What is Bipolar Depression Disorder? by
Arthur Buchanan
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.
Bipolar disorder typically begins in adolescence or early
adulthood and continues throughout life. It is often not
recognized as an illness, and people who have it may suffer
needlessly for years or even decades.
Effective treatments are available that greatly alleviate
the suffering caused by bipolar disorder and can usually
prevent its devastating complications. These include marital
break-ups, job loss, alcohol and drug abuse, and suicide.
Here are some facts about bipolar disorder.
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AWARENESS Manic-Depressive Illness Has a Devastating
Impact on Many People. 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 depression 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. Bipolar illness has been diagnosed in children
under age 12, although it is not common in this age bracket.
It can be confused with attention-deficit/hyperactivity
disorder, so careful diagnosis is necessary. D/ART: A
National Educational Program The National Institute of
Mental Health (NIMH) has launched the Depression/Awareness,
Recognition, and Treatment (D/ART) campaign to help people:
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 manic-depressive illness and utilize the
most up-to-date treatment approaches Organizes citizens'
advocacy groups to extend the D/ART program Works with
industry to improve recognition, treatment, and insurance
coverage for depressive disorders
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RECOGNITION
Bipolar disorder involves cycles of
mania and depression. Signs and symptoms of mania include
discrete periods of:-
- Increased energy, activity, restlessness, racing
thoughts, and rapid talking
- Excessive "high" or euphoric feelings
- Extreme irritability and distractibility
- Decreased need for sleep
- Unrealistic beliefs in one's abilities and powers
- Uncharacteristically poor judgment
- A sustained period of behavior that is different from
usual
- Increased sexual drive
- Abuse of drugs, particularly cocaine, alcohol, and
sleeping medications
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
Signs and symptoms of bipolar depression disorder include
discrete periods of:-
- 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
It may be helpful to think of the various mood states
in manic-depressive illness as a spectrum or continuous
range. At one end is severe depression, which shades into
moderate depression; then come mild and brief mood disturbances
that many people call "the blues," then normal
mood, then hypomania (a mild form of mania), and then
mania.
Some people with untreated bipolar disorder
have repeated depressions and only an occasional episode
of hypomania (bipolar II). In the other extreme, mania
may be the main problem and depression may occur only
infrequently. In fact, symptoms of mania and depression
may be mixed together in a single "mixed" bipolar
state.
Descriptions provided by patients themselves offer valuable
insights into the various mood states associated with
bipolar disorder:
Depression: I doubt completely my ability
to do anything well. It seems as though my mind has slowed
down and burned out to the point of being virtually useless....[I
am] haunt[ed]...with the total, the desperate hopelessness
of it all... Others say, "It's only temporary, it
will pass, you will get over it," but of course they
haven't any idea of how I feel, although they are certain
they do. If I can't feel, move, think, or care, then what
on earth is the point?
Hypomania: At first when I'm high, it's
tremendous...ideas are fast...like shooting stars you
follow until brighter ones appear...all shyness disappears,
the right words and gestures are suddenly there...uninteresting
people, things, become intensely interesting. Sensuality
is pervasive, the desire to seduce and be seduced is irresistible.
Your marrow is infused with unbelievable feelings of ease,
power, well-being, omnipotence, euphoria...you can do
anything...but, somewhere this changes.
Mania: The fast ideas become too fast
and there are far too many...overwhelming confusion replaces
clarity...you stop keeping up with it--memory goes. Infectious
humor ceases to amuse. Your friends become frightened...everything
is now against the grain...you are irritable, angry, frightened,
uncontrollable, and trapped.
Recognition of the various mood states is essential so
that the person who has manic-depressive illness can obtain
effective treatment and avoid the harmful consequences
of the disease, which include destruction of personal
relationships, loss of employment, and suicide.
Manic-depressive illness is often not recognized by the
patient, relatives, friends, or even physicians. An early
sign of manic-depressive illness may be hypomania--a state
in which the person shows a high level of energy, excessive
moodiness or irritability, and impulsive or reckless behavior.
Hypomania may feel good to the person who experiences
it. Thus, even when family and friends learn to recognize
the mood swings, the individual often will deny that anything
is wrong. In its early stages, bipolar disorder may masquerade
as a problem other than mental illness. For example, it
may first appear as alcohol or drug abuse, or poor school
or work performance. If left untreated, bipolar disorder
tends to worsen, and the person experiences episodes of
full-fledged mania and clinical depression.
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TREATMENT Most people with manic depressive illness can
be helped with treatment. Almost all people with bipolar
disorder--even those with the most severe forms--can obtain
substantial stabilization of 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 mood stabilizing anticonvulsants
carbamazepine and valproate have also been found useful,
especially in more refractory bipolar episodes. Often
these medications are combined with lithium for maximum
effect. Some scientists have theorized that the anticonvulsant
medications work because they have an effect on kindling,
a process in which the brain becomes increasingly sensitive
to stress and eventially begins to show episodes of abnormal
activity even in the absence of a stressor. It is thought
that lithium acts to block the early stages of this kindling
process and that carbamazepine and valproate act later.
Children and adolescents with bipolar disorder are generally
treated with lithium, but carbamazepine and valproate
are also used. Valproate has recently been approved by
the Food and Drug Administration for treatment of acute
mania. The high potency benzodiazepines clonazepam and
lorazepam may be helpful adjuncts for insomnia. Thyroid
augmentation may also be of value. For depression, several
types of antidepressants can be useful when combined with
lithium, carbamazepine, or valproate. Electroconvulsive
therapy (ECT) 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. Constructing
a life chart of mood symptoms, medications, and life events
may help the health care professional to treat the illness
optimally. Because manic-depressive illness is recurrent,
long-term preventive (prophylactic) treatment is highly
recommended and almost always indicated.
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Getting Help Anyone with bipolar disorder should be under
the care of a psychiatrist skilled in the diagnosis and
treatment of this disease.
Other mental health professionals, such as psychologists
and psychiatric social workers, can assist in providing
the patient and his or her family with additional approaches
to treatment.
Help can be found at: 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 People
With Manic-Depressive Illness Often Need Help To Get Help.
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 strong 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 suicidal tendencies 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
a while 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.
With Much Love, Arthur Buchanan President/CEO Out of
Darkness & Into the Light 43 Oakwood Ave. Suite 1012
Huron Ohio, 44839 Bipolar
Disorder 567-219-0994 (cell)
For more great ideas on managing Bipolar Depression
Disorders why not visit:-
Up-to-date
authoritative information about Bipolar (Manic-Depressive)
disorder, its diagnosis and treatment.
http://www.psycom.net/depression.central.bipolar.html
Bipolar
Disorder
http://www.psychologyinfo.com/depression/bipolar.htm
Bipolar
Disorder
http://www.nimh.nih.gov/Publicat/bipolar.cfm
Manic Depression,
AKA Bipolar Disorder, is a highly disruptive and sometimes
deadly brain disorder.
http://www.pendulum.org/
Other
Bipolar Depression Disorders Sites
For More Information:
Contact your local Mental Health Association,
community mental health center, or:
National Mental Health Association 2001 N. Beauregard
Street, 12th Floor Alexandria, VA 22311 Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA TTY Line 800/433-5959
National Clearinghouse on Teenage
Bipolar Depression Disorders Resources and Treatment
Phone: 800-729-6686 http://dasis3.samhsa.gov/
Boarding Schools
in Alaska
Boarding Schools
in Alabama
Boarding Schools
for Girls
Boarding Schools
Bipolar Disorder Treatment
ADD-ADHD
Teen Depression
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