Bipolar disorder

**Bipolar disorder **(formerly called manic depression) is a mental illness that exists along a spectrum. People with bipolar disorder have episodes of depression that alternate with periods of better mood.

In bipolar I disorder, these periods of better mood may involve mania: a high-energy state which can cause psychosis, extreme emotions like panic attacks, or euphoria. This feeling is often followed by a period of depression. People with bipolar I disorder switch between these two states.

In bipolar II disorder, a person never becomes manic or psychotic. Their episodes of depression are often longer and more severe, and they alternate with periods of hypomania. Other disorders on the bipolar spectrum include cyclothymia.

### Depression

In people with bipolar I disorder, depressive episodes can last from a few weeks to several months. In bipolar II disorder, depressive episodes may last many months.

People who are in a depressive state are often sad and pessimistic. They may lose interest in activities they usually like, or become isolated and lonely. Other symptoms include anxiety, hopelessness, changes in sleep, and suicidal thoughts.

When bipolar disorder develops at a young age, the first few episodes are usually depressive. Because a manic or hypomanic episode is needed to diagnose bipolar disorder, some people are diagnosed with major depression at first.

### Mania

People in a manic state are often over-confident and very optimistic. This can cause them to take large risks and do things that they usually wouldn't. A person who is manic may talk very quickly with no pauses, have thoughts that change very quickly, or act without thinking.

They may also experience psychosis, where they cannot tell what is real and what is not. They may think that they are unstoppable or that they are on a mission for God.

Manic episodes last for at least a week, but can last as long as three to six months. They are usually followed by a depressive episode. Mania may become so severe that it can affect the person’s ability to work or interact with others.

### Hypomania

Hypomania is a less extreme version of mania that never involves psychosis. As described by the Cleveland Clinic:> Hypomania is a condition in which you display a revved up energy or activity level, mood or behavior. The new “energized you” is recognized by others as beyond your usual self. Hypomania is a less severe form of mania, and both are commonly part of bipolar disorder.A hypomanic episode may last from a few days to a few months.

## Diagnosis

Bipolar disorder is an illness that can show in different ways. It is often diagnosed in adolescents or young adults. A few subtypes have been identified; these subtypes mostly describe the nature of the "episodes" of the disease.

A person with bipolar I disorder has had at least one manic episode. They may or may not have episodes of depression.

A person with bipolar II disorder has had at least one major depressive episode, and at least one hypomanic episode.

A person with cyclothymia has had a hypomanic episode, and feels depressed (but not so severely that it qualifies as a major depressive episode).

## Causes

The exact cause of bipolar disorder is unknown.

Genetics definitely play a role. A 2008 study estimated that there is a 71% chance of bipolar disorder passing from parent to child. Likewise, if one identical twin has bipolar disorder, there is a significant chance that the other will develop bipolar disorder in their lifetime.

MRI studies have shown that certain parts of the brain responsible for mood regulation are larger in bipolar patients. Bipolar disorder can be caused by certain conditions that affect the brain - like a stroke, brain injury, or certain infections.

Bipolar disorder can also be triggered by certain environmental factors, such as stressful life events, overwhelming problems of everyday life, certain medications, and recreational drugs.

## Treatment

Bipolar disorder is treatable. The most common treatment is mood-stabilizing medication. These medicines prevent and control the manic and depressive episodes. Historically, lithium has been one of the most common mood stabilizers used for bipolar disorder. Therapy can also be used to control the symptoms.

The same treatments and medicines do not work for everyone, and it is not uncommon for people to have symptoms return if they stop taking medication.

### Involuntary treatment

Sometimes, people need to be treated against their will. Patients may be thinking about or have tried to commit suicide, or they may be unable to see their situation properly. In many cases, teaching people about their disease helps. When they have gone through the phases of the illness a few times, they often see that treatment can make their life easier.

## Further reading

- Genetics links between five major psychiatric disorders: autism, ADHD, bipolar disorder, depression, and schizophrenia per recent study.doi:10.1016/S0140-6736(08)61345-8
- _5 Disorders Share Genetic Risk Factors, Study Finds_ February 28, 2013 The New York Times
- _Psychiatric Disorders Linked Genetically_ February 27, 2013 WSJ

## References

- .
- . Internet version published in Journal of the ACMS 2004.

## Other websites

- BipolArt - Proof that a high proportion of bipolar people are creative. A fantastic collection of drawings, paintings, inkings, photographs, music, etc. by artists who share this illness.
- Allpsych