Bipolar disorder is a brain disorder that is also called manic depression or manic depressive disorder. It causes shifts in mood, energy, and activity levels that are much more severe than the ups and downs everyone experiences now and then. With bipolar disorder, these shifts can be so severe that a person can’t carry out the tasks of daily life. Relationships and school or job performance can also be disrupted by bipolar symptoms, and some people with the disorder may consider suicide. Fortunately, effective treatment of bipolar disorder is available and can help people live full, productive lives. Bipolar disorder is, however, a long-term illness that needs to be managed for a person’s entire life.
It is thought that bipolar disorder develops as a result of several factors. Genetics, environmental influences, and brain chemistry may each play a role. Though family history (genetic predisposition) appears to increase a person’s likelihood of developing bipolar disorder, not everyone with a family history will develop the disorder. Imaging studies are being used to examine the brains of people with bipolar disorder, with some findings suggesting that their brains may differ from those of people without the condition.
In most cases, bipolar disorder develops relatively early in an affected person’s life—often before age 25. Some people experience their first symptoms during childhood, while others have symptoms later in life.
There are several conditions that may coexist with bipolar disorder, though it’s not entirely understood why or how these conditions are linked to bipolar disorder. Possible coexisting conditions include substance abuse, anxiety disorders (such as post-traumatic stress disorder and social phobia), and attention deficit hyperactivity disorder. People with bipolar disorder are also at a higher risk for physical illnesses including thyroid disease, migraine headaches, heart disease, diabetes, and obesity.
Bipolar disorder is characterized by periods of different intense emotional states, or “mood episodes.” These emotional states include mania (a manic episode) and depression (a depressive episode), and both are associated with mood and behavior changes. It is thought that stressful situations, particularly those that cause loss of sleep, may trigger episodes. Between episodes, a person may have no symptoms, but for some symptoms linger. Symptoms of each include:
It’s possible for mood episodes to include symptoms of both mania and depression. This is known as a mixed state.
Treatment of bipolar disorders begins with accurate diagnosis. This may involve a physical examination, a discussion a personal and family medical history, and lab tests. There are no lab tests to diagnose bipolar disorder, but tests can rule out other illness that may cause similar symptoms (such as a brain tumor or stroke). A family doctor can begin the process of diagnosing bipolar disorder but will often refer the patient to a mental health professional to complete the diagnosis.
Bipolar disorder can’t be cured, so the goal of treatment is to help patients control mood swings and symptoms so that they can lead functional, full, and productive lives. Effective long-term treatment involves a combination of medication and psychotherapy.
Prescription medications for bipolar disorder include:
All of the medications used to treat bipolar disorder may cause side effects, some of them very serious. Ask your doctor about the risks and benefits of medications prescribed to you before you begin taking them. To prevent or manage side effects and get the best results from treatment, work closely with your doctor and take medications only as prescribed—this involves notifying your doctor immediately if you are experiencing side effects and making any changes, such as discontinuing a medication, under your doctor’s supervision.
For some severe episodes of mania or depress, hospitalization may be required.
Methods of psychotherapy or “talk” therapy used in the treatment of bipolar disorder include: