Bipolar Disorder

According to the National Alliance on Mental Illness, 2.3 million Americans have been diagnosed with bipolar disorder and 5.7 million people have been affected worldwide. Bipolar disorder, also known as manic-depressive disorder, is a brain disease characterized by shifts in a person’s mood, energy level, and ability to function.

The disorder usually begins in late adolescence and requires ongoing treatment and management due to its recurrent and chronic nature. While the cause of this disorder is unknown, bipolar disorder appears to run in families, suggesting a genetic component.

The episodes of depression and mania a person with bipolar disorder experiences will vary in severity and can last anywhere from days to months. A person in a depressive episode may feel worthless, present with a low activity level or poor appetite, and speak or think of suicide. Due to the risk of self-harm, making an emergency plan of care is crucial to ensure the safety of a person in a depressive episode of bipolar disorder.

In contrast, a manic episode is characterized by so much energy that a person can function on very little sleep. He or she may have racing thoughts and pressured speech. It is in this phase that psychotic symptoms can surface. While in a psychotic state, a person is unable to tell the difference between reality and unreality and may experience hallucinations and/or delusions. This level of a mania requires immediate medical attention and treatment.

These extreme shifts in mood can put people who suffer from bipolar disorder, at significant risk for suicide. Studies have found approximately 25–50% of people with bipolar disorder attempt suicide at least once; this is one of the highest rates for any psychiatric disorder. Suicide attempts usually occur when a person goes untreated, an effective medication regimen has not been achieved, a person goes off his or her medication(s) due to non-compliance issues, or a person experiences a significant emotional stressor.

Given the wide range of symptoms a person could be experiencing, an accurate diagnosis of bipolar disorder can be difficult. If a person is in a depressive episode at the time of his or her evaluation, a diagnosis of depression could be mistakenly given. In contrast, a person in a manic phase who presents with an elevated mood, racing thoughts, impulsive behavior, increased activity level, and poor concentration could be mistaken for having an anxiety disorder or an attention deficit (hyperactivity) disorder.

Due to the potential difficulty of diagnosis, a thorough face-to-face evaluation by a professional is strongly recommended. Once a proper diagnosis is made, finding the right medication or combination of medications is important to help reduce symptoms and keep the person’s mood steady. Every person’s body chemistry is different, and what might work for one person might not work for another. It is extremely important the client work closely with the prescribing doctor during this phase of treatment.

Psychotherapy is also strongly recommended as part of the treatment plan. Working with an experienced psychologist, therapist, or counselor can help a person with bipolar disorder find better ways of managing his or her illness and coping with negative thinking and unhealthy patterns of behavior. At times, individual therapy or joining a support group may be critical for family members. Understanding and caring for a person with bipolar disorder can be quite difficult, and therapy and/or support may be vital.

Bipolar disorder is chronic and recurrent; most people require some form of treatment for the rest of their lives. A treatment plan that combines medication and psychotherapy as well as family support is optimal for managing the disorder over time.

For more information on Bipolar Disorder, visit the National Alliance on Mental Illness website.