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DBSA National

Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is a treatable medical illness marked by extreme changes in mood, thought, energy, and behavior. It is also known as manic-depressive disorder because a person’s mood can alternate between symptoms of mania and depression.

These changes in mood can last for hours, days, weeks, or even months. Unlike people with clinical depression (the lows), most people who have bipolar disorder talk about experiencing highs and lows.

Abnormalities in brain biochemistry and in the structure and/or activity of certain brain circuits are responsible for the extreme shifts in mood, thought, energy, and functioning that characterize bipolar disorder.

A diagnosis of bipolar I disorder is made when a person has experienced at least one episode of severe mania; a diagnosis of bipolar II disorder is made when a person has experienced at least one hypomanic episode but has not met the criteria for a full manic episode. Cyclothymic disorder, a milder illness, is diagnosed when a person experiences—over the course of at least two years (one year for adolescents and children)—numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that are not severe enough to meet criteria for major manic or depressive episodes.

Bipolar disorder with rapid cycling is defined as four or more episodes of illness within a 12-month period. This form of the illness tends to be more resistant to treatment than non-rapid-cycling bipolar disorder.

  • Heightened mood, exaggerated optimism and self-confidence
  • Decreased need for sleep (less than three hours) without fatigue
  • Grandiose delusions, inflated sense of self-importance
  • Excessive irritability, aggressive behavior
  • Increased physical, mental activity
  • Racing speech or flight of ideas, impulsiveness
  • Poor judgement, easily distracted, difficulty concentrating
  • Reckless behavior without concern for consequences, such as spending sprees, rash business decisions, erratic driving, sexual indiscretions
  • In severe cases, auditory hallucinations (hearing voices) or delusions (strong convictions about things that aren’t true)

If a person experiences five or more of the following symptoms each day during a two-week period or if these symptoms interfere with work or family activities, criteria for a major depressive episode are met:

  • Prolonged sadness or unexplained crying spells
  • Significant changes in appetite, sleep patterns
  • Irritability, anger, worry, agitation, anxiety
  • Pessimism, indifference
  • Loss of energy, persistent tiredness
  • Feelings of guilt, worthlessness
  • Inability to concentrate, indecisiveness
  • Inability to take pleasure in former interests, social withdrawal
  • Unexplained aches and pains
  • Recurring thoughts of death and suicide

Bipolar disorder affects more than 2.5 million adult Americans every year. (National Institute of Mental Health)

  • Up to 90 percent of bipolar disorders start before age 20, although the illness can start in early childhood or as late as the 40’s and 50’s. An equal number of men and women develop bipolar illness and it is found in all ages, races, ethnic groups, and social classes.
  • More than two-thirds of people with bipolar disorder have at least one close relative with the illness or with unipolar major depression, indicating that the disease has a heritable component. (National Institute of Mental Health)
  • Although bipolar disorder is equally common in women and men, research indicates that approximately three times as many women as men experience rapid cycling. (Journal of Clinical Psychiatry, 58, 1995 [Suppl.15])
  • Other research findings indicate that women with bipolar disorder may have more depressive episodes and more mixed episodes than do men with the illness. (Journal of Clinical Psychiatry, 58, 1995 [Suppl.15])
  • Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is 15&ndash30%. When both parents have bipolar disorder, the risk increases to 50–75%. (National Institute of Mental Health)
  • Some 20% of adolescents with major depression develop bipolar disorder within five years of the onset of depression. (Birmaher, B., “Childhood and Adolescent Depression: A Review of the Past 10 Years.” Part I, 1995)
  • Up to one-third of the 3.4 million children and adolescents with depression in the United States may actually be experiencing the early onset of bipolar disorder. (American Academy of Child and Adolescent Psychiatry, 1997)
  • When manic, children and adolescents, in contrast to adults, are more likely to be irritable and prone to destructive outbursts than to be elated or euphoric.
  • When depressed, children and adolescents may have many physical complaints, such as headaches and stomachaches or tiredness. They may also suffer from poor performance in school, irritability, social isolation, and extreme sensitivity to rejection or failure. (National Institute of Mental Health).
  • Bipolar disorder results in 9.2 years’ reduction in expected life span, and as many as one in five patients with bipolar disorder completes suicide. (National Institute of Mental Health)
  • Success rates of 70–85% were once expected with lithium for the acute phase treatment of mania, however, lithium response rates of only 40–50% are now commonplace. (Surgeon General Report for Mental Health)
  • Participation in a DBSA patient-to-patient support group improved treatment compliance by almost 86% and reduced in-patient hospitalization. (DBSA, 1999)
  • Consumers with bipolar disorder face up to ten years of coping with symptoms before getting an accurate diagnosis, with only one in four receiving an accurate diagnosis in less than three years. (DBSA, 2000)
  • A gender bias exists in the diagnosis of bipolar disorder: women are far more likely to be misdiagnosed with depression and men are far more likely to be misdiagnosed with schizophrenia. (DBSA, 2000)
  • Nearly 9 out of 10 consumers with bipolar disorder are satisfied with their current medication(s), although side effects remain a problem. (DBSA, 1999)
  • Consumers who report high levels of satisfaction with their treatment and treatment provider have a much more positive outlook about their illness and their ability to cope with it. (DBSA, 1999)

Reprinted from DBSA National website

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