Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and their ability to function. It is an illness that affects thoughts, feelings, perceptions and behavior and is distinguished from Major Depressive Disorder by the presence of manic or hypomanic episodes. It can cause dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Bipolar disorder is a chronic and generally life-long condition with recurring episodes of mania and depression that can last from several days to months that often begin in adolescence or early adulthood, and occasionally even in children. Most scientists now agree that there isn't a single cause for bipolar disorder rather, many factors act together to produce the illness.
It is classified according to symptom severity as Bipolar Disorder I, Bipolar Disorder II, and Cyclothymic Disorder. Bipolar Disorder Type I is usually characterized by at least one manic episode, with or without major depression. It involves episodes of severe mood swings,from mania to depression and is the classic manic-depressive form of the illness as well as the most severe type.
Bipolar II disorder is usually a milder form, involving milder episodes of hypomania that alternate with depression. Some people never develop severe mania but instead experience milder episodes of hypomania that alternate with depression.
When four or more episodes of illness occur within a 12-month period, a person has rapid-cycling bipolar disorder.
Bipolar disorder will typically develop in late adolescence or early adulthood. In children or teens it can be difficult to distinguish from other problems such as attention-deficit hyperactivity disorder (ADHD), conduct disorder, oppositional defiant disorder, and depression. It can also manifests in late life as well. Bipolar disorder may appear to be a problem other than mental illness - alcohol or drug abuse, poor school or work performance, or strained interpersonal relationships for instance.
Bipolar disorder affects more than one in forty American adults and affects men and women equally. Bipolar disorder often runs in families, and recent studies suggest a genetic component to the illness.
Different from the normal ups and downs that everyone can go through, the symptoms of bipolar disorder are severe. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives. Most people can achieve substantial stabilization of their mood swings and related symptoms with proper treatment. Between episodes, many people with are free of symptoms, but as much as one-third of people have some residual symptoms.
Treatment, in disabling bipolar disorder, is with mood stabilizers (classically, the lithium salts) that balance the manic and depressive states experienced by patients. Treatment and maintenance of this disorder is necessary throughout a person's life once bipolar disorder has been diagnosed. Treatments may include medication, talk therapy, and/or support groups.
The following medications may be used to treat bipolar disorder (many patients are treated with a combination of two or more of these medications):
Lithium A mood stabilizer, often used as initial treatment (helps prevent manic and depressive episodes from returning)
Valproate (Depakote), carbamazepine (Tegretol), lamotrigine, topiramate
Antiseizure medications, also used as mood stabilizers instead or in combination with lithium.
Benzodiazepines, clonazepam (Klonopin) or lorazepam (Ativan) Can be used to treat agitation or insomnia.
Zolpidem (Ambien) Used to treat insomnia.
Antidepressants Serotonin reuptake inhibitors or bupropion (Wellbutrin) can be used to treat depression.
Antipsychotic medications Uused for acute manic or mixed episodes and maintenance treatment.
Classic antipsychotic medications (eg, haloperidol (Haldol)) are not often used because of risks of tardive dyskinesia (uncontrollable movements).
Atypical antipsychotic medications (eg, risperidone, olanzapine, aripiprazole, zisprasidone, and quetiapine) are more effective with less risk of tardive dyskinesia Treatment may need to be continued for prolonged periods or indefinitely, depending on the pattern of the illness, to prevent significant mood swings.
Treatment of depression may also include support groups, talk therapy or other strategies that you and your health care provider may want to try. Treatment should not be postponed, however, because of the risk of suicide and school failure.
