PsychMD.info - Bipolar Disorder

Bipolar Disorder
(Manic-Depressive Illness)

What is Bipolar Disorder?

Bipolar Disorder, also known as manic-depressive illness, is a serious medical illness that causes shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe.

Signs and Symptoms:

Bipolar disorder causes 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. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.

Signs and symptoms of mania (or a manic episode) include:

increased energy, activity, and restlessness
excessively "high," overly good, euphoric mood
extreme irritability
racing thoughts and talking very fast, jumping from one idea to another
distractibility, can't concentrate well
little sleep needed
unrealistic beliefs in one's abilities and powers
poor judgment
spending sprees
a lasting period of behavior that is different from usual
increased sexual drive
abuse of drugs, particularly cocaine, alcohol, and sleeping medications
provocative, intrusive, or aggressive behavior
denial that anything is wrong

Signs and symptoms of depression (or a depressive episode) include:

lasting sad, anxious, or empty mood
feelings of hopelessness or pessimism
feelings of guilt, worthlessness, or helplessness
loss of interest or pleasure in activities once enjoyed, including sex
decreased energy, a feeling of fatigue or of being "slowed down"
difficulty concentrating, remembering, making decisions
restlessness or irritability
sleeping too much, or can't sleep
change in appetite and/or unintended weight loss or gain
chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
thoughts of death or suicide, or suicide attempts

How common is Bipolar Disorder?

About 1% of U.S. adults ages 18 to 54 (>2 million people) have Bipolar Disorder during the course of a given year.

Treatment (combination of psychotherapy, education, and medication(s) may be helpful):

cognitive-behavioral therapy (CBT): helps people with bipolar disorder learn to change inappropriate or negative thought patterns and behaviors associated with the illness.
psychoeducation: involves teaching people with bipolar disorder about the illness and its treatment, and how to recognize signs of relapse so that early intervention can be sought before a full-blown illness episode occurs. Psychoeducation also may be helpful for family members.
family therapy: uses strategies to reduce the level of distress within the family that may either contribute to or result from the ill person's symptoms.
interpersonal and social rhythm therapy: helps people with bipolar disorder both to improve interpersonal relationships and to regularize their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.
medications: some of the medications that have been used to treat Bipolar Disorder include:
- lithium (Lithobid)
- valproic acid (Depakote)
- carbamazepine (Tegretol)
- lamotrigine (Lamictal)
- gabapentin (Neurontin)
- topiramate (Topamax)
- clozapine (Clozaril)
- olanzapine (Zyprexa)
- risperidone (Risperdal)
- quetiapine (Seroquel)
- ziprasidone (Geodon)
- fluoxetine/olanzapine (Symbyax)

Before taking medication for Bipolar Disorder:

Ask your doctor to tell you about the effects and side effects of the medication he or she is prescribing.
Tell your doctor about any alternative therapies or over-the-counter medications you are using.
Ask your doctor when and how the medication will be stopped. Some medications cannot safely be discontinued abruptly; they have to be tapered slowly under a physician's supervision.
Be aware that some medications are effective only as long as they are taken regularly, and symptoms may occur again when the medications are discontinued.
Work together with your doctor to determine the right dosage of the right medication to treat Bipolar Disorder.

Reference: National Institute of Mental Health