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All of us experience times in life when we feel a bit up and other times when we feel a bit down. People living with bipolar disorder experience a dramatically intensified oscillation between high periods and low periods. The high periods can lead to reckless, dangerous and irresponsible behaviors and the low periods provoke lasting sadness and a greatly elevated risk of suicide. Bipolar disorder is one of the most serious of mood disorders.

Almost 6 million Americans suffer from some form of manic depression, also known as bipolar disorder. People with untreated bipolar disorder are at a high risk for substance abuse and addiction, anxiety, eating disorders and suicide (15% of those with bipolar commit suicide).

Symptoms of bipolar disorder typically emerge in early adulthood, but sometimes begin in childhood, and even with treatment, the disorder seems to endure for a lifetime. With treatments that include medication and psychotherapy, symptoms can be controlled and the impact of the disorder greatly lessened.

Without treatment, the intervals between bouts of mania/depression shorten and the severity of symptoms increase. Bipolar disorder is an under diagnosed condition, and many people that do eventually receive an accurate diagnosis suffer with the disorder for years prior to treatment. Early diagnosis and correct treatment can alleviate a lot of suffering.

Bipolar Disorder Symptoms

Manic and depressive symptoms vary greatly.

Symptoms of the Manic Phase

Manic states begin suddenly and escalate in severity as time passes. The initial symptoms of a manic state can be quite pleasurable, and people sometimes won't admit that anything is wrong or accept treatment for a state of mood that they quite enjoy. Unfortunately, as a manic state progresses, the symptoms escalate in severity, often leading to severe personal consequences, such as the loss of a career or family.

Symptoms of mania include:

  • Delusion and hallucination (only experienced by those with bipolar I)
  • Elevated and pleasurable mood
  • A lessened need to sleep
  • Racing thoughts
  • Excitement
  • Abundant energy
  • Risk taking behaviors
  • Fast talking, switching topics excitedly and quickly
  • Restlessness
  • Feelings of omnipotence, grandiosity
  • Impulsive behaviors (can include impulsive major life decisions)
  • Substance abuse
  • Decreased judgment

Episodes of major mania can start out quite pleasurably, but as symptoms escalate in severity, patients can put themselves in danger or otherwise harm themselves through erratic/impulsive and disorganized behaviors. Since many people abuse alcohol or drugs during a manic phase, addiction often emerges as a co-occurring problem.

Symptoms of the Depressive Phase:

  • Sadness
  • Guilty feelings (without valid cause)
  • Feelings of worthlessness or hopelessness
  • A lack of energy
  • An inability to concentrate or make decisions
  • Memory problems
  • Crying spells
  • Irritability
  • Changes in eating habits leading to weight gain or loss
  • A withdrawal from social activities
  • Suicidal thoughts

Most people experience longer bouts of depression than mania.

People sometimes experience a mixed phase, during which time symptoms of mania and depression are felt together. People might feel energetic and grandiose at the same time as feeling hopeless, guilty and irritable. This mixed bipolar state is very uncomfortable and patients experiencing a mixed phase are at an elevated risk of suicide.

Different Types of Bipolar Disorder

There are 4 major distinct types of bipolar disorder. Follow the link to read about each type in detail.

How Long Does It Last?

People most typically experience a first episode of either mania or depression in their late teens or during early adulthood, although much earlier onset is also possible.

90% of people who experience one bipolar episode will experience at least one more. Most people live with the disorder for a lifetime, and on average, a bipolar patient will progress through 8-10 episodes over a lifetime.

Although treatment will not provide a cure, treatment can minimize the severity of symptoms.

Who Is Most at Risk for Bipolar Disorder?

Researchers don’t know exactly what causes bipolar disorder, although most suspect that altered levels of certain neurotransmitters play a significant role.

The disorder is transferred genetically; having a close relative with the disorder increases your risk; having one parent or sibling with bipolar disorder increases your risks of the disorder by between 400% and 600%.

Although these numbers seem alarming, children of bipolar parents are still far more likely to escape the disease, than succumb to it.

Studies done on identical twins prove that genetics alone do not tell the whole story. In some cases, one identical twin will experience bipolar disorder, while another won’t, even though both have identical genetic material. Environmental factors interact with genetic predispositions to produce the disorder. Some environmental factors that increase the risk of the disorder include:

  • Some medications can induce symptoms of mania
  • A major life changing event, either good or bad. Major life stressors, even when positive, such as getting married, can induce the disorder in someone susceptible to it.
  • Too little sleep can lead to mania

Bipolar Disorder Diagnosis

It is sadly normal for someone with bipolar to suffer with the disease for years or even decades prior to an accurate diagnosis.

A number of factors complicate the accurate diagnosis and treatment of bipolar disorder, such as:

  • People often only seek help while experiencing depressive symptoms and as such are wrongly diagnosed with major depression instead of bipolar
  • Many physical illnesses can mimic the symptoms of the disorder, such as HIV, diabetes, lupus, syphilis and others
  • There are no physical tests for bipolar disorder

It is important to provide accurate information about the way your moods change over time, and in many cases it is extremely useful for family members to meet with your doctor to provide their own account of your symptoms. If your doctor suspects bipolar disorder, she will first want to rule out physical causes, such as HIV, lupus and many others.

Bipolar Disorder Treatment

Bipolar treatment can reduce the severity of symptoms and help to prevent the re occurrence of bipolar mood states.

Bipolar patients most typically take prescription medications, such as mood stabilizers and also engage in psychotherapy. Since bipolar is a life-long condition, treatment should be chronically administered, even during periods of symptoms remission.

Please see bipolar disorder treatments, for a more complete overview of the treatments that work to reduce symptoms severity.

Making Lifestyle Changes

In addition to the use of effective medications and continuing involvement in psychotherapy, certain lifestyle and social modifications can be helpful, such as:

  • Making sure to get sufficient sleep
  • Getting and staying physically fit, engaging in regular exercise
  • Maintaining a stable routine
  • Avoiding drugs and alcohol at all costs
  • Avoiding stress
  • Learning to recognize the early symptoms of an active episode and taking action as soon as you do
  • Learning to trust the opinion of friends and family, who may recognize the beginnings of a manic episode before you do
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Page last updated Aug 05, 2010

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