Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is a brain disorder that causes extreme changes in mood, thinking, and behavior. There are usually two phases, a manic phase and a depressed phase. In the manic phase you feel highly energized and are very active. In the depressed phase you are very depressed. Most people with bipolar disorder have these severe mood swings many times during their lives. Some people have mostly manic phases. Others may have mostly depressed phases. Some people have a mix of manic and depressed symptoms. Bipolar disorder used to be called manic-depressive disorder.

Bipolar disorder may last a lifetime. Symptoms tend to get worse if not treated. Follow the treatment prescribed. Bipolar disorder can be managed even if it is not cured.

What is the cause?

About 1% of people develop bipolar disorder. It usually begins during the young adult years. About as many men as women get bipolar disorder.

The exact causes of the disorder are unclear. However, it does run in families. If you have relatives with bipolar disorder, you are more likely to have it.

Parts of the brain may not work normally during manic and depressive episodes. But exactly what triggers these switches is unclear.

If you are a woman, episodes may be more likely right before your monthly period or after the birth of a child.

What are the symptoms?

During a manic episode you may:

• Have a very high sense of self-worth and a feeling of being "on top of the world."
• Be very talkative and talk fast, maybe so fast that others have trouble following what you are saying.
• Have racing thoughts and ideas to the point of being disorganized and muddled.
• Have trouble concentrating and jump between different ideas.
• Be very restless and hyperactive.
• Have more feelings of anxiety and panic.
• Go for days with little or no sleep and not feel tired.
• Be very irritable and get into fights with others.
• Have bursts of high interest in sex and sexual activity.
• Be too active and act recklessly. For example, you might spend all your money, or take a sudden trip without planning.

If you have a very intense episode, you may also have symptoms like confusion, delusions (ideas that aren't true), or hallucinations (see or hear things that are not there).

A manic episode may be followed by a period of normal mood and behavior or a period of depression.

During a period of depression, you may:

• Feel hopeless or just not care about anything.
• Be irritable.
• Have trouble falling asleep, wake up very early, or sleep too much.
• Notice increases or decreases in your appetite and weight.
• Notice a lower energy level, although you may sometimes feel overexcited.
• Lose sexual desire and function.
• Feel worthless and guilty.
• Have trouble concentrating or remembering things.
• Have unexplained physical symptoms.
• Think often about death or suicide.

These symptoms may last for days or weeks. Rapid cycling patterns are defined by 4 or more mood disturbances (major depressive, mixed, manic, or hypomanic episodes) in a year.

You may also have what is called a mixed episode. A mixed episode is mania with depressed symptoms at the same time. In a mixed episode you may be overly active, withdraw from others, feel worthless, and cry often.

How is it diagnosed?

Your healthcare provider or mental health therapist will ask about your symptoms and any drug or alcohol use. You may have lab tests to rule out medical conditions such as thyroid gland problems.

How is it treated?

Medicines are the most effective treatment for bipolar disorder. If an episode is severe, you may need to spend some time in a hospital.

Medicines

Several types of mood stabilizing medicines can help treat bipolar disorder. Your healthcare provider will work with you to carefully select the best one for you.

Sometimes you may need other medicines. Your provider may prescribe an antidepressant, an antipsychotic, or an antianxiety medicine. However, it is possible that symptoms may become worse if you take antidepressants.

There are no nonprescription medicines for bipolar disorder.

Psychotherapy

Counseling and psychotherapy are usually very helpful. They help you learn how to maintain a positive lifestyle and attitude, which can reduce your episodes.

Natural Remedies and Alternative Treatments

Omega-3 fatty acids may help to reduce symptoms of depression. No herbal or natural remedies are effective in treating bipolar disorder.

Controlling stress, keeping to a regular sleep schedule, having friends or family to support you, and being more relaxed may help manage manic or depressive episodes.

How can I take care of myself?

• Take your medicines every day, even if you are feeling well. Stopping your medicines when you feel well may bring about episodes.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, take walks. Try deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs, because they can make your symptoms worse. Exercise according to your healthcare provider's instructions.
• Check your medicines. Check with the healthcare provider treating you for bipolar disorder before you take other medicines to make sure there is no conflict with your bipolar medicines.
• Get support. Talk with family and friends. Contact organizations such as the Depression and Bipolar Support Alliance (DBSA), the National Alliance for the Mentally Ill (NAMI), and the Mental Health America for information and support.
• Watch yourself for the beginning signs of a manic or depressive episode. Ask others around you to also watch closely.

When should I seek help?

If you are showing the signs of either a manic or depressive episode, seek professional help quickly. Do not try to treat your illness by yourself. Professional treatment is necessary. If bipolar disorder is not treated, it tends to get worse. The mania and depression can be more severe and episodes happen more often. Most of the time, you will feel much better after a few weeks of treatment.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others. Also get emergency help if manic behavior becomes so wild that it endangers you or others.