Bipolar Disorder

By Charles Hopkins Published 05/25/2007 | Health

Bipolar disorder is a serious mental illness also known as manic-depressive illness. It is characterized by extreme moods swings in the sufferer, far more extreme than the ups and downs in mood experienced by the general population.

Moods can range from severe depression all the way up to feelings of extreme elation, called mania. Between these extreme moods patients may experience a whole spectrum of moods ranging from depression, mild depression (also called dysthymia), periods of normal mood, a mild form of mania called hypomania and full-blown mania.

During episodes of mania the patient may experience extreme highs with increased energy. Other symptoms of this phase may include:

-Hyperactivity - Jumping from one activity or idea to another.
-Recklessness or aggression.
-Increased libido.
-Impaired judgment.
-Restlessness, irritability and difficulty concentrating.
-Ability to manage with little or no sleep.
-Substance abuse.
-Exaggerated expectations of one's abilities.

Periods of depression are characterized by symptoms such as:

-Extreme sadness, feelings of hopelessness and helplessness.
-Deriving little or no pleasure from activities.
-Sleeping excessively or inability to sleep.
-Diminished sexual desire.
-Unexplained changes in appetite and behavior.
-Suicidal thoughts.
-Low energy levels.
-Poor concentration and memory.
-Aches and pains, which have no physical explanation.

Extreme episodes of mania or depression may be accompanied by psychotic symptoms such as hallucinations and delusions. During manic episodes delusions of grandeur may be experienced while in the depressive phase patients may hold deluded beliefs that some horrible catastrophe has befallen them.

Unfortunately, there is no physiological test such as a blood test to diagnose bipolar disorder. However, recent studies in brain imaging have shown that the brains of manic-depressives may have physical differences. Given the many and varied symptoms, diagnosis of bipolar disorder is not always easy and is often confused with other mental illnesses such as schizophrenia, depression or attention deficit hyperactivity disorder.

Substance abuse, anxiety disorders and obsessive-compulsive disorders as well as thyroid problems also commonly occur in individuals who suffer from bipolar disorder.

In Type 1 Bipolar disorder patients experience episodes of both depression as well as mania at different times. In Type 2, depression may occur alternating with mild mania (hypomania) but never progresses beyond hypomania. Where depression and mania alternate rapidly it is called rapid-cycle bipolar disorder and such patients may experience many cycles within a week or even a day. Where elements of mania and depression co-exist it's called a mixed bipolar state. Type 1 is the classic form of bipolar disorder.

The exact cause of bipolar disorder is not known. However, the consensus of current research is that it has many rather than a single cause. Scientists believe it is partly genetic but is the result not of a single gene but the interaction of several genes. Studies of identical twins have shown that where one twin has the disorder the other identical twin has a significantly increased likelihood of developing the disorder, but it does not happen in a hundred percent of cases. This confirms that genes do play a part but other factors are at play too.

Treatment for bipolar disorder includes medication as well as psychosocial strategies such as behavioral and cognitive therapy.

Medications commonly used are mood stabilizers such as Lithium, anti-psychotics and anti-convulsives. An anti-depressant may be used to treat the depressive stage. However, it would not usually be used on its own without a mood stabilizer due to the risk of triggering a manic episode. Electro-convulsive Therapy too may be used where drug therapies are inappropriate such as in the case of pregnancy.

Psycho-social treatments aim to change negative thought patterns associated with the extreme mood swings. They also provide education on identifying depression and manic episodes. These strategies may be aimed at patients as well as their families.

Bipolar disorder is a long-term illness and lifelong support and medication may be required to control it. Many sufferers can lead healthy and fruitful lives as long as an appropriate treatment regime is followed. Those who do best are patients who are diagnosed early, receive suitable treatment and have the support of family or community.