Bipolar disorder isn't like the normal ups and downs we all experience. It's a serious mental illness.
It's often compared to a rollercoaster ride because of its extreme highs and lows. But unlike a rollercoaster ride, there's nothing amusing about bipolar disorder.
According to the National Institute of Mental Health, as many as 2.6 percent of Americans over age 18 have bipolar disorder. Also known as manic depression, this serious mental illness is characterized by unusual and extreme swings in a person's mood, energy, and ability to function.
How is it different from the normal ups and downs we all go through? "The symptoms of bipolar disorder last much longer and are much more severe," says psychiatrist Joshua P. Golden, M.D. "We may feel down for part of a day, a few days, or even a week or two. However, bipolar symptoms, when left untreated, can last many months and sometimes longer." Without treatment, these symptoms can result in failed relationships, economic problems, drug addiction, and even suicide.
Although there's no cure for bipolar disorder, there are effective ways to help keep it in check. These typically include medication, often in combination with psychotherapy. But the first step in coping with the illness is knowing how to read the signs.
The states of bipolar disorder
A person with bipolar disorder typically goes through alternating periods of emotional highs and lows called episodes, with periods of normal behavior in between.
Mania
During a high (manic) episode, a person may show symptoms such as:
- Increased energy and restlessness
- Euphoria, grandiosity (exaggerated sense of importance)
- Rapid speech, irritability
- Inability to concentrate
- Poor judgment
- Decreased need for sleep or food
- Aggressive, socially inappropriate behavior
- Abuse of alcohol and other drugs
"People going through a manic episode tend to engage in extravagant behavior that lacks judgment and often gets them into serious trouble," says Lawrence H. Price, M.D., Clinical Director and Director of Research at Butler Hospital in Providence, Rhode Island and Professor of Psychiatry and Human Behavior at Brown Medical School. "For example, someone might have an affair, go on an expensive spending spree, gamble, or invest in a risky business venture." It's common for a manic person to deny that anything is wrong. Yet the changes in his or her mood and behavior are often frighteningly noticeable to friends and family.
Depression
During a low episode, a person feels deep despair, emptiness, and melancholy. Other symptoms may include:
- Feelings of guilt, worthlessness, and helplessness
- Loss of interest in activities one usually enjoys
- Difficulty concentrating, remembering, or making decisions
- Increased (or decreased) need for sleep
- Changes in appetite, or unintended weight loss or gain
- Low self-esteem
- Suicidal thoughts and/or behaviors
"People often assume that having a depressive episode automatically indicates that someone has bipolar disorder," says Dr. Golden. "But to make that diagnosis, there should be at least one or more manic episodes."
Mixed
Some people with bipolar disorder experience a "mixed" episode, when symptoms of mania and depression are present at the same time. "This condition is extremely volatile, often leading to psychosis [complete loss of touch with reality]," says Dr. Price. "It's different for each person. One patient I had honestly believed he could fly. He ended up jumping off a building and seriously injuring himself."
Who's at risk?
According to Dr. Price, "We don't know exactly what causes bipolar disorder, but there is a strong genetic component." In fact, two-thirds or more of people with bipolar disorder also have a relative with the same illness or some other mood disorder. "While genetics increases the risk, it's not inevitable you'll get it," Dr. Price adds. Researchers are working to find out what other factors may play a role.
Treatment and self-care
"Bipolar disorder is frequently misdiagnosed, which is why it's important to be seen by a doctor who specializes in mood disorders," says Dr. Price. "An experienced physician can help identify patterns of behavior or triggers that lead to episodes of bipolar disorder."
A treatment plan for bipolar disorder includes medication in combination with therapy. If you are being treated for this condition, be sure to:
- Take your medications. Even if you're feeling well, resist the temptation to skip your medication. Be sure to schedule and keep your regular appointments with your doctor.
- Watch for warning signs. Call your doctor if you feel an episode coming on. Ask your friends and family to help watch for your warning signs.
- Avoid alcohol and other drugs. Drugs, especially stimulants and antidepressants, and alcohol can trigger an episode.
- Check before taking other medications. Call your doctor to make sure another drug will not have a bad interaction with your bipolar disorder medications.
Living with bipolar disorder isn't easy, but with proper treatment and support, it's possible to lead a healthy and productive life.
