Thus even when family and friends learn to recognize the mood swings the individual often will deny that anything is wrong. In its early stages bipolar disorder may masquerade as a problem other than mental illness. For example, it may first appear as alcohol or drug abuse, or poor school or work performance. If left untreated, bipolar disorder tends to worsen and the person experiences episodes of full-fledged mania and clinical depression. Sensuality is pervasive, the desire to seduce and be seduced is irresistible.
Infectious humor ceases to amuse.
One medication, lithium, is usually very effective in controlling mania and preventing the recurrence of both manic and depressive episodes. More recently, the mood-stabilizing anticonvulsants carbamazepine and valproate have also been found useful especially in more refractory bipolar episodes. Often these medications are combined with lithium for maximum effect. Some scientists have theorized that the anticonvulsant medications work because they have an effect on kindling , a process in which the brain becomes increasingly sensitive to stress and eventually begins to show episodes of abnormal activity even in the absence of a stressor. It is thought that lithium acts to block the early stages of this kindling process and that carbamazepine and valproate act later.