Mental Health

Bipolar Disorder (”Manic Depression”)

What Is Bipolar Disorder?

Bipolar disorder is also called Manic Depression. The term “manic depression” isn’t the preferred term because of the connotation society has imparted to the words “mania” and “manic”. The word “mania” has become vernacular (commonly used) and has lost the medical seriously warranted in this disorder. In fact, some patients are offended when stores advertise their “July Mania” sales because the patients believe these terms downplay the pain that bipolar disorder brings to their lives and loved ones.

Bipolar Disorder (sometimes abbreviated as BP or BPD) is a neurobiochemical disorder from which a person experiences extreme “highs” and “lows” in mental perception (mood). Physical manifestations of a “high” swing may be extremely rapid thoughts coursing through the person’s head which often does not make sense or the ability for the person to go without sleep or food for several days. Physical manifestation of a “low” state may be excessive sleeping (hypersomnia).

As with many disorders, there is a spectrum of these two poles of mood (hence “bi-polar”) from extreme to mild episodes depending on the individual. Some people can experience the farthest of the extremes of the mood swings and are therefore suffering from “Classical” or Type I bipolar disorder. Along the spectrum are several variations of bipolar disorder which are assigned types II to V (2-5).

To accurately diagnose the type of bipolar disorder an individual has, he or she must consult with a professional with experience in diagnosing and treating bipolar disorders. People who suffer from bipolar disorder have described their moods as an unpredictable yo-yo, or liken the experience as being on a perpetual roller coaster ride.

Patients who experience only the down cycle have Major depressive disorder (abbreviated MDD) or Depression - these patients have Unipolar (one pole of mood) depression.

Who Gets Bipolar Disorder?

Bipolar disorder is estimated to affect approximately 5% of the U.S. population (year 2000 estimate). Bipolar disorder does not discriminate, and affects people of all races and ages. Children as young as two years old have been observed to suffer from bipolar disorder. While many professionals accept that young children can suffer from bipolar disorder, this is still under diagnosed and often misdiagnosed as ADD/ADHD.

Bipolar disorder often has a genetic basis. Therefore, a physician will ask the patient if there were family members who had symptoms of bipolar disorder. Researchers are still identifying bipolar disorder-causing gene(s) and some progress has been made. A potential molecular target that may be altered in patients with bipolar disorder is a protein called Bcl-2. This protein protects neurons (brain cells) from dying and helps neurons regenerate. However the findings are preliminary and has theoretically rather than practical implications at this point. Bcl-2 also plays a role in many disease states including cancer (in this case, Bcl-2 is the culprit and protects cancer cells from dying).

What Triggers Bipolar Disorder?

The onset of bipolar disorder-related symptoms often appear in early adolescence, and young children have also been diagnosed with bipolar disorder.

Triggers are often “invisible”. Recognizing symptoms and potential triggers are important in managing bipolar disorder. A bipolar disorder episode may be triggered by diverse factors such as sleep, stress, diet, physical activity, and the person’s own lifestyle. Each person has a unique “threshold” (tolerance level to an emotional or physical stimulation) that responds differently to triggers.

In conjunction with a medication and/or therapy regimen, some have found it helpful to keep track of certain triggers so they can anticipate symptoms. For example, high sugar content in some individuals’ diet may increase the risk of mania and they can reduce dietary sugar intake. Other non-medical practices like meditation and acupuncture may complement medication and therapy. Exercise is a critical element to relieving emotional and physical stresses.

What are the symptoms of bipolar disorder?

A helpful way of thinking about bipolar disorder symptoms is to see the symptoms in a “spectrum” rather than discrete behaviors because you may miss mild episodes. Mild episodes that did not receive proper medical attention may escalate into more serious episodes. Below is a short list of “gauges” for your reference; the medically accepted criteria for diagnosing bipolar disorder, DSM-IV, includes a more comprehensive list of symptoms of mania and depression.

Manic episode (less severe in hypomania):

* talking excessively and/or rapidly compared to usual character
* decreased need to eat or sleep, even for a few days
* exaggerated grandeur, “having plans to save the world”, “unifying religions”
* extreme cases include hallucinations and severe paranoia

depressive episode (overlaps with dysthymia):

* excessive sleeping or prevalent insomnia - disruption in usual sleeping pattern
* antisocial behavior and irritability
* prolonged feelings of inexplicable sadness, worthlessness

Why?

Many people ask the “Why me” question when confronted with a serious challenge. The alternative question is “why not me?” I find people who ask “Why not me?” inspirational because they used a devastation as a source of strength and growth.

Even though society is becoming aware of the devastating effects mental illness has on an individual and the people surrounding that individual, we are still quick to judge that person as being weak in character or having an immoral personality, and after having justified to ourselves why this is a bad person, we go about our own business. This may be easier for society to accept than to take actions to help the mentally ill, which does take a tremendous investment in time, effort, and money (as with all worthy causes).

What Treatments are Available?

There are many “first-line” treatments available. Often, these medications alone can control both the manic symptoms and depressive symptoms. However, an antidepressant may be added if depression is not alleviated with the mood stabilizer alone. It is extremely dangerous for a person suffering from bipolar disorder to take an antidepressant alone, because this can induce mania in the person.

New medications and treatment methods are becoming available for bipolar disorder, to improve the symptoms and quality of life for patients.

Is there Hope?

Yes.

Bipolar disorder does not have a “cure” but it can be managed with education, therapy, and healthy lifestyle practices (exercise, proper diet, enough sleep).

As with cancer and diabetes, bipolar disorder requires a ‘regimen’ of medical, dietary, and behavioral management. People with mental illnesses can lead productive lives. The key is to seek help before something catastrophic happens to our moods.

There is Hope when we create it for ourselves.

© 2008 by Jane Chin, Ph.D. (email) All Rights Reserved.
Abstract logo images by Asif Akbar