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What Is Bipolar Disorder?
People with bipolar disorder experience alternating periods of energy and euphoria (mania) and extreme sadness and hopelessness (depression). People with the disorder are at risk for suicide and legal problems. Treatment involves the use of medications to help balance mood. Without treatment, the disorder may become worse over time.

In order to fully understand bipolar disorder, and develop a true sense of how the disease can inform a person’s life, consider the case of Vincent van Gogh. The artist experienced periods of profound creativity, where he spoke incessantly, wrote hundreds of letters and completed multiple paintings each day. Those periods of mania were quickly followed by deep valleys of depression, when van Gogh found it hard to eat, sleep or relax. While the disease provided the artist with moments of intense pleasure, and his increased energy levels may have allowed him to create some of the most beautiful images in all of Western art, this productivity came at a high price. In fact, experts believe he died at his own hand at the end of such a depressive episode.

Today, over 10 million people in the United States have bipolar disorder, according to the National Alliance on Mental Illness. These people may face many of the same symptoms felt by van Gogh, and they may be at high risk of damage due to their disease, but each year scientists learn more about the disease. In fact, there are many treatments available that can ease symptoms and allow someone with bipolar disorder to live a normal life.

Mania and Depression

Cycling between periods of happiness (known as mania) and periods of depression, regardless of what is happening in the person’s life, is the hallmark of bipolar disease.

Everyone experiences a bit of mood cycling during the day. A person might wake up feeling happy and relaxed, and then become tense and angry during their morning commute. This is all quite normal. People with bipolar disorder, by contrast, may experience deep and significant mood cycles for no reason at all.

During the manic phase, the person might feel:

  • Elated and happy
  • Motivated to achieve goals
  • Impulsive and likely to drink too much or spend too much money
  • Grandiose or powerful
  • Extremely chatty
  • Very energetic
  • Sexually charged
  • Unable to concentrate

During the depressive phase, by contrast, the person might feel:

  • Profoundly sad and hopeless
  • Sluggish and sleepy
  • Anxious or worried
  • Guilty or ashamed about deeds done during mania
  • Painful
  • Unable to eat
  • Irritable
  • Isolated and alone

The disease can vary quite a bit from person to person. Some find that the depression is of major concern, while others are concerned about their behavior during manic episodes. Some people seek out help on their own, during the moments when they feel relatively stable and calm. Others never seek treatment in private inpatient or outpatient rehab centers at all.

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Severity of the Disease

Typically, doctors place people with bipolar disease into one of four groups:

  • Bipolar I: People with this form of the disease swing wildly between mania and depression, and they have significant difficulty staying in relationships, performing in school or holding down jobs.
  • Bipolar II: This form of the disease is somewhat more mild. People may be able to hold down jobs or stay in relationships, but they may struggle with depression periodically.
  • Cyclothemia: This is the mildest form of bipolar disorder. Here, people may have disruptions in their lives due to the disease, but they may not feel extreme highs or lows.
  • Rapid cycling: People with this form of the disease may move between the two states incredibly rapidly, sometimes even moving between euphoria and depression in the same day.

Without treatment, the disease tends to become more severe with time. Often, the disease begins in childhood and it can be difficult for doctors to spot the disease in people who are young. Children with bipolar disorder may experience symptoms such as explosive anger, long periods of weeping and inability to focus. These nonspecific symptoms are easy to pass off as common childhood moodiness.

According to the National Institute of Mental Health, at least half of all people who are diagnosed with bipolar disease developed the illness when they were younger than 25.

Without treatment, the periods of mania and depression may come closer together. Symptoms might also become more severe. Instead of just feeling powerful, for example, a manic person might become convinced that she is famous and loved by fans, and she might try to hug strangers and give autographs. During the depressive phase, this same person might find it hard to get out of bed.

Side Effects

People who have bipolar disorder often have difficulty controlling their weight. In fact, according to a study published in the Journal of Clinical Psychiatry, 58 percent of bipolar people studied were overweight, 21 percent were obese and five percent were extremely obese. Because of their additional weight, these patients had higher rates of arthritis and high blood pressure. The disease might make it simply too difficult for the people to care for their physical health as they should.

Having bipolar disease is a significant risk factor for suicide. During a depressive episode, when the world seems hopeless and the person has an inability to believe that things will get better, suicide may seem like a valid option. A study published in the Archives of General Psychiatry demonstrated a clear link between bipolar disorder and suicide, but interestingly, researchers also found that the death rate from any cause was higher in people who had bipolar disorder than people who did not. In other words, having bipolar disorder had such a profound impact on those studied that they died at higher rates from any cause, not just suicide. The disease seems to make it impossible for people to care for themselves properly and avoid premature death.

During a period of mania, some people with bipolar disease commit crimes or acts of violence. They have become detached from reality during these episodes and they may be completely unable to tell right from wrong. They may hurt others during these periods, and face significant law enforcement intrusion as a result, or they may be hurt during these episodes during fierce battles with bystanders or police. Injuries during psychosis are a real and terrible problem for people with bipolar disorder.

Risk Factors

Almost anyone can get bipolar disorder, but it does seem to be a disease that runs in families. It could be that there is a genetic marker that researchers could find that would help explain why some people develop bipolar disorder and others do not, and that research is still ongoing.

Currently, scientists do know that certain parts of the brain look different in people with bipolar disease. One study published in the Archives of General Psychiatry found that people who had bipolar disorder had an enlargement in the part of the brain called the amygdala. This part of the brain is concerned with regulating mood, and it’s possible that people with bipolar disorder are receiving too many signals of this sort from this swollen part of their brain. The researchers report that the amygdala changes were the same across the study sample, regardless of how long the patients had been living with bipolar disease, and this suggests that the amygdala changes somehow caused, rather than were caused by, the bipolar disorder. More research must be done in this area to make the connection clear.

Some people suggest that there must be some sort of trigger that causes bipolar disease. The people may be born with a genetic propensity to develop the disease, but with the propensity in place, they need some sort of push to actually progress the symptoms of the disorder. Experiencing a traumatic event, such as being the victim of an assault, might be enough of a trigger to cause symptoms.

Treatment Options

Living with someone who has bipolar disorder can be stressful and confusing. You might wonder what has happened to propel the person into a deep depression, and you might be confused when the person is unable to articulate the cause for the depression.

During a manic phase, you might be worried for your own safety or the safety of your children, and you might feel guilty for these feelings. In short, living with someone with bipolar disorder can be both confusing and dangerous, and it’s not a situation that should be allowed to continue. The person can get better, and the whole family can heal, if the person enters a targeted treatment program for bipolar disorder.

Medications often form the cornerstone of treatment for people with bipolar disorders. These medications can help soothe the connections between the brain, helping the person to stay calm during mania and stay positive during depression. Some people may simply never cycle again once they begin treatment, and this could be real and incredible help. Getting help early in the disease is key, however, as the longer the disease progresses, the harder it seems to be to reverse. Often, this means family members must step in and help the person access needed treatment. We can help you have that conversation. Call us today to find out more about real treatments that can help the person you love.

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