Healthinmind/Mental Health Disorders/Mood Disorders

Bipolar Disorder (also know as Manic/Depressive Disorder)

Bipolar disorder is a combination of depression and manic or hypomanic episodes. Diagnosis of Bipolar I is given when the depression is mixed with manic episodes, Bipolar II when the depression is mixed with hypomanic episodes.

About 1.2% of the population (2.2 million adults) is affected by bipolar disorder. It usually begins in adolescence or early adulthood.

If someone you know and love is having a manic episode,  you probably can recognize it because the person "feels" different to you and you are feeling uncomfortable with his/her behavior. People who do not know the person well may find him/her especially energetic or fun to be with, at least initially.

People with bipolar disorder cycle through manic or hypomanic episodes and  depressive episodes. Of course, for the person undergoing these changes, the manic episodes are much more enjoyable, even though they eventually have to face the consequences of their behavior (bills, financial trouble, relationship problems, etc.).

If you or a loved one suffers from these symptoms you should seek professional help immediately. There are medications that can help control the severity of the symptoms and avoid the dangerous "highs" or the terrible "lows."

Bipolar disorder is a serious illness that can be relatively well controlled with careful medical attention.

The following symptoms indicate a manic or hypomanic episode:

	inflated self-esteem or grandiosity, the person feels there is little he or she cannot accomplish
	less sleep; the person goes on and on without any apparent need to rest
	talks more and speech is more pressured (hurried)
	flight of ideas, that is, jumps from one subject to the next
	easily distractible, seems to be aware of every little thing that surrounds him or her
	increased energy, seems to be hyper
	seeks pleasure, with no regard for consequences (buys things he/she can't afford, increased and or indiscriminate sexual encounters, etc.)
	symptoms are not caused by substance abuse (such as cocaine) or a medical problem.

At least three of these must be present for at least 4 days (for hypomanic) or 1 week (for manic).

If the condition is so severe that it causes impairment in social or occupational functioning, it is a manic episode; if not, it is hypomanic.

Remember: the person having a manic episode does not have control over this behavior.

Treatment of Bipolar Disorder:

In order to control the symptoms of bipolar disorder, psychiatrists prescribe various types of medication:

Mood stabilizers: designed to improve symptoms during acute manic or hypomanic episodes. Most well known is Lithium, but there is also Valproate, and Carbamazepine. Since they are all different, if one doesn’t work, one of the others probably will.

Antianxiety medications: to help sleep or reduce physical or mental agitation. These may help people while they wait for the mood stabilizer to work.

Antipsychotic medication: to help with delusions or hallucinations, which some people may have during a severe manic episode.

Antidepressants: it is important that the psychiatrist know that the person is bipolar and not only depressed, since sometimes medication for depression can cause a manic episode for people with bipolar disorder, especially when given alone. 

Visit our medications page to learn more about psychiatric medications in general and important factors to consider when taking these medications.  That page will lead you to a more detailed description of  medications for bipolar disorder and to a table comparing the various  medications on the market.

Although Bipolar Disorder is a biochemical disorder, therapy and other treatments can help medication improve the individual's quality of life.

Psychotherapy:

For some individuals, the manic and/or depressive episodes are precipitated by life events or stressors. Also, manic episodes result in disruptions in the lives of the patient and those around him/her. For these and other reasons, psychotherapy can be an effective aid in the treatment of Bipolar Disorder. Through psychotherapy patients can:

	Learn to deal with life stressors more effectively and reduce the strain that may lead to a manic episode
	Learn to mend relationships strained by the illness
	Learn to deal with the consequences of having the illness

Health Behaviors:

A person’s own behavior may help determine how much an illness will incapacitate him/her. Some good habits to adopt are:

	Sleep well, have a regular sleep pattern
	Eat a healthy, well-balanced diet and get regular exercise
	Avoid the use of alcohol or other drugs
	Learn stress management techniques
	Spend time with people who love you and care about you

Read a sample case history of a manic episode.

Read a book on the subject:

Bipolar Disorder : A Guide for Patients and Families (Johns Hopkins Press Health Book) by Francis M. Mondimore, M.D.

An Unquiet Mind by Kay Redfield Jamison

Visit a web site of the National Institutes of Mental Health, which features extensive information on bipolar disorder. 

                                                                                                                                Last updated  12/19/03