What is it?
Bipolar disorder is characterized by intense mood swings from depression to mania. During depressive phases, patients feel guilty, sad, lethargic, and may have thoughts of suicide. During manic phases, they feel energized and creative, and will often engage in destructive behaviors. They also often display a lack of concern for the well-being of both themselves and those around them, which can have significant negative impacts on their professional and personal lives. The condition has three different major forms. The first, Bipolar Disorder I, is the most severe. It is characterized by both depressive and manic moods, usually within a few weeks of each other, but occasionally as little as a couple hours or as long as several months. The patient will suffer episodes an average of four times annually, and will sometimes experience “mixed states,” where they feel simultaneously manic and depressed. The second type is Bipolar Disorder II, which has similar symptoms to type I, except instead of full-on mania, patients experience hypomania. Hypomania has the same high-flying emotions associated with mania, but lacks the destructive behavior, so the patient is able to retain their good judgment. Hypomania also doesn't typically last as long as mania, and patients are able to return to normal in between episodes. However, type II is more of a chronic condition, and patients are at a very high risk for suicide. The third type is Cyclothymic Disorder, which is less severe than either of the other two types, but its episodes can last as long as two months, making it more of a chronic condition. Like type II, its sufferers fluctuate between depression and hypomania, though the latter tends more toward irritability than euphoria. Sometimes Cyclothymic disorder will escalate into type I or II, but it can also stay a chronic condition. If someone suffering from bipolar disorder does not fit into any of those three types, they are classified as Not Otherwise Specified, or NOS. Sometimes a patient will swing from manic to depressive within a matter of days or hours, which is called “rapid cycling” and can occur with any variety of bipolar disorder. It is usually temporary.Symptoms
Bipolar disorder is different from other medical conditions in that it carried two separate sets of symptoms—those associated with mania, and those with depression. They are as follows: Manic symptoms:Depressive symptoms:
Treatment
There is no cure for bipolar disorder, but there are several options for treatment. Because it is the result of a chemical imbalance in the brain, it is most often treated with medication. The most common treatment is lithium carbonate, which first came into use in Europe in 1949, and quite a bit later in the United States (it had previously been used as a salt substitute, but was banned due to its toxicity). Lithium is a highly effective treatment for bipolar disorder because it controls both the manic and depressive episodes, and its relative abundance makes it quite a bit cheaper than other options. Its side-effects, which include digestive problems, water retention, minor hair loss, acne and hand tremors, are minor and often temporary, though they are more pronounced in children, senior citizens and pregnant women. It is very important, however, that the dosage be carefully monitored; if it builds up to toxic levels, it can seriously damage the circulatory, gastrointestinal and neurological systems of the body. The oldest treatment for bipolar disorder is anti-psychotic drugs, specifically neuroleptics, which are also used to treat schizophrenia. The most commonly used neuroleptic is a drug called chlorpromazine, though thioxthixene and haloperidol are equally effective. They are primarily used to treat manic episodes, though lithium out-preforms them. They also carry a number of nasty side-effects that often prevent patients from complying with their prescriptions, including parkinsonism, apathy, impaired motor skills and akathisia (restless leg syndrome). Some patients are resistant to lithium treatment, and for them doctors often prescribe anti-convulsants—most commonly divalproex, carbamazipine and valproate. The studies on these drugs and their effectiveness have been largely inconsistent, though there is some evidence that they may be more effective than lithium. Side effects are mostly mild, with loss of apetite, loss of balance, double vision, headaches and poor motor skills, though in some rare and more serious cases it can cause a loss of white blood cells or liver damage. There are also non-pharmaceutical treatments for bipolar disorder, including electro-convulsive therapy (mostly used to treat acute episodes), psychotherapy and sleep management.The Bipolar Community Online:
Life, Love and Bipolar An online community for sufferers of bipolar disorder. bphope.com: BP Magazine A magazine directed at sufferers of bipolar disorder, with articles on how to cope and personal stories from BP sufferers. Pendulum.org A forum where suffers of BP and their loves ones can talk to one another and gain support.Additional Resources:
Mental Health America: Bipolar Disorder in Children An explanation of bipolar disorder in children, and a number of resources for parents and guardians. Common Pharmacological Treatments of Bipolar Disorder and Subtypes: a Review A paper by David E. Cox, reviewing the effectiveness of various pharmacological treatments for bipolar disorder. New York Times Health Guide: Bipolar Disorder An overview of bipolar disorder, plus related topics and bipolar disorder in the news. National Institute of Mental Health A comprehensive view of bipolar disorder, including advise for loved ones. National Alliance on Mental Health: Bipolar Disorder An overview of bipolar disorder, its symptoms and how to treat it. University of Washington: Neuroscience: Bipolar Disorder A brief overview of bipolar disorder, and an explanation of how it is thought to work chemically. University of Maryland Medical Center A comprehensive explanation of what bipolar disorder is, what to expect from it and how it is treated. University of Michigan Depression Center A basic overview of bipolar disorder, along with several other mental health issues. UT Dallas: Student Counseling Center: Self-Help: Bipolar Disorder An overview of bipolar disorder and how to identify and treat it. PubMed Health An overview of bipolar disorder, what to expect from it and how to respond to it. MedicinePlus: Bipolar Disorder A very brief overview of bipolar disorder.