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What is Bipolar Disorder

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What is Bipolar Disorder?

Bipolar disorder is a serious illness.

It is more common than you may think; approximately 3 in every 100 Americans have bipolar disorder. Bipolar disorder is caused by a combination of factors, and periods of depression or mania can appear for no apparent reason or be triggered by something going on in your life.

What is bipolar disorder?

Bipolar disorder (also known by its older name, manic depression) is a serious brain illness that is characterized by extreme changes in moods, thinking, and behavior between two poles—depression and mania. It is an illness, not a type of personality or a lack of character or self-control.

“Mania” is a mood extreme marked by agitation, restlessness, euphoria, and recklessness. During a manic phase a person might sleep only a few hours a night, go on a spending spree, engage in risky sex, or impulsively quit a job and start new projects.

During the depression phase, the same person might feel unable to get out of bed and overwhelmingly sad. Problems brought on from the impulsive behavior during a manic phase—like losing a job or being in debt—may contribute to feelings of self-doubt and hopelessness.

Because the poles are so extreme, bipolar disorder is extremely disruptive to a person’s life and the lives of those around them. The highs and lows of bipolar disorder can affect a person’s perception of reality and interfere with the ability to reason and make good decisions.

Most people with bipolar disorder cycle between the poles of depression and mania slowly—there may be periods of normal mood in between the poles of depression and mania. Some people have rapid cycling bipolar disorder, which means they have four or more distinct episodes of highs and lows over the course of a year. People with bipolar disorder may also experience a “mixed state” with the lows of depression and agitation of a manic phase.

Bipolar disorder is a lifelong condition that can be managed with medication, education, therapy, support, and healthy habits.

Sources: National Institute of Mental Health; Depression and Bipolar Support Alliance

Who experiences bipolar disorder?

Bipolar disorder is more common than you may realize. Nearly 10 million people in the United States have bipolar disorder; that’s about 3 of every 100 Americans.

Bipolar disorder is a lifelong condition that usually appears in the teens or early 20s, although it can be diagnosed in childhood or later in adulthood. The rates of bipolar disorder are similar for men and women and across race, ethnicity, socioeconomic status.

The first phase for women is usually a depressive phase. Men are more likely to experience an initial manic episode. Women tend to experience more depressive phases than men. Women are also more likely to cycle rapidly (more often than four times a year) through phases.

Bipolar disorder has been diagnosed in children as young as 3 years old. One of the challenges diagnosing and treating bipolar disorder in children and teens is telling it apart from attention deficit hyperactivity disorder. Many of the symptoms of mania and ADHD are similar. A child and adolescent psychiatrist or psychologist can work with you to properly diagnose your child and make sure that he receives the best treatment.

Sources: National Alliance on Mental Illness; PsychCentral

What causes bipolar disorder?

Researchers believe that bipolar disorder is caused by a combination of factors. They’ve learned that genetics plays a role, and they’re learning more about differences in the brain, nervous system, and hormones of people with bipolar disorder. Environmental factors may also play a role in triggering episodes of depression or mania.

Genetic factors
Scientists are convinced that genetics play a role. Bipolar disorder tends to run in families. For example, people with a sibling or parent with bipolar disorder are more likely to develop the illness themselves (although most do not). About half of the people with bipolar disorder have a close family member with bipolar disorder or another mood disorder, such as major depression. However, genetics are not the only factor. Scientists have studied identical twins and found that 40% to 50% of the time if one twin has bipolar disorder, the other twin does as well. But since it’s only about half the time and identical twins share the same set of genes, something else besides genetics is involved.

Biology and chemistry
Bipolar disorder is biological and involves changes in the brain and neurotransmitters—the chemical messengers in the brain. Hormonal imbalances have also been linked to bipolar disorder. A chemical imbalance in some of these neurotransmitters and hormones affects the brain’s ability to regulate mood. Researchers are continuing to learn more about the causes of bipolar disorder through brain imaging and other techniques.

Researchers don’t think that upbringing, stress, lifestyle, or other environmental factors can cause bipolar disorder by themselves. They have learned that multiple factors, including genetics and brain chemistry, are involved. Environmental changes and stress do seem to play a role, however, in the onset of bipolar disorder, triggering manic or depressive episodes and making the disorder worse over time. This has important implications for treating bipolar disorder.

Sources: National Institute of Mental Health; PsychCentral

Bipolar disorder triggers

Many times a depressive or manic episode comes on for no apparent reason at all. In other cases, there does seem to be a trigger that can start the cycle.

Triggers are different for everyone, but may include:

  • Stress from drastic or sudden life changes—even positive ones, such as getting married or starting a new job—can trigger a depressive or manic episode
  • Substance abuse can trigger either mania or depression, depending on the drug, and can make an episode worse
  • Certain medications can trigger a manic episode, which is why it is so important to work with a doctor to properly diagnose and treat bipolar disorder
  • Seasonal changes may affect some people; manic episodes are more common in the summer, and depression is more common at other times of year
  • Sleep deprivation, even losing one night of enough sleep, can trigger a manic episode in some people

If you have bipolar disorder, it is important to work with your therapist and doctor to learn what may trigger episodes for you so that you can best manage your illness.

Sources: Helpguide.org

Common misconceptions

People with bipolar disorder suddenly and frequently change personality, like Jekyll and Hyde.
It is a common misconception that people with bipolar disorder have volatile, sudden mood swings. Most people with bipolar disorder are in a depressed period much more of the time than they are in a manic period. They may also have long stretches of normal mood functioning. People with rapid cycling bipolar disorder have four or more distinct episodes of highs and lows over the course of a year. Scientists estimate that most people with bipolar disorder will have eight or nine cycles in their lifetime.

The only thing you can do about bipolar disorder is take medication.

While medication is an important foundation to treating bipolar disorder, medication in combination with psychotherapy is more effective than medication alone. Once a person’s mood is stabilized, doctors and therapists focus on preventing another cycle. For this, healthy habits can be as important as staying on medication.

People with bipolar disorder can’t lead a normal life.

This is false. Living with bipolar disorder has its challenges, like any other chronic disease (heart disease, alcoholism, and diabetes, for example). But treatments are available and the symptoms can be managed. Bipolar disorder is common enough (about 3 in 100 Americans) that chances are, you know someone who has the disorder and they’re managing just fine.

Bipolar disorder only affects people’s moods.

Medical professionals call bipolar disorder a “mood disorder.” However, bipolar disorder, especially if it’s left untreated, affects far more than a person’s mood. It affects your thinking, memory, and judgment. It can change your sleep patterns, appetite, and sex drive. Your energy level and self-esteem can be dramatically affected. In severe episodes bipolar disorder can affect your perception of reality. Bipolar disorder has also been linked to higher risk of substance abuse, diabetes, heart disease, migraine headaches, self-injury, and suicide. Getting treatment at any time, but especially early treatment, can help manage and avoid these effects and risks.

Bipolar disorder is hard to live with, but it’s not nearly as serious as other illnesses.

Bipolar disorder is a very serious illness. Bipolar disorder can be ruinous to people’s lives and to their family’s lives. Bipolar disorder can interfere with a person’s perception of reality. And people with bipolar disorder have a greatly increased risk of self-injury and suicide.

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