Bipolar Disorder / Manic Depression

Definition of Bipolar Disorder

Bipolar disorder, also known as manic depression, is a mood disorder that causes people to shift between extremes in mood and energy.

Causes of Bipolar Disorder

Bipolar disorder is most likely caused by imbalance of neurotransmitters (chemical messengers) in the brain.[3] For many people, manic depression is inherited, with many people in the same family suffering from the disorder.[3] Stressful events in one’s life such as abuse or a breakup can also trigger the disorder or an episode of depression.[3]

Symptoms of Bipolar Disorder

To be considered bipolar disorder, an individual must experience symptoms of both mania (“ups”) and depression (“downs”).[7] However, the pattern and severity of these symptoms can look very different between two people with the same disorder.

The manic phase of bipolar disorder lasts at least one week.[5] During a manic episode, a person may feel unusually excited, joyful, or agitated. They may suddenly take on big projects and have trouble controlling their impulses, leading to destructive behavior such as quitting one’s job or spending a great deal of money. They might also be unusually distracted or irritable, and may find themselves involved in confrontations.[1,5]

Symptoms of mania, or manic symptoms, include:

  • increased energy
  • excessively good mood
  • little need for sleep or rest
  • feelings of euphoria or “high”
  • inflated self-esteem
  • high activity level
  • unusually poor judgment
  • talkativeness
  • increased sex drive
  • trouble concentrating[1,5,7,8]

Some people may experience an elevated mood with some of these symptoms to only a moderate degree that allows them to continue functioning. This is caused hypomania.

Symptoms of depression include:

  • Long-lasting feelings of sadness or emptiness
  • Loss of interest or pleasure in activities
  • Trouble concentrating
  • Trouble sleeping
  • Weight loss
  • Thoughts of death[4]

Types of Bipolar Disorder

There are four categories of bipolar disorder:

  1. Bipolar I Disorder (“raging bipolar”) is diagnosed after at least one episode of mania or one mixed episode (an episode with both manic and depressive symptoms) lasting at least seven days. Symptoms of the episode are severe and the person may experience hallucinations, be violent, or require hospitalization. Episodes of depression must also be present to be considered bipolar I.
  2. Bipolar II Disorder (“swinging bipolar”) involves at least one episode of hypomania (elevated mood) and one depressive episode, without the full-blown mania of bipolar I.
  3. Bipolar Disorder Not Otherwise Specified (BP-NOS) is the label given when the person has symptoms of bipolar disorder without matching either bipolar I or II.
  4. Cyclothymia involves persistent, shifts in mild symptoms of hypomania and depression for at least two years, without symptoms of the above.[1,2]

Treatment for Bipolar Disorder

The most common treatment for bipolar disorder is medication, usually in conjunction with talk therapy.[6] Common medications for bipolar disorder include mood stabilizers such as lithium and valproic acid (Depakote), atypical antipsychotics such as aripiprazole (Abilify), and antidepressants like Fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft).[6] Some people may need to try more than one medication or a combination of medications until they find the best treatment for them. For cases that do not respond to medication and therapy, electroconvulsive therapy (ECT) may also be prescribed.[6]

References

  1. Bipolar Disorder. Retrieved from:: http://www.brown.edu/Courses/BI_278/Other/Clerkship/Didactics/Readings/Bipolar Disorder.pdf
  2. Bipolar Disorder. National Institutes of Mental Health. Retrieved from http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml
  3. Causes of bipolar disorder. NHS Choices. Retireved from http://www.nhs.uk/Conditions/Bipolar-disorder/Pages/Causes.aspx
  4. Diagnostic Criteria for Major Depressive Episode. Pendulum.org. Retrieved from http://www.pendulum.org/information/information_criteria_depression.html
  5. Diagnostic Criteria for Manic Episode. Pendulum.org. Retrieved from http://www.pendulum.org/information/information_criteria_mania.html
  6. How is Bipolar Disorder Treated? National Institutes of Mental Health. Retrieved from http://www.nimh.nih.gov/health/publications/bipolar-disorder/how-is-bipolar-disorder-treated.shtml
  7. Manic Depression / Bipolar Disorder. The Ohio State University Wexner Medical Center. Retrieved from: http://medicalcenter.osu.edu/patientcare/healthcare_services/mental_health/mental_health_about/mood/bipolar_disorder/Pages/index.aspx
  8. What is Bipolar Disorder? National Alliance on Mental Illness. Retrieved from http://www.nami.org/Content/NavigationMenu/Mental_Illnesses/Bipolar1/Home_-_What_is_Bipolar_Disorder_.htm

By C. J. Newton, MA, Therapists.com Editor

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