Bipolar Disorder, often called Manic Depression, is a medical condition that
involves severe mood swings in an individual. It is a lifetime condition that needs to be
treated to keep it in remission (APA). It is not just a mental illness, but a medical disease
involving the brain.
The disease progresses as the years pass and the frequency of mood changing
episodes becomes more frequent (MHN). Bipolar Disorder involves depressive and manic
phases. With the symptoms presented, clinicians often misdiagnose patients as
Bipolar affects an individuals thoughts, feelings, health, behavior and ability to
function. The disease is not a result of a weak personality, as many people believe.
Instead, it is a medical condition where there is an instability in the transmission of nerve
impulses of the brain (neurotransmitters) that signal appropriate moods (NDMDA). The
bipolar patient responds with inappropriate mood swings independent of what is going on
around them (APA). Bipolar compromises the judgment of those that suffer from it.
Some even experience hallucinations (Shalala).
The disease of bipolar itself is classified as Type I and Type II. Type I are those
that have had prior episodes of mania. One percent of Americans are diagnosed with this.
Type II are those that have hypomania phases only (Shalala). A very small percentage (.6)
of Americans have Type II.
Bipolar disorder affects men and women equally. There is no discrimination when
it comes to mental illness (MDA). Cycling is defined by the shifts from one phase to
another. Women are more prone to the more rapid cycling. This is due to the different
hormone changes in the female body. A male is apt to cycle every two to four years, while
a female may cycle four or more times annually (Shalala).
The best way to understand bipolar is to learn about the different phases that an
individual experiences. There are four different phases: depressive, manic, hypomania
and mixed episode (APA).
The depressive phase can last for several months. The patient will show depressed
behavior daily, weight loss, diminished pleasure, fatigue, feelings of worthlessness, lack of
concentration, restlessness, insomnia or hypersomnia (over sleeping), impaired functioning
and suicidal thoughts. These symptoms are present without any evidence of drug or
alcohol abuse (Long). Any thoughts of death or suicide should be taken seriously.
The word mania comes from the French and means crazed or frenzied (Shalala).
In the manic phase, the individual sleeps only a few hours, yet is feels perfectly rested.
They tend to be talkative, distracted and overly goal-oriented. Unfortunately, they seldom
follow through with their goals. Pleasurable activities become very important, particularly
those that involve high risk. The ego becomes inflated beyond reality and their thoughts
and ideas race continuously (Long).
Hypomania is a much milder form of mania. In this phase, the individual can easily
fall into a deep depression or escalate into full-blown mania (APA).
The last phase, mixed episode, is when an individual shows symptoms from both
manic and depressive phases.
There are many different theories on what causes bipolar disorder. There seems to
be a connection with family prevalence. Those with a parent with the disorder have a one
in seven chance of being bipolar themselves. An earlier age of onset is typical in these
cases. the typical age of onset is adolescent and earlier adulthood (Shalala).
Other probable causes are biochemistry, biological clocks and psychological stress.
It is known that those with bipolar disorder are more vulnerable to emotional and physical
The diagnosis of bipolar disorder typically takes up to eight years. Clinicians
mistakenly diagnose depression, anxiety, schizophrenia or paranoia. Inappropriate
treatments only make the disorder worse. Anti-depressants lift the patient into the manic
phase and anti-anxiety drugs such as Valium or Xanax depress the patient. Psychotherapy
alone does not help (Shalala).
There are solutions for the bipolar patient. Education is the most important. Not
only the patient needs to be educated, but also those close to them. Understanding why
someone is bipolar and what symptoms to watch for is the first step in helping the
individual get better and maintain a healthy balance (Francell).
Medications are prescribed to the patients to balance the chemicals in the brain.
The most prescribed drug is Lithium. It acts as a mood stabilizer and is often used in
conjunction with an anti-depressant such as Paxil or Zoloft. Other mood Stabilizers are
Tegretol and Depakote. These medications require close monitoring of the levels in the
blood to prevent toxicity (Parikh). Medications are most likely needed for a lifetime to
maintain remission (APA).
When medications fail to work, electoconvulsive therapy is appropriate. Far from
being cruel and inhuman, the electric currents have shown positive responses in patients
Psychotherapy in conjunction with medication is a useful aid in helping bipolars
deal with emotional and physical stresses. The years lost to the disorder before diagnosis
can be dealt with. Support groups also help the individual share the fears and concerns
Proper treatment of bipolar disorder prevents suicide, substance abuse and
social/personal problems. Eighty percent of bipolars can lead healthy, productive lives
(APA) American Psychiatric Association. Expert Consensus Treatment Guidelines for
Bipolar Disorder: A Guide for Patients and Families. Expert Knowledge
Systems. 03 February 2000. <http://www.psychguides.com/bphe.html>
Francell, Edward G. Jr. Medication – The Foundation of Recovery. Internet Mental
Health. 03 February 2000. <http://www.mentalhealth.com/fr20.html>
Genet. Am J Hum. Evidence for Linkage of Bipolar Disorder. Internet Mental Health.
03 February 2000. <http://www.mentalhealth.com/fr20.html>
Long, Philip W., MD Bipolar I Disorder – American Description. Internet Mental
Health. 03 February 2000. <http://www.mentalhealth.com/dis1/p21-md02.html>
(MHN) MentalHelp.Net. Bipolar: Your Complete Well-Connected Guide. Nidus
Information Services, Inc.03 February 2000.
(MDA) Mood Disorders Association. Bipolar Affective Disorder. Disability
Information And Resource Center, Inc.03 February 2000.
(NDMDA) National Depressive and Manic-Depression, Association. Overview of
Bipolar Disorder and Its Symptoms.National Depressive and
Manic-Depression, Association. 03 February 2000.
Parikh, Sagar, MD Acute Mania. Internet Mental Health. 03 February 2000.
Shalala, Donna E. Mood Disorders. Dept. of Health and Human Services. 03 February