You may have missed the memo wherein we started calling “manic depression” by the newer moniker “bipolar disorder.” But by whatever name it is known, it can be a killer: the suicide rate among those affected is greater than 6 percent, and self-harm occurs in 30 to 40 percent of the patients.
The “bi” in bipolar refers to the two extremes in moods which characterize the ailment's symptoms. During the emotional highs (hypomania), those afflicted will feel euphoric and energetic; during the lows (depression), they will feel sad, hopeless, and lose interest in most activities. These shifts can be as frequent as several times a week or as rare as just a few times per year.
Bipolar disorder itself is divided into two types: bipolar I and bipolar II. Those with the former suffer from manic phases for at least a week, and often have separate depression phases as well. Those with bipolar II have bouts of major depression, but instead of full manic episodes, they have low-grade hypomanic swings that are less intense and may last less than a week.
A third form of the behavior is described as a “mixed episode,” during which time depression and hypomania symptoms are experienced at the same time. Unpredictable behavior may result, including taking dangerous risks when feeling hopeless and suicidal but energized and agitated.
Bipolar disorder has no known cause. Current theories point in the direction of some combination of genetic, biological and environmental factors. There are known pathways in the brain that are involved with mood, energy, thinking, and biological rhythms, and it may very well be that the circuits function abnormally in people with bipolar disorder.
It is important to understand that bipolar disorder will not “go away,” will not get better on its own. If you – or if you think one of your loved ones – suffers from these severe swings in mood, see a doctor. She will perform a physical exam to possibly identify a medical problem which might be generating the symptoms. Barring those, a psychological evaluation will then be performed. As part of this diagnosis, you may be asked to keep a “mood chart,” a document that will serve as a diary of your daily emotions and sleep patterns.
If you are diagnosed with bipolar disorder, your doctor will likely initially prescribe “mood stabilizers,” such as lithium and valproic acid. If these alone are not effective, your prescriptions may be stepped up to anti-depressants or anti-psychotics, both of which come with baggage full of side effects.
Psychotherapy plays a vital role in the treatment of bipolar disorder. In some cases, electroconvulsive therapy, in which electrical currents are passed through the brain, will prove helpful. This is usually the treatment of last resort for patients who do not respond to medication or are at a high risk of suicide.