Bipolar Disorder


What Is Bipolar Disorder?



Bipolar disorders are one of several medical conditions called
depressive disorders. Depressive disorders affect the way a person's
brain functions.

Depressive disorders are widespread. In the United States alone, it's
estimated that more than 17.4 million adults have a depressive disorder
each year. That works out to about 1 out of every 7 people, so there's a
good chance that you or someone you know is dealing with a depressive
disorder.





Bipolar
disorder goes by many names: manic depression, manic-depressive
disorder, manic-depressive illness, bipolar mood disorder, and bipolar
affective disorder are medical terms for the same condition.

Bipolar disorder is classified into four different types: Bipolar I,
Bipolar II, Cyclothymic Disorder, or Bipolar Disorder Not Otherwise
Specified. Mental health experts separate the condition into these four
types because the symptoms of bipolar disorder show up differently in
different people. When doctors know what type someone has, they can
tailor treatment to that person's specific needs.How Does It Affect People?



Bipolar disorder affects both men and women. For many people, the
first symptoms show up in their early twenties. However, research has
shown that the first episode of bipolar disorder is occurring earlier:
It often shows up in adolescence, and even children can have the
disorder.

Recent research suggests that kids and teens with bipolar disorder
don't always have the same behavioral patterns that adults with bipolar
disorder do. For example, kids who have bipolar disorder may experience
particularly rapid mood changes and may have some of the other
mood-related symptoms listed below, such as irritability and high levels
of anxiety. But they may not show other symptoms that are more commonly
seen in adults.

Because brain function is involved, the ways people with bipolar
disorder think, act, and feel are all affected. This can make it
especially difficult for other people to understand their condition. It
can be incredibly frustrating if other people act as though someone with
bipolar disorder should just "snap out of it," as if a person who is
sick can become well simply by wanting to.

Bipolar disorder isn't a sign of weakness or a character flaw; it's a
serious medical condition that requires treatment, just like any other
condition.What Are the Signs and Symptoms?



A person with bipolar disorder will go through episodes of mania (highs) and at other times experience episodes of depresion
(lows). These aren't the normal periods of happiness and sadness that
everyone experiences from time to time. Instead, the episodes are
intense or severe mood swings, like a pendulum that keeps arcing higher
and higher.

Symptoms of mania include:

• racing speech and thoughts
  
• increased energy
  
• decreased need for sleep
  
• elevated mood and exaggerated optimism
  
• increased physical and mental activity
  
• excessive irritability, aggressive behavior, and impatience
  
• poor judgment
  
• reckless behavior, like excessive spending, making rash decisions, and erratic driving
  
• difficulty concentrating
  
• inflated sense of self-importance
  

Symptoms of depression include:

• loss of interest in usual activities
  
• prolonged sad or irritable mood
  
• loss of energy or fatigue
  
• feelings of guilt or worthlessness
  
• sleeping too much or inability to sleep
  
• drop in grades and inability to concentrate
  
• inability to experience pleasure
  
• appetite loss or overeating
  
• anger, worry, and anxiety
  
• thoughts of death or sucide
  

In adults, episodes of mania or depression usually last for weeks or
months, although they can be shorter in length. In children and
adolescents, though, these episodes can be much shorter, and a kid or
teen can even go back and forth between mania and depression throughout
the day.

Episodes of mania or depression may happen irregularly and follow an
unpredictable pattern or they may be linked, with a manic episode always
following a period of depression, or vice versa. Sometimes episodes
have a seasonal pattern. Mania in the spring, for example, may be
followed by depression in the winter.

Between episodes, someone with bipolar disorder usually returns to
normal (or near-normal) functioning. For some people, though, there is
little or no "break period" between their cycles. These mood swing
cycles can change slowly or rapidly, with rapid cycling between mania
and depression being much more common in women, children, and
adolescents.

Some people with bipolar disorder turn to alcohol and drugs because
they feel temporarily better when they're high. But using alcohol and
drugs can have disastrous results for people with bipolar disorder.
Substance abuse can actually make the symptoms worse, as well as making
the condition hard for doctors to diagnose.
What Causes Bipolar Disorder?



