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Bipolar Disorder or Manic Depression

Bipolar disorder is a mental illness that causes extreme mood swings. This condition is also called manic-depressive illness. It may be caused by a chemical imbalance in the brain.

Bipolar disorder sometimes runs in families. If you have a parent who has bipolar disorder, you have a greater chance of having it. Both men and women can have bipolar disorder. In most cases, bipolar disorder first appears in young adults, but children and adolescents might also suffer from this disorder.

Signs and symptoms of Bipolar Disorder

Bipolar disorder is characterized by two extremes - the polar opposites that give the condition its name.

Signs and symptoms of the manic phase (Bipolar I)

• euphoria, feeling "high"
• Decreased need for sleep
• Unusally pressured, rapid and/or prolonged speech
• Easily irritated or distracted
• Spending too much money
• Racing thoughts or flights of ideas.

Hypomania (Bipolar II) eposide may last as little as 4 days and are characterized by a clear change in functioning that falles short of engendering marked impairment, in addition to having three or more of the accompanying manic symptoms. Psychotic features also may occur in bipolar disorders and typically reflect manic mood (e.g., grandiose delusions). Cyclothymic disorder parallels dysthymia, defined by 2 years or more of alternating mild depressive and hypomanic episodes.

Although bipolar disorder can be diagnosed from just a manic episode, most persons with this disorder also experience the other extreme, depression.

Signs and symptoms of the depressive state:

• Lasting sad, anxious, or empty mood
• feeling worthless or guilty
• difficulty concentrating or making decisions
• Fatigue or loss of energy
• loss of self-esteem
• diminished interest in daily activities
• withdrawal from others
• drug or alcohol use
• thoughts of death or suicide

What are the Causes of Bipolar Disorder ?

While there are many biological factors associated with mania and depression, none of them has been proven to be a cause or to be diagnostic of bipolar disorder.

At least 50% of people with bipolar disorder have a parent with a mood disorder, most often major depressive disorder. A person has a 30% chance of inheriting a mood disorder if one parent has bipolar disorder, and a 60% chance if both parents have it. Research has found an even greater risk among twins, especially identical twins, who have a parent with bipolar disorder.

New mothers with bipolar disorder have a great risk-30% to 50%-for an episode during the first month after childbirth. This means that the pregnancy must be managed properly to ensure safety for both mother and child.

Treatments for Bipolar Disorder

Widely used to treat bipolar disorder, lithium proves highly effective in relieving and preventing manic episodes. The drug curbs the accelerated thought processes and hyperactive behavior without the sedating effect of antipsychotic drugs. In addition, it may prevent the recurrence of depressive episodes; however, it's ineffective in treating acute depression.

Lithium has a narrow therapeutic range, so treatment must be initiated cautiously and the dosage adjusted slowly. Therapeutic blood levels must be maintained for 7 to 10 days before effects appear; therefore, antipsychotic drugs often are used in the interim for sedation and symptomatic relief. Because lithium is excreted by the kidneys, any renal impairment necessitates withdrawal of the drug.

Valproic acid is an alternative to lithium for those who don't tolerate it. It's especially helpful in rapid cycling courses of bipolar disorder. Carbamazepine is helpful in the treatment of mania but isn't formally approved by the FDA for bipolar disorder.

Antidepressants occasionally are used to treat depressive symptoms. However, these drugs may trigger a manic episode.