Bipolar disorder, also known as manic depressive disorder, is one of the mental disorders listed in the category of mood disorders. Those with bipolar disorder experience episodes of mania which are characterized by high amounts of energy and elevated moods. They also experience depressive episodes which are characterized by low energy levels, anhedonia (an inability to experience pleasure), and a persistent sad or hopeless mood. There are also cases of mixed episode bipolar disorder in which both mania and depression are experienced at the same time.
Bipolar disorder is thought to affect over 5 million adults in the United States and it affects both sexes equally. The average age of onset of bipolar disorder is 21, but the disorder may begin at almost any age. There are two major types of bipolar disorder: Bipolar I Disorder and Bipolar II Disorder. Two other forms of Bipolar disorder that are not diagnosed as often are Cyclothymic Disorder and Bipolar Disorder Not Otherwise Specified. In Bipolar I Disorder, patients may experience more severe manic symptoms such as psychosis or hallucinations than those with Bipolar II.
The symptoms of both forms of bipolar disorder can be severe, and in most cases those who have bipolar disorder require treatment in order to be stabilized and functional. Treatment for bipolar disorder has shown to be effective at minimizing symptoms, and there are various forms of treatment used. Medications include mood stabilizing, anti-depressant, and anti-psychotic medications. Various forms of psychotherapy are also used including cognitive behavioral therapy, family-focused therapy, interpersonal and social rhythm therapy, and patient education about the illness.
Bipolar Disorder Symptoms
The symptoms of bipolar disorder vary between individuals greatly due to the complex nature of the illness. Between both major types of bipolar disorder there are differing symptoms, and between each patient there will also be variation. As mentioned previously, bipolar disorder consists of both manic and depressive symptoms. Manic symptoms can be dramatic and may include unpredictable mood swings, excessive happiness, excitement, irritability, a decreased need for sleep, increased sex drive, racing thoughts, and delusions of grandeur.
Depression is characterized by a persistently sad mood that does not change over time, anxiety, irritability, decreased energy, uncontrolled crying, decreased or increased appetite, increased need for sleep, trouble with decision making and focus, and suicidal thoughts. Those who are diagnosed with Bipolar I disorder have had at least one “full-on” manic episode in their lives. Those with Bipolar II disorder have their moods cycle between hypomania (a less severe form of mania) and depression but never reach full-on mania.
It may be difficult to spot bipolar disorder because of the varied symptoms that may occur. Those with bipolar disorder might quit their job impulsively, rack up large credit card debts, and be able to sleep with only a few hours of rest per night if they are in a manic episode. In a depressive episode, they might have trouble getting out of bed, show signs of feeling hopelessness and despair, and have difficulties with performing daily tasks.
Bipolar Disorder Causes
There causes of bipolar disorder are not very well understood, but there are many sound ideas that have been suggested. It is thought that genetic factors play a very strong role in the development of bipolar disorder. It is shown that a person’s environment also has a significant impact. For instance, those with bipolar disorder often have had stressful life events or were raised in abusive or negligent households. The physical causes of bipolar disorder are thought to be related to an imbalance or changes in brain chemicals called neurotransmitters.
Neurotransmitters including noradrenaline, serotonin, and dopamine are involved in various brain functions, and changes in these neurotransmitters have been linked to mood disorders such as bipolar disorder. Serotonin is involved in functions such as mood, sleep-wake cycles, eating, sexual activity, learning, memory, and impulsivity, and changes in serotonin are thought to contribute to mood disorders such as depression and bipolar disorder.
Studies of bipolar patients have shown that the disorder runs in families. There are various studies of identical twins that show if one twin has bipolar disorder, the chance of the second twin also having the disorder is anywhere from 40 to 70 percent. Bipolar II disorder is thought to be more heritable than Bipolar I disorder by various studies.
Effects of Bipolar Disorder
Bipolar disorder has various effects on both children and adults, and symptoms also vary between individuals. The age of onset may vary, however the diagnosis of bipolar disorder in very young children is not common. Children and adolescents who have bipolar disorder might show symptoms similar to ADHD which is more common. Some of the medications for ADHA may also trigger bipolar-like symptoms.
Young children might be more irritable than adults when they are in a manic episode. In children and adolescents, mania and depression may occur in rapid cycles and be more unpredictable. Between episodes, children with bipolar disorder may return to normal functioning, and a similar effect is seen in adults between manic and depressive episodes.
Adults may show less irritability during manic episodes than children; however their manic and depressive episodes typically last longer than children. Adults may also have seasonal manic and depressive episodes. Substance abuse problems often develop in adults and make treating bipolar disorder much more difficult. Suicide is a substantial risk for adults with bipolar disorder, and adults have a higher potential to act on suicidal thoughts with more harmful methods. Both adults and children often struggle with school and work due to an inability to focus and decreased energy levels during depressive episodes.
Treatment for Bipolar Disorder
For those who are suspected of having bipolar disorder, treatment is necessary to help them return to normal functioning and to decrease bipolar symptoms. Bipolar disorder requires long term treatment involving psychotherapy and medications to help a person be functional as they struggle with the illness. Treatment begins with an accurate diagnosis of the disorder, and a patient must undergo a thorough initial evaluation by a doctor or bipolar specialist.
Other potential causes of bipolar-like symptoms must be eliminated. After a diagnosis is made, patients will typically begin treatment on an outpatient basis. For patients who are suicidal, inpatient monitoring and treatment may be required for a period of time until they are stabilized. Patients who are addicted to drugs may require a separate treatment for their drug addictions which will assist in the treatment of bipolar disorder.
Medication is used to help patients control symptoms such as mood swings and depressive symptoms. Medications may also be used to control hallucinations that patients with Bipolar II may experience. Psychotherapy in various forms greatly assists patients with coping with symptoms and regulating stress. Education is used to teach patients about the illness, various triggers that may make bipolar disorder worse, and how to live productively with the disorder.