Doctors and scientists don't know the exact cause of bipolar
disorder, but they think that biochemical, genetic, and environmental
factors may all be involved. It's believed this condition is caused by
imbalances in certain brain chemicals called neurotransmitters. If the neurotransmitters aren't in balance, the brain's mood-regulating system won't work the way it should.

Genes
also play a role. If a close relative has bipolar disorder, a person's
risk of developing the condition is higher. This doesn't mean, though,
that if you have a relative with bipolar disorder you will automatically
develop it! Even in studies involving identical twins raised in the
same home, one twin sometimes had bipolar disorder whereas the other did
not. Researchers are now working on identifying the gene or genes
involved in bipolar disorder.

Environmental factors may play a role in bipolar disorder. For some teens, stresses such as a death in the family, their parents' divorce
or other traumatic events could trigger a first episode of mania or
depression. Sometimes, going through the changes of puberty can set off
an episode. In girls, symptoms can be tied to their monthly menstrual cycle

How Is Bipolar Disorder Diagnosed?



Most people with bipolar disorder can be helped — but a psychiatrist
or psychologist must first diagnose the disorder. Sadly, many people
with the condition are never diagnosed or are not diagnosed properly.
Without proper diagnosis and treatment, the disorder can become worse.
Some teens with undiagnosed bipolar disorder can end up in a psychiatric
hospital or residential treatment center, in the juvenile justice
system, abusing drugs, or committing suicide.

Because children and teens with bipolar disorder do not usually show
the same patterns of behavior as adults who have the condition, a mental
health professional will observe a teen's behavior carefully before
making a diagnosis. This includes getting a complete history of the
person's past and present experiences. Family members and friends can
also provide helpful insights into the person's behavior. The doctor may
also want a teen to have a medical exam to rule out other conditions.

Diagnosing bipolar disorder can be difficult. As yet, there aren't
any laboratory tests like a brain scan or blood test that will diagnose
it. In teens, bipolar disorder can sometimes be mistaken for illnesses
like schizophrenia and posttraumatic stress disorder, attention deficit
hyperactivity disorder (ADHD), and other depressive disorders. That's
why a complete, detailed history is so important.
How Do Doctors Treat It?



Although there's no cure for bipolar disorder, treatment can help
stabilize moods and help the person manage and control symptoms. Like
other teens with long-lasting medical conditions (such as asthma, diabetes, or epilepsy), teens with bipolar disorder need to work closely with their doctors and other medical professionals to treat it.

This team of medical professionals, together with the teen and family, develop what is called a treatment plan.
Teens with bipolar disorder will probably receive medication, such as a
mood stabilizer, from a psychiatrist or other medical doctor. A
psychologist or other type of counselor will provide counseling or
psychotherapy for the teen and his or her family. Doctors will watch the
symptoms closely and offer additional treatment advice if necessary.

Living With Bipolar Disorder



Teens normally face ups and downs with school, family, work, and
friends. Dealing with bipolar disorder at the same time is a very
difficult challenge. One 16-year-old reader who was diagnosed with
bipolar disorder at 14 wrote to us about the experience:

"I had mood swings that were the worst anyone could have ever seen.
My poor parents thought I hated them, but really I was sick and didn't
even realize it. But now I am on medications for my disorder and I live a
pretty normal life. My family and friends support me, and they, along
with my therapist, have helped me get to the point where I am today. I
just want other teens to know that even though it is hard at times to be
bipolar, things will get better."

If you've been diagnosed with bipolar disorder, taking your
medications as prescribed, reporting any changes in how you feel or
function, and participating in therapy will be key to living a
successful life. In addition to treatment, making a few lifestyle
changes, such as reducing stress, eating well, and getting enough sleep
and exercise can help someone who is living with the condition. And many
teens find it helps to join a support network such as a local support
group for people with bipolar disorder.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: November 2010