What Is Bipolar Disorder?

By bp Magazine







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According to the Diagnostic and Statistical Manual of Mental Disorders (DSM–V), bipolar disorder is a treatable illness marked by extreme changes in mood, thought, energy, and behavior. It is also known as manic depression because a person’s mood can alternate between the “poles”—mania (highs) and depression (lows). The change in mood can last for hours, days, weeks, or months.

What bipolar is not

This illness is NOT a character flaw or sign of personal weakness.

Who bipolar affects

Bipolar disorder is found among all ages, races, ethnic groups, and social classes. According to data from the National Comorbidity Survey Replication (NCS-R), this disease affects nearly eleven million Americans at some point in their lives. It usually begins in late adolescence, often appearing as depression during teen years, although it can start in early childhood or later in life.

Although an equal number of men and women develop bipolar disorder, the presentation and course of the illness differs across the sexes. A peer-reviewed research study published in the academic journal Psychiatric Clinics of North America in 2003 identified several sex-related differences related to bipolar disorder. Firstly, men tend to begin their illness with a manic episode, while women begin with a depressive episode. Similarly, women experience mixed mania, depressive episodes, and rapid cycling more often than men.

The illness tends to run in families and appears to have a genetic link. In fact, a review article published in the well-respected academic journal Neuroscience referred to bipolar disorder as “the most heritable of medical disorders.” Ongoing research seeks to identify the specific genes that predispose someone to this illness.

Like depression and other serious illnesses, bipolar disorder can also negatively affect spouses, partners, family members, friends, and co-workers. To browse topics related to caregivers and loved ones of people with bipolar disorder, click here.

Types of bipolar disorder

Different types of bipolar disorder are determined by patterns and severity of symptoms of highs and lows. The DSM-V identifies four basic types:

Bipolar I disorder is characterized by one or more manic episodes that last at least a week or are so severe that the individual requires hospitalization. Episodes of depression lasting for at least two weeks and hypomania may also occur, along with mixed states (when symptoms of depression and mania or hypomania are present together).

Bipolar II disorder is characterized by one or more depressive episodes accompanied by at least one hypomanic episode. Hypomanic episodes have symptoms similar to manic episodes but are less extreme and don’t last as long. However, the person’s behavior is clearly different from the norm to observers. According to the 2003 research study, Bipolar II is more common in women than in men.

Cyclothymic disorder is characterized by periods of elevated mood states (like mania or hypomania) and periods of depressed mood lasting for at least 2 years. What distinguishes cyclothymic disorder from Bipolar I and II is symptom severity––neither the elevated nor depressed mood states are extreme enough to meet the diagnostic criteria for (hypo)mania or depression. But, that does NOT mean that this specific disorder does not require treatment.

Other Specified and Unspecified Bipolar and Related Disorders include bipolar symptoms that do not match the criteria for Bipolar I, Bipolar II, or cyclothymic disorder.

For descriptions of additional mood disorders, click here.

Symptoms

Most people who have this illness talk about experiencing “highs” and “lows.” These swings can be severe, ranging from extreme energy to deep despair. The severity of the mood swings and the way they disrupt normal life activities distinguish bipolar mood episodes from ordinary mood changes.

Symptoms of mania:

• Increased physical and mental activity and energy

• Heightened mood, exaggerated optimism, and self-confidence

• Excessive irritability, aggressive behavior

• Decreased need for sleep without experiencing fatigue

• Racing speech, thoughts, and flight of ideas

• Increased sexual drive

• Reckless behavior

Symptoms of depression:

• Prolonged sadness or unexplained crying spells

• Significant changes in appetite and sleep patterns

• Irritability, anger, worry, agitation, anxiety

• Pessimism, loss of energy, persistent lethargy

• Feelings of guilt and worthlessness

• Inability to concentrate, indecisiveness

• Recurring thoughts of death

To browse topics on recognizing and managing symptoms, click here.

How common is it in children?

Bipolar disorder is more likely to affect the children of parents who have the disorder than it is the children of parents that do not. According to a 2007 longitudinal study, when one parent has this illness, the risk that their children will develop bipolar disorder is approximately 30-40% (a 1 in 4 or 1 in 3 chance). Similarly, when both parents have the disorder, the risk that their children develop it as well increases to upwards of 60% (a 1 in 2 chance).

Symptoms may be difficult to recognize in children because they can be mistaken for age-appropriate emotions and behaviors of children and adolescents. Symptoms may appear in a variety of behaviors.

According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children with depression in the United States may actually be experiencing the early onset of bipolar disorder.

To browse topics on bipolar disorder in children, click here.

Treatment options

Several different therapies currently exist, with many promising new treatments currently under investigation. Because bipolar disorder can be difficult to treat, it is highly recommended that you consult a psychiatrist or a general practitioner with experience in treating this illness. Treatments may include medication, talk therapy, and support groups.

