Bipolar Disorder
What is it?
Bipolar disorder, also known as manic-depressive disorder, is a serious
mental illness marked by mood shifts and episodes of depression and mania.
The Diagnostic and Statistical Manual of Mental Disorders lists four
separate categories of bipolar disorder: bipolar I, bipolar II,
cyclothymia, and bipolar not-otherwise-specified (NOS).
Bipolar I is marked by manic episodes followed by periods of depression
that may not be severe. In contrast, Bipolar II is marked by major
depressive episodes and hypomanic periods, or milder episodes of mania.
Cyclothymia is defined as episodes of hypomania and depressive periods
that do not reach major depressive proportions. Bipolar NOS means that the
bipolar state does not fit into the other categories.
Who gets it?
Both children and adults may develop bipolar disorder but most
commonly, the disorder develops from adolescence through the early
twenties. Studies have shown that people who have family members with
emotional disorders may be more susceptible to bipolar disorder. Many
patients with bipolar disorder have a history of substance abuse. A
possible biological cause is the presence of calcium build-up in the cells
of bipolar patients. Bipolar disorder is just as prevalent among women as
men although their symptoms may vary.
What causes it?
There is no clear cause of bipolar disorder. It may be genetic, the
result of substance abuse – especially cocaine – or caused by the presence
of calcium build-up in the cells.
What are the symptoms?
Children may display symptoms in different ways than adults. When
manic, children and adolescents may be irritable and have destructive
outbursts rather than elation or euphoria like their adult counterparts.
Children may complain of headaches, muscle aches or stomachaches when
in a depressive state. Also, performance at school may suffer, they may
talk about running away from home, become isolated, be extremely sensitive
to rejection and have periods of unexplained crying.
Whereas adult-onset bipolar disorder may be more patterned, childhood-
or early adolescent-onset bipolar disorder may be rapid-cycling, meaning
the episodes of depression and mania may shift more frequently. The
childhood or early adolescent-onset bipolar disorder may even be more
severe.
Diagnosis
A psychiatrist or psychologist usually diagnoses bipolar disorder.
Interviews and tests may be used and, because of the complexity of the
disorder, it may take several visits, and sometimes months or years, to
definitively diagnose a patient with bipolar disorder.
Treatment
Bipolar disorder is treated with medications including a combination of
mood stabilizing agents, anti-depressants, anti-psychotics and
anticonvulsants. An individualized combination of the medications is
determined in order to regulate the patient’s manic and depressive
episodes. Psychotherapy and counseling may be used in combination with
medications.
Electroconvulsive therapy can be used as a treatment for unipolar and
bipolar depression and mania. Because of the stigma attached to ECT, it is
often used after medication options are explored. ECT is given under
anesthesia and muscle relaxants are used to prevent convulsions. The exact
reasons ECT works is unknown, but it seems that the electrical currents
sent to the brain alter the electrochemical processes of the brain and,
consequently, relieve depression.
Whereas many patients respond to medications, ECT and psychotherapy, a
small number of those suffering with bipolar disorder don’t respond to any
treatments. Generally, bipolar disorder requires lifelong treatment.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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