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Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. It is characterized by extreme changes in mood - from mania to depression. These mood changes are drastic and severe. They are not the same as the normal ups and downs that everyone goes through. Bipolar disorder often begins in adolescence or early adulthood and may persist throughout life. About 5.7 million American adults (2.6 percent of the population) have bipolar disorder.

Signs and Symptoms of Bipolar Disorder

The signs and symptoms of bipolar usually begin to appear in late adolescence or early adulthood. They can however begin in childhood or later in life. Bipolar disorder, like many other mental illnesses, often not recognized as an illness, is often not recognized as an illness. People may "brush off" the symptoms or they may be thought of as just part of the persons personality. Far too often, people with bipolar, suffer for years before it is properly diagnosed and treated. Since there are two phases to bipolar disorder, the symptoms can be classified as being part of the "Manic" phase or part of the "Depressive" Phase.

Symptoms of the Manic Phase

  • Increased Energy
  • Less need for sleep
  • Inreased activity
  • Restlessness
  • Excessive talking very fast, jumping from one topic to another
  • Extreme irritability
  • Euphoria
  • Increased self-esteem and unrealistic beliefs in one's abilities and powers
  • Recklessness. impulsiveness and poor judgment (fast driving, excessive spending, high-risk business investments, and sometimes promiscuous sex)
  • Hallucinations and or delusions
  • Abuse of drugs, alcohol, and sleeping medications
  • Denial that anything is wrong

Symptoms of the Depressive Phase
  • Depressed mood and low self-esteem
  • Crying, anxiety, guilt, worthlessness or hopelessness
  • Irritability
  • Difficulty concentrating, remembering, making decisions
  • Insomnia or sleeping too much
  • Loss of interest or pleasure in activities once enjoyed
  • Thoughts of death or suicide, or suicide attempts

Because of the stigma still attached to bipolar disorder (and to many other mental illnesses), patients and/or their families often ignore symptoms or attribute them to part of that persons personality. Research suggests that almost 75% of cases go untreated or are treated inappropriately. Bipolar disorder is an illness just as diabetes, heart disease, etc. are illnesses. There is treatment available. If you have any of these symptoms, or a loved one does, please seek help.

Causes of Bipolar Disorder

Doctors are still unsure what cause bipolar disorder. It appears that there is not one simple cause, but a variety of biologic, genetic and environmental factors, involved in causing bipolar. Bipolar disorder often runs in families, so researchers have been looking for specific genes that may be involved. It appears likely that many different genes act together, and in combination with other factors of the person or the person's environment, to cause bipolar disorder. Experts believe that an imbalance of brain chemicals produces the symptoms of bipolar disorder. When levels of these chemicals are too high, mania (manic phase) occurs. When levels are low, there is depression.

Treatment for Bipolar Disorder

Medication and psychotherapy are the main treatments for bipolar disorder. Doctors often use one set of medications to treat the manic phase symptoms, another set of medications to treat the depressive symptoms, and a set of medications to stabilize the mood over time.

Medications for Manic Phase

If you are suffering from manic phase symptoms, your doctor initially may treat you with an antipsychotic drug (Abilify, Clorazil, Zyprexa, & Seroquel are some examples) and/or a benzodiazepine (Ativan, Xanax, Valium, and Klonopin are some examples) to quickly control hyperactivity, sleeplessness, hostility, and irritability. These medications are usually taken for a brief time, up to two weeks or so, with other mood-stabilizing drugs. Treatment during the manic phase often requires hospitalization because there is high risk for unpredictable, reckless behavior and noncompliance with treatment.

Mood Stabilizing Medications

Mood stabilizers help control mood swings, prevent recurrences of mood swings, and reduce the risk of suicide. They are usually taken for a long time, commonly for many years. Examples include lithium and certain anticonvulsant drugs.

Medications for Depressive Phase

Treating a depressive episode in bipolar disorder is challenging. Antidepressant medications often trigger a manic episode. There are a couple of medications that have been approved by the FDA to treat both the manic and depressive episodes of bipolar disorder. These medications include quetiapine (Seroquel), and the antipsychotic drug Zyprexa, when used with the antidepressant Zoloft. For more severely ill patients, some doctors may prescribe lithium and an antidepressant -- usually either Wellbutrin or Paxil. Once depression has resolved, mood stabilizers are the best proven treatments to prevent future depression. If these medications fail, or if there are suicidal tendencies, doctors may recommend electroconvulsive therapy (ECT). It helps nearly 75% of the patients who are given this treatment.

Electroconvulsive therapy (ECT)

Electroconvulsive therapy is generally used as a last resort, or when patients pose a severe threat to themselves or others and it is dangerous to wait until drugs take effect. In electroconvulsive therapy, an electric current is sent through the scalp to the brain. Before beginning the electroconvulsive therapy, a person is given a muscle relaxant and put under general anesthesia. Electrodes are placed on the patients scalp and a small amount of electrical current is passed through the brain for less than a second. Patients are carefully monitored during the treatment. The patient wakes up moments later does not remember the treatment or events surrounding the treatment, and is often confused. This confusion typically lasts for only a short period of time. ECT is given up to three times a week for two to four weeks. ECT profoundly affects brain metabolism and blood flow to various areas of the brain. How that correlates to easing depression remains unknown, but this therapy is often highly effective.


Psychotherapy, along with medication, is an important part of treatment for bipolar disorder. The therapist therapist will help you detect patterns leading up to episodes of bipolar disorder, trying to identify triggers for these episodes. Psychotherapy helps provide strategies for managing stress and coping with uncertainties. It also helps you understand bipolar disorder and your treatments, including the need to take your medications as directed, for as long as your doctor orders.

Living with bipolar disorder can be challenging, for the patient, as well as their families. If you, or a loved one, have bipolar disorder there are some things you can do to make life a little easier. It is very important to educate yourself about bipolar disorder. Learn as much as you can learning about the disorder -- its symptoms, early signs of an episode, and types of treatment. Pay attention to warning signs. You and your caregivers may have identified a pattern to your episodes of bipolar disorder, what triggers them, and what to do. Make sure medication is taken as directed. Keep a regular routine. This not only helps you remember to take your medication but also regular sleep, eating, and activity appear to help people with bipolar disorder control their moods. Do not use alcohol or drugs. These substances can trigger mood episodes. They can also interfere with the effectiveness of medication. Join a support group. For you, it can help you learn coping skills, receive encouragement, and share concerns. You will also feel less isolated. Remember, there are over 5 million people in the U.S. who have bipolar disorder. You are not alone! For your family members and friends, they can gain a better understanding of the illness, share their concerns, and learn how to best support loved ones with bipolar disorder.


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DISCLAIMER: The information on this website should NOT be used as a substitute for professional medical advice, diagnosis, or treatment. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please contact your doctor or other qualified health care provider with any questions you may have regarding a medical condition.

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