Bipolar Disorder: An Overview
Bipolar disorder is a brain disorder that causes extreme changes in mood, energy, activity levels and the ability to carry out everyday tasks. Formerly called manic depression, bipolar disorder is also known as manic-depressive illness.
Bipolar Manic Depression Episodes
Bipolar disorder symptoms include mood shifts called episodes. During a manic episode, a person is likely to have significantly increased energy with racing thoughts and grandiose ideas, along with other symptoms that indicate a hyperactive state. A less severe manic shift is called a hypomanic episode.
The opposite shift is a depressive episode marked by sadness, hopelessness and similar symptoms. A person can also have a mixed episode that combines the symptoms of bipolar depression and mania.
Types of Bipolar Disorder
The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, identifies four types of bipolar disorder:
- Bipolar I Disorder: Manic or mixed episodes that last at least seven days or severe manic symptoms that require immediate medical care. Typically, the person also has depressive episodes lasting at least two weeks.
- Bipolar II Disorder: Depressive episodes shifting back and forth with hypomanic episodes, but no manic or mixed episodes; less severe than Bipolar I. A person may have an elevated mood, irritability, and some changes in functioning but usually can get on with a normal daily routine.
- Bipolar Disorder Not Otherwise Specified (BP-NOS): Bipolar symptoms are clearly out of a person’s normal range of behavior but do not meet diagnostic criteria for either Bipolar I or II.
- Cyclothymic Disorder, or Cyclothymia: Mild form of bipolar disorder involving hypomanic episodes that shift back and forth with mild depression for at least two years.
Diagnosing Bipolar Disorder
Because people are more likely to seek medical help when experiencing bipolar depression than when experiencing a manic episode, a complete history and psychological evaluation are important in diagnosing bipolar disorder. A doctor will also conduct a physical exam and lab tests to check for physical problems that could be causing symptoms. However, no lab test or brain scan can diagnose bipolar disorder.
Treating Bipolar Disorder
Treating bipolar disorder symptoms is a lifelong process, usually involving a combination of treatments. Medications commonly used include:
- Anticonvulsants (mood-stabilizing medications)
- Antidepressants
- Antipsychotics
- Benzodiazepines (anti-anxiety medications)
- Lithium.
Finding the right medication or combination of medications generally requires some trial and error. Also, changes in symptoms may require changes in medications.
Psychotherapy is important in treating bipolar disorder. Various types of therapy may be helpful, including cognitive behavioral therapy to help a person identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
Other possible medical treatments, usually reserved for more severe cases of bipolar disorder, include electroconvulsive therapy (ECT) and hospitalization. Also, general self-care measures — such as exercise, sleep, avoiding alcohol and drugs and getting support — are important. Bipolar disorder is a serious condition requiring lifelong management with the help of a knowledgeable and supportive healthcare provider.
Resources
Mayo Clinic Staff. (January 5, 2010). Bipolar disorder: Symptoms. Retrieved May 14, 2010, from the Mayo Clinic website: www.mayoclinic.com/health/bipolar-disorder/DS00356/DSECTION=symptoms.Mayo Clinic Staff. (January 5, 2010).
Bipolar disorder: Tests and diagnosis. Retrieved May 14, 2010, from the Mayo Clinic website: www.mayoclinic.com/health/bipolar-disorder/DS00356/DSECTION=tests-and-diagnosis.
Mayo Clinic Staff. (January 5, 2010). Bipolar disorder: Treatments and drugs. Retrieved May 14, 2010, from the Mayo Clinic website: www.mayoclinic.com/health/bipolar-disorder/DS00356/DSECTION=treatments-and-drugs.
National Institute of Mental Health Staff. (n.d.). Bipolar disorder. Retrieved May 14, 2010, from the National Institute of Mental Health website: www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml.