Bipolar disorder

What is bipolar disorder?
Bipolar disorder is an illness that causes extreme mood changes from manic episodes of very high energy to the extreme lows of depression. It is also called manic-depressive disorder.

This illness can cause behavior so extreme that you cannot function at work, in family or social situations, or in relationships with others. Some people with bipolar disorder become suicidal.

Having this disorder can make you feel helpless and hopeless. But you are not alone. Talking with others who suffer from it may help you learn that there is hope for a better life. And treatment can help you get back in control.

Family members often feel helpless when a loved one is depressed or manic. If your loved one has bipolar disorder, you may want to get counseling for yourself. Therapy can also help a child who has a bipolar parent.

What causes bipolar disorder?
The cause of bipolar disorder is not completely understood. We know that it runs in families. It may also be affected by your living environment or family situation. One possible cause is an imbalance of chemicals in the brain.

What are the symptoms?
The symptoms depend on your mood swings. In a manic episode, you may feel very happy, energetic, or on edge. You may feel like you need very little sleep. You may feel overly self-confident. Some people spend a lot of money or get involved in dangerous activities when they are manic.

After a manic episode, you may return to normal, or your mood may swing in the opposite direction to feelings of sadness, depression, and hopelessness. When you are depressed, you may have trouble thinking and making decisions. You may have memory problems. You may lose interest in things you have enjoyed in the past. You may also have thoughts about killing yourself.

The mood swings of bipolar disorder can be mild or extreme. They may come on slowly over several days or weeks or suddenly over a few minutes or hours. The mood swings may last for a few hours or for several months.


How is bipolar disorder diagnosed?
Bipolar disorder is hard to diagnose. There are no lab tests for it. Instead, your doctor or therapist will ask detailed questions about what kind of symptoms you have and how long they last. To be diagnosed with bipolar I disorder, you must have had a manic episode lasting at least a week (less if you had to be hospitalized). During this time, you must have had three or more symptoms of mania, such as needing less sleep, being more talkative, behaving wildly or irresponsibly in activities that could have serious outcomes, or feeling as if your thoughts are racing. In bipolar II disorder, the manic episode may be less severe and shorter.

Your urine and blood may be tested to rule out other problems that could be causing your symptoms.

How is it treated?
The sooner bipolar disorder is identified and treated, the better your chances of getting it under control. One of the most important parts of dealing with a manic episode is recognizing the early warning signs so that you can start treatment early with medicine that is especially for manic phases.

A variety of medicines is used to treat bipolar disorder. You may need to try several before you find the right combination that works for you.

Most people with bipolar disorder need to take a medicine called a mood stabilizer every day.
Medicines called antipsychotics can help get a manic phase under control.
Antidepressants are used carefully for episodes of depression, because they cause some people to move into a manic phase.
People often have to try several different medicines before finding what works for them. Regular checkups are important so that your doctor can tell if your treatment is working.

Counseling for you and your family is also an important treatment. It can help you cope with some of the work and relationship issues that your illness may cause.

Charting your mood is one way you can start to see your patterns and symptoms. Keep a notebook of your feelings and what brought them on. If you learn what triggers your mood swings, you may be able to avoid them sometimes.

People often stop taking their medicines during a manic phase because they feel good. But this is a mistake. You must take your medicines regularly, even if you are feeling better.

Who is affected by bipolar disorder?
Over 3 million Americans—about 1% of the population, or 1 in every 100 people—have bipolar disorder, with similar rates in other countries.1 Bipolar disorder occurs equally among males and females. It often begins between the ages of 15 and 24.

Prevention
Bipolar disorder cannot be prevented, but often the mood swings can be controlled with medicines.

About 1 in 3 people will remain completely free of symptoms of bipolar disorder by taking mood stabilizer medicine, such as carbamazepine or lithium, for life.
To help prevent a depressive or manic mood episode, you can:
Eat a balanced diet.
Exercise daily.
Avoid extensive travel into other time zones.
Get approximately the same number of hours of sleep every night.
Avoid alcohol and illegal drugs.
Reduce stress at work and at home.
Limit caffeine and nicotine during manic episodes.
Seek treatment as soon as you notice symptoms of a depressive or manic episode coming on.
Changes in your sleep patterns can sometimes trigger a manic or depressive episode. If you plan extensive travel into other time zones, you may want to call your doctor before you leave. Find out from your doctor if you should make any changes in your medicines and what to do if you have a manic or depressive episode while you are away.