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What is Bipolar Disorder?

Published on Jun 18, 2014
Authored by Nick DeMartinis, MD

Bipolar disorder, once called manic-depressive disorder or illness, is a mental illness that affects more than 5 million Americans. The disorder is best known for its dramatic and unpredictable changes in energy levels and mood. These can range from extreme highs (mania) with feelings of irritability and/or euphoria to extreme lows (depression) with feelings of hopelessness. Such shifts in mood may occur infrequently or may cycle rapidly and cause disruptions in normal daily life. Relationship difficulties, poor work or school performance and unemployment are common problems in untreated bipolar disorder.

If left undiagnosed and untreated, bipolar disorder can get worse over time. Fortunately, while there is no cure, in most cases, the disorder is treatable.

Signs And Symptoms Of Bipolar Disorder

Bipolar disorder is based on the occurrence of a period of unusually intense emotional states, called an episode. Bipolar episodes represent a drastic change in usual mood states and behaviors and range from joyful and overexcited (manic episodes) to extremely sad and hopeless (depressive state).

Symptoms of mania may include:

  • A period of feeling “high”, or having an abnormally elevated mood
  • Increased energy and goal-directed activity
  • Bouts of talkativeness and racing thoughts
  • Extreme irritability or agitation
  • Being easily distracted
  • Making rash decisions and acting impulsively
  • Having sudden unrealistic belief in one’s abilities
  • Participating in pleasure-seeking and high-risk activities
  • Getting very little sleep

Symptoms of depression may include:

  • A period of feeling hopeless, sad or empty
  • Feelings of guilt or worthlessness
  • Loss of interest in normal activities
  • Trouble concentrating, remembering, or making decisions
  • Feelings of being slowed down or restlessness
  • Having thoughts of suicide
  • Sleep problems

The signs and symptoms of bipolar disorder may vary depending on your specific diagnosis. Keep in mind that there are several different bipolar diagnoses, which are based on differences in the occurrence, types, and severity of symptoms and/or the causes of the disorder. These diagnoses include: bipolar I disorder, bipolar II disorder, cyclothymic disorder, substance/medication-induced bipolar and related disorder, bipolar and related disorder due to another medical condition, among others.

In the most extreme forms of the disorder, symptoms may be so severe that people believe they are seeing objects or people and hearing voices that are not real or believing they have super powers. These hallucinations and delusions have led some people with bipolar disorder to be mistakenly diagnosed with schizophrenia.

More common mild or moderate symptoms can still be troublesome enough to disrupt normal function at work, school, or home. People with even moderate untreated bipolar disorder can have difficulty with relationships, keeping their job or doing well at school. Additionally, some people suffering from bipolar disorder may be at a higher risk for substance dependence and abuse.

Seeking Treatment And Getting Help

Often times, people in a manic state do not feel that anything is wrong. Early manic symptoms can create a positive sense of being focused and getting more done. Even when symptoms increase and begin to disrupt normal activities, people may not report their manic symptoms to a doctor.

If you or someone you know suffers from what you think may be bipolar disorder, the best thing you can do is to see, or recommend seeing, a doctor. Experienced providers can help diagnose symptoms of bipolar disorder based on history and description of past behaviors. You may also want to contact other friends and family members who can express similar concerns. Sometimes it takes more than one person pointing out symptoms for someone to realize they need to seek help from a trained healthcare professional.

Therapy And Successful Management  

Certain medications are used to treat bipolar disorder, including mood stabilizers and atypical antipsychotic drugs. Depending on response to the medication, a person with bipolar disorder may need one or more of these treatments.

Psychotherapy when used in combination with medication can be very effective in helping to treat bipolar disorder. Other actions that can also help manage symptoms include:

  • Getting enough sleep
  • Eating healthy meals regularly
  • Keeping track of moods and emotional states so you can learn warning signs that may occur before a shift to mania or depression, and discuss how to prevent episodes with your doctor
  • Taking medications as prescribed

Another thing to keep in mind is that people diagnosed with the disease will want to see a primary care doctor for check ups concerning other physical health problems linked to bipolar disorder. These include substance dependency, anxiety or panic disorders, metabolic syndrome, and eating disorders.

Sticking with a treatment plan and taking care of yourself can help you get a good start on managing symptoms of the disease. In fact, with proper care many people with bipolar disorder can lead healthy, productive lives.

Nick DeMartinis, MD, is a Director of the Neuroscience Research Unit for Pfizer Worldwide Research and Development.

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