Bipolar disorder, also known as manic depression, is a mental illness that causes dramatic swings in mood between two opposite emotional states (poles), mania and depression. There is often a period of normal mood between the two extremes. The length of this cycle varies considerably from one person to another, as do the extremes, which may be mild or severe. Manic-depressive illness generally starts before the age of 35 and affects nearly 1 in 100 people, according to the American Psychiatric Association (APA). Research into causes of the disease is focused in 3 areas: genetic or hereditary factors, environmental influence, and chemical imbalances in the body. Though the disease is considered incurable, and can be disabling, the majority of people respond to treatment.

SYMPTOMS MAY INCLUDE: 
During the manic stage:

• A surge of high energy with euphoria, expansiveness, or great irritability
• Decreased need of sleep; days may pass with little or no sleep
• Continual talking; speech that is fast, loud, pressured and difficult to understand
• A great feeling of self-confidence, leading to a sense that nothing can be harmful
• A lack of judgment and risky decision-making
• Shopping sprees, taking great financial risks, sexual escapades, driving recklessly, other unusual behavior such as walking in front of moving cars
• Hyperactivity that leads to planning and participating in multiple projects; often starting something that could not possibly be completed.
• Thoughts race quickly and jump from one topic to another (flight of ideas). At one moment cheerful and outgoing, then extremely suspicious of others, suddenly lashing out in anger

Symptoms of the depressive stage of bipolar disorder are identical to those of major or unipolar depression and may include:

• Lack of energy.
• Feelings of worthlessness or guilt, long periods of sadness, and lack of interest in activities that have brought pleasure in the past.
• Withdrawal from family, friends, work, and sex may occur.
• Disturbed eating and sleeping patterns: Either an increase or decrease in appetite; either insomnia or a need for a great deal more sleep
• Feelings of lethargy, apathy, and being overwhelmed; difficulty concentrating or making decisions.
• Physical symptoms: Constipation and various aches or pains, with no clear cause
• thoughts of death and suicide attempts with severe depression

WHAT YOUR DOCTOR CAN DO:

• Diagnose bipolar disorder with a thorough medical evaluation: Asking about symptoms; doing a detailed medical and family history; performing a thorough physical exam; and ordering diagnostic tests as needed.
• Identification of the manic stage is necessary to differentiate between bipolar disorder and other depressive illnesses.
• Rule out other diseases or conditions. Many other illnesses may cause symptoms similar to those in manic depression.
• Prescribe the medication lithium carbonate, either alone or with other drugs. According to the APA, Lithium successfully reduces or eliminates the manic episodes and symptoms in up to 70% of those who take it. It is also effective in reducing depressive episodes. Lithium can have moderate to severe side effects.
• Measure levels of lithium with routine blood tests.
• Hospitalization may be necessary at times, either to adjust medications or to prevent harm either to yourself or someone else while severely manic or depressed.

WHAT YOU CAN DO:

• Take medication as prescribed. Work closely with your doctor to find the right combinations and dosages. DO NOT stop medication without consulting your doctor first. Report side effects and adverse reactions.
• Keep follow-up appointments with your doctor for check-ups and for blood tests for lithium levels.
• Psychotherapy is often extremely beneficial, both for you and for your family members trying to understand and cope with the impact of the disease. Talk to your doctor about a referral to a therapist.
• Learn all you can about bipolar disorder. There are multiple resources available.

WHAT YOU CAN EXPECT:

• With treatment, many people are symptom-free while for others the symptoms are very mild.

Without treatment:

• Manic episodes can last for weeks, finally exhausting both body and mind. Behavior during the mania can often lead to problems at home, at work, with relationships and with finances.
• Some people become a danger to themselves or to others during the depressive stage
• As with any serious illness, manic depression can be extremely disruptive to self-esteem and relationships, particularly with spouse and family. Living with the disorder and its effects will require ongoing effort on your part and on the part of family members.

CALL 1061 OR SEEK IMMEDIATE MEDICAL ASSISTANCE If you develop symptoms of Bipolar disorder; if your symptoms persist despite receiving treatment; or if you suffer side effects from the medications.