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
• 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
• 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
• 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
• 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
• 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
• 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
WHAT YOU CAN EXPECT:
• With treatment, many people are symptom-free while for others the
symptoms are very mild.
• 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
• 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
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.