What is Bipolar Disorder?
Bipolar disorder used to be known as manic depressive disorder. It’s a serious illness, one that can lead to risky behavior, damaged relationships and careers, even suicidal tendencies — if it’s not treated.
Bipolar disorder is characterized by extreme changes in mood (poles) — from mania to depression. Between these mood swings, a person with Bipolar disorder may experience normal moods.
“Manic” describes an increasingly restless, energetic, talkative, reckless, powerful, euphoric period. Lavish spending sprees or impulsive risky sex can occur. Then, at some point, this high-flying mood can spiral into something darker — irritation, confusion, anger, feeling trapped.
“Depression” describes the opposite mood — sadness, crying, sense of worthlessness, loss of energy, loss of pleasure, sleep problems.
But because the pattern of highs and lows varies for each person, bipolar disorder is a complex disease to diagnose. For some people, mania or depression can last for weeks or months, even for years. For other people, bipolar disorder takes the form of frequent and dramatic mood shifts.
What are the Symptoms?
The primary symptoms of bipolar disorder are dramatic and unpredictable mood swings. The illness has two strongly contrasting phases.
In the manic phase:
• Euphoria or irritability
• Excessive talk; racing thoughts
• Inflated self-esteem
• Unusual energy; less need for sleep
• Impulsiveness, a reckless pursuit of gratification — shopping sprees, impetuous travel, more and sometimes promiscuous sex, high-risk business investments, fast driving
• Hallucinations and or delusions (in cases of bipolar disorder with psychotic features)
In the depressive phase:
• Depressed mood and low self-esteem
• Low energy levels and apathy
• Sadness, loneliness, helplessness, guilt
• Slow speech, fatigue, and poor coordination
• Insomnia or oversleeping
• Suicidal thoughts and feelings
• Poor concentration
• Lack of interest or pleasure in usual activities
A bipolar disorder diagnosis is made only by taking careful note of symptoms, including their severity, length, and frequency. The most telling symptoms of bipolar disorder include severe mood swings (going from extreme highs to extreme lows) that don’t follow a set pattern.
The psychiatrist will ask questions about personal and family history of mental illness. The doctor will also ask detailed questions about symptoms, including how long they last and how frequently they occur. Other questions will focus on reasoning, memory, ability to express oneself, and ability to maintain relationships.
Blood and urine tests — such as a toxicology screening — may be done to rule out other causes of symptoms. In a toxicology screening, blood, urine, or hair are examined for the presence of drugs. Blood tests also include a check of thyroid stimulating hormone (TSH) level, since depression is sometimes linked to thyroid function.
The exact causes of bipolar disorder are unknown. While genetic vulnerability and life stress are involved in triggering it, experts believe that an underlying imbalance of brain chemicals produces the symptoms. When levels of these chemicals are too high, mania occurs. When levels are low, there is depression.
This biological understanding of the disorder has opened doors for targeted treatments.