These include marital breakups, job loss, alcohol and drug abuse, and suicide. At least 2 million Americans suffer from manic-depressive illness. Bipolar disorder tends to run in families and is believed to be inherited in many cases. Despite vigorous research efforts, a specific genetic defect associated with the disease has not yet been detected. Bipolar illness has been diagnosed in children under age 12, although it is not common in this age bracket.
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.