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Bipolar disorder is usually diagnosed after a person has one or more manic episodes. People who have the classic form of bipolar disorder experience alternating periods of depressed moods and periods of manic or excited moods. This condition is sometimes referred to as “mood swings” or manic depressive disorder. Other people with bipolar disorder have episodes of a manic mood without episodes of depression. Still others with bipolar disorder have a mixture of depression and mania, a state of hyperactivity, at the same time.
There are different types of bipolar disorder. The type depends whether the recent mood was elevated, depressed, or mixed.
Some of the characteristics of mania appear as opposites of depression. Rather than a general slowing down of thought and activity, which is very common in depression, the person with mania experiences a speeding up of thought and activity. Also, with a manic episode the person’s self-esteem and mood are elevated, which is unlike what happens in depression. A person experiencing a manic episode frequently encounters difficulty with relationships and problems at work, at school, or with the law.
There is a milder form of mania which is called hypomania. The person who is hypomanic experiences speeded up speech, thought, and behaviors, but usually functions normally.
Characteristics of bipolar disorder include the manic and depressed phases.
Characteristics associated with mania include:
If not controlled, mania can escalate and become a severe condition with psychotic behavior.
Depressive characteristics include:
Severe depression may lead to thoughts and plans of suicide. If not treated adequately, death through suicide is a very real possibility in the severely depressed person with bipolar disorder.
Yes, bipolar disorder tends to run in families. It is quite likely that people with bipolar disorder have close relatives who also have bipolar disorder or depressed moods.
Bipolar disorder is equally common in men and women in the United States . The first episode in men is usually a manic episode. Women are more likely to experience depression as a first episode of their bipolar disorder.
Young people under the age of thirty (30) are at greater risk than older people for developing bipolar disorder.
About one percent (1%) of the population has bipolar disorder.
A mental health professional makes a diagnosis of bipolar disorder by taking a careful personal history from the client/patient. It is important to the therapist to learn the details that surround any stressful event or events in that person’s life.
Most people with mania show hyperactivity in their thoughts, words, and actions. They usually speak rapidly and are commonly over-talkative. The manic phase of bipolar disorder, with its elevated or euphoric mood, usually begins over a period of one to two weeks. Severe irritability may cause some people with mania to experience and express rage quickly. If such a condition worsens, that person can lose control and the mania can lead to psychotic thinking and bizarre behavior.
No laboratory tests are required to make a diagnosis of bipolar disorder nor are there any physical conditions that must be met. However, it is very important not to overlook a physical illness that might mimic or contribute to this psychological disorder. If there is any question that the individual might have a physical problem, the mental health professional should recommend a complete physical examination by a medical doctor. Laboratory tests might then be necessary as a part of the physical workup.
The primary treatment for mania is medication. For decades the treatment of choice for bipolar disorder has been lithium which helps to control the mood fluctuations. In the last few years, however, medicines like Depakote (divalproex) or Tegretol (carbamazepine) have also been used quite successfully to stabilize mood. Antipsychotic medication is used to control severe mania.
The careful use of antidepressants can sometimes help to counteract the depression associated with bipolar disorder.
Individual, family, or group psychotherapy can help a person with bipolar disorder and his/her family learn to cope with this illness.
Although most individuals who experience a manic episode return to full functioning, they remain at risk for recurrent episodes of mania. Medicines like lithium, Depakote, or Tegretol may be used long term to help to prevent the recurrent episodes of mania and/or depression. Usually, the severity of the manic and depressive cycles lessens with increased age.
If you, a friend, or a family member would like more information and you have a therapist or a physician, please discuss your concerns with that person.
The Washington University School of Medicine in St. Louis , Missouri , is seeking individuals diagnosed with Bipolar 1 Disorder to participate in a non-treatment study. Information about the study can be found at http://zork.wustl.edu/bipolar/
Developed by John L. Miller, MD
Page last modified on September 28, 2005