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Understanding Bipolar Disorder

What is bipolar disorder?

Bipolar disorder, or manic depression, is a serious brain disorder that causes extreme shifts in mood, energy, and functioning.

It affects 2.3 million adult Americans, which is about 1.2 percent of the population, and can run in families.

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The disorder affects men and women equally. Bipolar disorder is characterized by episodes of mania and depression that can last from days to months.

Bipolar disorder is a chronic and generally lifelong condition with recurring episodes that often begin in adolescence or early adulthood, and occasionally even in children. It generally requires lifelong treatment, and recovery between episodes is often poor.

Generally, those who suffer from bipolar disorder have symptoms of both mania and depression (sometimes at the same time).

What are the symptoms of mania?

Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include:

-- either an elated, happy mood or an irritable, angry, unpleasant mood

-- increased activity or energy

-- more thoughts and faster thinking than normal

-- increased talking, more rapid speech than normal

-- ambitious, often grandiose, plans

-- poor judgment

-- increased sexual interest and activity

-- decreased sleep and decreased need for sleep

What are the symptoms of depression?

-- Depression is the other phase of bipolar disorder. The symptoms of depression may include:

-- depressed or apathetic mood

-- decreased activity and energy

-- restlessness and irritability

-- fewer thoughts than usual and slowed thinking

-- less talking and slowed speech

-- less interest or participation in, and less enjoyment of activities normally enjoyed

-- decreased sexual interest and activity

-- hopeless and helpless feelings

-- feelings of guilt and worthlessness

-- pessimistic outlook

-- thoughts of suicide

-- change in appetite (either eating more or eating less)

-- change in sleep patterns (either sleeping more or sleeping less)

What are the causes of bipolar disorder?

While the exact cause of bipolar disorder is not known, most researchers believe it is the result of a chemical imbalance in certain parts of the brain.

Other evidence suggests that the disorder results from impairments of the function of intracellular signaling pathways (the "machinery" inside nerve cells) within specific areas of the brain.

Scientists have found evidence of a genetic predisposition to the illness. An active area of research involves trying to understand what those genes are that lend susceptibility to developing the disorder.

Bipolar disorder tends to run in families, and close relatives of someone with bipolar disorder are more likely to be affected by the disorder.

Sometimes life events such as a serious loss, chronic illness, illicit or prescription drug use or financial problems, can trigger an episode in some individuals with a predisposition to the disorder.

There are other possible "triggers" of bipolar episodes: the treatment of depression with an antidepressant medication may trigger a switch into mania, sleep deprivation may trigger mania, or hypothyroidism may produce depression or mood instability.

It is important to note that bipolar episodes can and often do occur without any obvious trigger.

How is bipolar disorder treated?

While there is no cure for bipolar disorder, it is a treatable and manageable illness.

After an accurate diagnosis, most people can be successfully treated.

Medication is an essential part of successful treatment for people with bipolar disorder. Maintenance treatment with a mood stabilizer substantially reduces the number and severity of episodes for most people, although episodes of mania or depression may occur and require a specific additional treatment.

In addition, psychosocial therapies, including cognitive-behavioral therapy, interpersonal therapy, family therapy, and psycho-education are important to help people understand the illness and to develop skills to cope with the stresses that can trigger episodes.

Changes in medications or doses may be necessary, as well as changes in treatment plans during different stages of the illness.

For more information on bipolar and other forms of mental disorders, contact the National Alliance on Mental Illness helpline at 1-800-950-NAMI (6264) or visit www.nami.org.

Information courtesy of the National Alliance on Mental Illness.