The deep mood swings of bipolar disorder may last for weeks or months, causing great disturbances in the lives of those affected, and those of family and friends, too. Today, a growing volume of research suggests that bipolar disorder occurs across a spectrum of symptoms, and that many people aren't correctly diagnosed. Left untreated, bipolar disorder generally worsens, and the suicide rate is high among those with bipolar disorder. But with effective treatment, you can live an enjoyable and productive life despite bipolar disorder.
Causes:
It's not known what causes bipolar disorder. But a variety of biochemical, genetic and environmental factors seem to be involved in causing and triggering bipolar episodes:
Biochemical- Some evidence from high-tech imaging studies indicates that people with bipolar disorder have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. The naturally occurring brain chemicals called neurotransmitters, which are tied to mood, also may play a role. Hormonal imbalances also are thought to be a culprit.
Genes- Some studies show that bipolar disorder is more common in people whose biological family members also have the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder. Some studies also show links between bipolar disorder and schizophrenia, pointing to a shared genetic cause.
Environment- Environment also is thought to play a causal role in some way. Some studies of identical twins show that one twin has the condition while the other doesn't — which means genes alone aren't responsible for bipolar disorder. Environmental causes may include problems with self-esteem, significant loss or high stress.
Symptoms:
Bipolar disorder symptoms are characterized by an alternating pattern of emotional highs (mania) and lows (depression). The intensity of signs and symptoms can vary from mild to severe. There may even be periods when your life doesn't seem affected at all.
Signs and symptoms of the manic phase of bipolar disorder may include:
* Euphoria
* Extreme optimism
* Poor judgment
* Rapid speech
* Aggressive behavior
* Agitation
* Increased physical activity
* Risky behavior
* Increased drive to perform or achieve goals
* Increased sexual drive
* Decreased need for sleep
* Tendency to be easily distracted
* Inability to concentrate
* Drug abuse
Signs and symptoms of the depressive phase of bipolar disorder may include:
* Sadness
* Hopelessness
* Suicidal thoughts or behavior
* Anxiety
* Guilt
* Sleep problems
* Appetite problems
* Fatigue
* Loss of interest in daily activities
* Irritability
* Chronic pain without a known cause
Treatment:
Bipolar disorder is a long-term condition that requires lifelong treatment, even during periods when you feel better. Bipolar disorder treatment is usually guided by a psychiatrist skilled in treating the condition. But you may have others on your treatment team as well, including psychologists, social workers and psychiatric nurses, because the condition can affect so many areas of your life.
Medication options include:
Mood stabilizers- Mood stabilizers are most the commonly prescribed medications for bipolar disorder. These medications help regulate and stabilize mood so that you don't swing between depression and mania. Lithium (Eskalith, Lithobid) has been widely used as a mood stabilizer and is generally the first line of treatment for manic episodes. Your doctor may recommend that you take mood stabilizers for the rest of your life to prevent and treat manic episodes.
Anti-seizure medications- The medications are used to prevent mood swings, especially in people with rapid cycling bipolar disorder. These medications, such as valproic acid (Depakene), divalproex (Depakote) and lamotrigine (Lamictal), also are widely used as mood regulators. These medications are also known as anticonvulsants.
Antidepressants- Use of antidepressants in bipolar disorder, although once common, is now controversial. Antidepressants may not be advised at all, depending on your situation. There's limited data indicating that antidepressants are effective for bipolar disorder, and in some cases they can trigger manic episodes.
Electroconvulsive therapy(ECT)-ECT is geared mainly for people who have episodes of severe depression with suicidal tendencies or for people who haven't seen improvements in their symptoms despite other treatment. Electroconvulsive therapy is a procedure in which electrical currents are passed through your brain to trigger a seizure. Researchers don't fully understand just how ECT works. But it's thought that the seizure causes changes in brain chemistry that may lead to improvements in your mood.
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