Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, is a mental illness characterized by alternating episodes of serious mania and depression with periods of normal mood in between. The illness affects more than two percent of the general population, men and women equally, over a lifetime. Unfortunately, due to stigma surrounding the disorder, misdiagnosis, and the tendency of those with manic-depression to deny that anything is wrong, only a fraction of these people ever receive treatment. The onset is nearly always in adolescence or early adulthood. Although vigorous research efforts have not uncovered a specific genetic defect associated with bipolar disorder, it tends to run in families and is thought to be inherited in many cases. In fact, 80 to 90 percent of affected individuals have a relative with either depression or bipolar disorder.

The manic mood associated with manic depression can be a pleasurable, euphoric and productive state, but can involve potentially dangerous lapses of judgment, impulsive and potentially ruinous behavior and, in the most severe forms, can involve extreme agitation and loss of reason. Manic symptoms include: feeling on top of the world; grandiose delusions in which individuals believe they have special connections with God, celebrities, or political leaders; hyperactivity; invincibility; excessively risky behavior, including reckless driving, outlandish spending sprees, or out-of-character sexual behavior; uncontrollable racing thoughts and rapid speech; less need for sleep; and sudden irritability or rage, particularly when grandiose plans are thwarted. Sliding down from the high-energy mania into the depths of depression is frightening and dreaded. All of the grandiose and energized moods give way to intense sadness, lack of interest in previously enjoyed activities, fatigue, and thoughts of death or suicide.

Various medications are effective in the treatment of bipolar disorder, but there are many other options for managing and coping with this illness. In addition to psychotherapy and or support groups, people who have manic depression have found these strategies to be helpful:

• Learn as much as possible about bipolar disorder through books, support groups, other mental health consumers, and conferences. Over time, the individual who becomes more familiar with his/her illness learns to recognize his/her own patterns of abnormal behavior and can seek appropriate and timely care.
  
  
• Identify and reduce sources of stress. Stressful events can trigger episodes of illness and sustain them.
  
  
• Balance times of activity and stimulation with quiet, low-key times.

• Develop a network of trusted friends with whom one can talk honestly, including others with the disorder.
  
  
• Eat a healthy, well-balanced diet at regular intervals, minimizing junk food, caffeine, tobacco, and particularly alcohol. There is a high incidence of alcohol and other substance abuse in people with manic-depressive illness. This may represent an ill-advised form of self-medication or be part of the social expansiveness associated with a manic episode. Whatever the cause, the use of alcohol or other drugs can worsen the symptoms of mania and depression, make it more difficult to diagnose the illness, and have unhealthy interactions with the medicines used to treat bipolar disorder.
  
  
• Exercise regularly for its many psychological and physical benefits.
  
  
• Learn to recognize warning signs that symptoms of mania or depression are developing and take prompt, appropriate action. Call your physician if symptoms become distressing, if it becomes impossible to sleep, or if emotions get out of control.

Medications form the core of treatment for the disorder; without them, the likelihood of treatment success is slim. However, a comprehensive treatment program would be incomplete without psychotherapy and support. Because bipolar disorder is treatable, many people are able to return to more normal, satisfying, and productive lives.