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Bipolar disorder, also known as manic-depressive illness,
is a brain disorder that causes unusual shifts in a person's
mood, energy, and ability to function. Different from the
normal ups and downs that everyone goes through, the symptoms
of bipolar disorder are severe. They can result in damaged
relationships, poor job or school performance, and even suicide.
But there is good news: bipolar disorder can be treated,
and people with this illness can lead full and productive
lives.
About 5.7 million American adults or about 2.6 percent of
the population age 18 and older in any given year, have
bipolar disorder. Bipolar disorder typically develops in
late adolescence or early adulthood. However, some people
have their first symptoms during childhood, and some develop
them late in life. It is often not recognized as an illness,
and people may suffer for years before it is properly diagnosed
and treated. Like diabetes or heart disease, bipolar disorder
is a long-term illness that must be carefully managed throughout
a person's life.
What Are the Symptoms of Bipolar Disorder?
Bipolar disorder causes dramatic mood swings—from
overly "high" and/or irritable to sad and hopeless, and then
back again, often with periods of normal mood in between.
Severe changes in energy and behavior go along with these
changes in mood. The periods of highs and lows are called episodes of
mania and depression.
Signs and symptoms of mania (or a manic episode)
include:
- Increased energy, activity, and restlessness
- Excessively "high," overly good, euphoric mood
- Extreme irritability
- Racing thoughts and talking very fast, jumping from one
idea to another
- Distractibility, can't concentrate well
- Little sleep needed
- Unrealistic beliefs in one's abilities and powers
- Poor judgment
- Spending sprees
- A lasting period of behavior that is different from usual
- Increased sexual drive
- Abuse of drugs, particularly cocaine, alcohol, and sleeping
medications
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
A manic episode is diagnosed if elevated mood occurs with
three or more of the other symptoms most of the day, nearly
every day, for 1 week or longer. If the mood is irritable,
four additional symptoms must be present.
Signs and symptoms of depression (or a depressive
episode) include:
- Lasting sad, anxious, or empty mood
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in activities once enjoyed,
including sex
- Decreased energy, a feeling of fatigue or of being "slowed
down"
- Difficulty concentrating, remembering, making decisions
- Restlessness or irritability
- Sleeping too much, or can't sleep
- Change in appetite and/or unintended weight loss or gain
- Chronic pain or other persistent bodily symptoms that
are not caused by physical illness or injury
- Thoughts of death or suicide, or suicide attempts
A depressive episode is diagnosed if five or more of these
symptoms last most of the day, nearly every day, for a period
of 2 weeks or longer.
A mild to moderate level of mania is called hypomania.
Hypomania may feel good to the person who experiences it
and may even be associated with good functioning and enhanced
productivity. Thus even when family and friends learn to
recognize the mood swings as possible bipolar disorder, the
person may deny that anything is wrong. Without proper treatment,
however, hypomania can become severe mania in some people
or can switch into depression.
Sometimes, severe episodes of mania or depression include
symptoms of psychosis (or psychotic symptoms).
Common psychotic symptoms are hallucinations (hearing, seeing,
or otherwise sensing the presence of things not actually
there) and delusions (false, strongly held beliefs not influenced
by logical reasoning or explained by a person's usual cultural
concepts). Psychotic symptoms in bipolar disorder tend to
reflect the extreme mood state at the time. For example,
delusions of grandiosity, such as believing one is the President
or has special powers or wealth, may occur during mania;
delusions of guilt or worthlessness, such as believing that
one is ruined and penniless or has committed some terrible
crime, may appear during depression. People with bipolar
disorder who have these symptoms are sometimes incorrectly
diagnosed as having schizophrenia, another severe mental
illness.
It may be helpful to think of the various mood states in
bipolar disorder as a spectrum or continuous range. At one
end is severe depression, above which is moderate depression
and then mild low mood, which many people call "the blues" when
it is short-lived but is termed "dysthymia" when it is chronic.
Then there is normal or balanced mood, above which comes
hypomania (mild to moderate mania), and then severe mania.
In some people, however, symptoms of mania and depression
may occur together in what is called a mixed bipolar
state. Symptoms of a mixed state often include agitation,
trouble sleeping, significant change in appetite, psychosis,
and suicidal thinking. A person may have a very sad, hopeless
mood while at the same time feeling extremely energized.
Bipolar disorder may appear to be a problem other than mental
illness—for instance, alcohol or drug abuse, poor school
or work performance, or strained interpersonal relationships.
Such problems in fact may be signs of an underlying mood
disorder.
To read the rest of this excellent article
(including diagnosis and treatment information) from the
National Institute of Mental Health, please click here: http://www.nimh.nih.gov/publicat/bipolar.cfm
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