Bipolar Disorder

Bipolar disorder, also known as manic depression, can be a serious and debilitating mental illness. This disorder affects one percent (approximately three million people) of the population in the United States. It occurs equally in men and women. Although the exact cause remains unknown, it is believed that biologic, genetic, and environmental factors are involved in triggering the episodes of this illness. These episodes may last for weeks or months. Bipolar disorder frequently begins in adolescence or young adulthood, and peaks between 20 and 30 years of age. There is no cure for this illness; however, it can be controlled

with medication and other therapies.

Bipolar disorder involves phases of mania and depression. People with bipolar disorder tend to alternate between these two phases. Usually mania is the first episode in males, and depression is the first in females. The manic phase is characterized by feelings of euphoria, decreased need for sleep, poor judgment and insight, reckless or irresponsible behavior, aggressiveness, poor concentration, and increased energy. The depressive phase is characterized by intense feelings of sadness or hopelessness, disturbances in sleep and appetite, exhaustion, irritability, and recurring thoughts of suicide.

There are three stages of mania that starts with hypomania. During the hypomania stage, the bipolar patients say that they are vigorous, and self-assured. The hypomania state seems as though the patients are ?addicted? to their mania. The second stage to mania is shown by a loss of judgment and an irritable mood. The third stage is obvious when the patient experiences delusions and behavior becomes hyperactive. Sometimes this behavior is associated with aggression.

Typically, bipolar individuals experience between eight to ten manic-depressive episodes in their lifetime. As the individual ages, it is reported that, the depressive phase becomes longer and increases in incidence. According to the National Depressive and Manic Depressive Association (NDMDA), this disturbing disorder can create developmental delays, family disruptions, and occupational setbacks.

Evidence suggests that people who have bipolar disorder have differences in the chemical messengers between nerve cells in the brain (neurotransmitters). There may also be an irregularity in the genes that regulate the neurotransmitters. Environmental factors that may contribute to bipolar disorder include psychologically disturbing events, drug abuse, and alcoholism.

When both manic and depressive symptoms occur simultaneously it is called a mixed episode. There is a mixture of despair, agitation, and apprehension. During this episode patients report feeling dysphoric, depressed, and despondent. Still they exhibit the energy associated with mania. Rapid cycling mania is another appearance of bipolar disorder. Mania may be present with four or more distinct episodes within a one-year period.

Since there is no cure for bipolar disorder, medication and psychotherapy are the major treatments. Mood stabilizers, anti-seizure medications, antidepressants, and some anti-psychotic medications are used for treatment. At times, treatment such as electroconvulsive therapy (ECT) is employed.

Lithium is a mood stabilizer that has been