts of suicide or death. Symptoms must last at least two weeks to be considered a depressive episode.
Mania
A manic episode includes feeling overexcited, elated, euphoric or irritable, according to the DSM. Other indicators might include the need for little sleep, having extravagant ideas, being hyperactive or easily distracted, talking a lot or very fast, and having racing thoughts. These symptoms occur only during a manic episode and are noticeable to others. To meet criteria for a manic episode, the symptoms must last at least a week or be so severe that hospitalization is needed.
Alternating Moods
Depressive episodes alternate with manic episodes in bipolar I disorder. For some, the cycling between episodes of depressive and manic moods is continuous, while others might experience a normal mood between depressive and manic episodes. Rapid cycling is when at least four depressive or manic episodes occur within a year, as defined by the DSM.
Rates
About 0.8 percent of adults--more than 2 million in the United States--have bipolar I disorder at some point in their lives, according to a study by Dr. Lewis Judd in the January 2003 issue of "The Journal of Affective Disorders." Dr. Judd also found that women and men have bipolar I disorder at the same rate.
Treatment
Medications are effective in alleviating the symptoms of bipolar I disorder in most people. Some of the primary medication categories for bipolar I disorder treatment include mood stabilizers such as lithium and Depakote, and atypical antipsychotics such as Zyprexa, Seroquel and Risperidal. Antidepressants such as Prozac and Zoloft are sometimes combined with mood stabilizers to treat bipolar I disorder. Psychotherapy helps the patient cope with fluctuating moods, prevent relapse and adhere to medication regimens.
References
- "Diagnostic and Statistical Manual of Mental Disorders (4th ed. Text Revision)"; American Psychiatric Association; 2002
- "Journal of Affective Disorders"; The Prevalence and Disability of Bipolar Spectrum Disorders in the US Population: Re-Analysis of the ECA Database Taking into Account Subthreashold Cases; Lewis Judd and Hagop Akiskal; January 2003
