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What is Bipolar Disorder?

Bipolar disorder, also known as manic-depressive illness, is a medical illness that is manifested by unusual 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. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

STATISTICS
about 5.7 million American adults or about 2.6 percent of the population age 18 and older in any given year, have bipolar disorder.
The median age of onset for bipolar disorders is 25 years. Bipolar disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them late in life.

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/lows are called episodes of mania or 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.

  • DIAGNOSIS
    To reach a diagnosis of bipolar disorder, a psychiatrist will usually conduct the following:

  • A complete medical history and physical exam
  • These are conducted in order to rule out other physical conditions.
  • A complete psychiatric history
  • The possibility of other mental disorders should be considered. Furthermore, bipolar disorder is characterized by mood swings that tend to cycle. In reviewing a patient's history, previous mood swings (perhaps of less severity or duration) may come to light.
  • A family history of medical and psychiatric concerns
  • Current research indicates that mood disorders have genetic underpinnings - they tend to run in families. Therefore, if there is a family history of depression or bipolar disorder, it is a good indication that this is the case for the current patient as well.
  • An evaluation of current symptoms
  • As described above, there are a number of symptoms that are common for manic and depressive episodes.
    If no physical cause is found, if no other psychiatric disorder better accounts for symptoms, if the current symptoms have been of significant duration or cause significant impairment in functioning, a patient may then be diagnosed with bipolar disorder.

    TREATMENT
    Most people with bipolar disorder—even those with the most severe forms—can achieve substantial stabilization of their mood swings and related symptoms with proper treatment. Because bipolar disorder is a recurrent illness, long-term preventive treatment is strongly recommended and almost always indicated. A strategy that combines medication and psychosocial treatment is ideal for managing the disorder over time.

    In most cases, bipolar disorder is much better controlled if treatment is continuous than if it is on and off. But even when there are no breaks in treatment, mood changes can occur and should be reported immediately to your doctor. The doctor may be able to prevent a full-blown episode by making adjustments to the treatment plan. Working closely with the doctor and communicating openly about treatment concerns and options can make a difference in treatment effectiveness. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person's life.

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