What is Bipolar Disorder?

BIPOLAR DISORDER--which is also known as manic-depressive illness and will be called by both names throughout this publication--is a mental illness involving episodes of serious mania and depression. The person's mood usually swings from overly "high" and irritable to sad and hopeless and then back again, with periods of normal mood in between.

AWARENESS

• At least 2 million Americans suffer from manic-depressive illness. For those afflicted with the illness, it is extremely distressing and disruptive.
• Like other serious illnesses, bipolar disorder is also hard on spouses, family members, friends, and employers.
• Family members of people with bipolar disorder often have to cope with serious behavioral problems (such as wild spending sprees) and the lasting consequences of these behaviors.
• Bipolar disorder tends to run in families and is believed to be inherited in many cases. Despite vigorous research efforts, a specific genetic defect associated with the disease has not yet been detected.

• Recognize the symptoms of depressive disorders, including bipolar disorder
• Obtain an accurate diagnosis
• Obtain effective treatments

D/ART Also:

• Encourages and trains health care professionals to recognize the signs of bipolar disorder and utilize the most up-to-date treatment approaches
• Organizes citizens' advocacy groups to extend the D/ART program
• Works with business and industry to improve recognition, treatment, and insurance coverage for depressive disorders

• Extreme irritability and distractibility
• Excessive "high" or euphoric feelings
• A sustained period of behavior that is different from usual
• Increased energy, activity, restlessness, racing thoughts, and rapid talking
• Decreased need for sleep
• Unrealistic beliefs in one's abilities and powers
• Extreme irritability and distractibility
• Uncharacteristically poor judgment
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Obnoxious, provocative, or intrusive behavior
• Denial that anything is wrong

Signs and symptoms of depression include:

• Persistent sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in ordinary activities, including sex
• Decreased energy, a feeling of fatigue or of being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleep disturbances
• Loss of appetite and weight, or weight gain
• Chronic pain or other persistent bodily symptoms that are not caused by physical disease
• Thoughts of death or suicide; suicide attempts

TREATMENT

• Almost all people with bipolar disorder--even those with the most severe forms--can obtain substantial relief from their mood swings.
• One medication, lithium, is usually very effective in controlling mania and preventing the recurrence of both manic and depressive episodes.
• Most recently, the anticonvulsants carbamazepine and valproate have also been found useful, especially in more refractory bipolar episodes.
• For depression, several types of antidepressants can be useful when combined with lithium, carbamazepine, or valproate.
• Electroconvulsive therapy (electroshock) is often helpful in the treatment of severe depression and/or mixed mania that does not respond to medications.
• As an adjunct to medications, psychotherapy is often helpful in providing support, education, and guidance to the patient and his or her family.

• University- or medical school-affiliated programs
• Hospital departments of psychiatry
• Private psychiatric offices and clinics
• Health maintenance organizations
• Offices of family physicians, internists, and pediatricians

• Often people with bipolar disorder do not recognize how impaired they are or blame their problems on some cause other than mental illness.
• People with bipolar disorder need encouragement from family and friends to seek treatment. Family physicians can play an important role for such referral.
• If this does not work, loved ones must take the patient for proper mental health evaluation and treatment.
• If the person is in the midst of a severe episode, he or she may have to be committed to a hospital for his or her own protection and for much needed treatment.
• Anyone who is considering suicide needs immediate attention, preferably from a mental health professional or a physician; school counselors and members of the clergy can also assist in detecting and/or making a referral for more definitive assessment or treatment. With appropriate help and treatment, it is possible to overcome suicidal tendencies.
• It is important for patients to understand that bipolar disorder will not go away, and that continued compliance with treatment is needed to keep the disease under control.
• Ongoing encouragement and support are needed after the person obtains treatment, because it may take awhile to discover what therapeutic regimen is best for that particular patient.
• Many people receiving treatment also benefit from joining mutual support groups such as those sponsored by the National Depressive and Manic Depressive Association (NDMDA), the National Alliance for the Mentally Ill (NAMI), and the National Mental Health Association.
• Families and friends of people with bipolar disorder can also benefit from mutual support groups such as those sponsored by NDMDA and NAMI.

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