Comprehensive list of questions and answers about signs, symptoms and treatment of bipolar disorder and other related mood disorders.

1. What is bipolar disorder?
2. What are the differences between bipolar I and bipolar II disorders?
3. What is rapid cycling?
4. At what age does bipolar disorder appear?
5. Is bipolar disorder genetic?
6. How is bipolar disorder treated?
7. What medications are used to treat bipolar disorder?
8. What is a manic episode?
9. What is hypomania?
10. What is dysthymia?
11. What is major depression?
12. What is atypical depression?
13. What is meant by a mixed state?
14. What is seasonal affective disorder?
15. What is postpartum depression?
16. What is schizoaffective disorder?
17. What resources are available for people suffering from bipolar disorder?
18. How can family members assist the bipolar patient?
19. What are the challenges of bipolar disorder?

Bipolar disorder is a common, recurrent, severe psychiatric illness that affects an individual's mood, behavior and ability to think clearly. It occurs in 1% to 2% of the population in the United States. A variant, called bipolar II disorder, is probably even more common and occurs in up to 3% of the general population in this country.

2. What are the differences between bipolar I and bipolar II disorders?

Bipolar I disorder is characterized by episodes of mania that alternate with periods of depression or periods in which individuals have simultaneously occurring manic and depressive symptoms called mixed states. In contrast, bipolar II disorder is characterized by recurrent episodes of depression and milder symptoms of mania, called hypomania. Hypomanic episodes typically do not impair an individual's ability to function to the extent that full-blown manic episodes do Additionally, hypomanic episodes are not complicated by psychotic symptoms.

The term rapid cycling was originally coined by David Dunner, M.D., and Ron Fieve, M.D., in the 1970s when they identified a group of individuals who did not respond well to lithium. These patients typically had four or more episodes of mania or depression in the 12-month interval prior to lithium treatment. This definition has been adopted formally by DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) and specifically means the occurrence of four or more mood episodes within the preceding year. In severe cases, rapid cycling can occur even within a one-day period.

4. At what age does bipolar disorder appear?

Bipolar disorder most commonly presents in the late teens and early 20s. Unfortunately, for most individuals, lifelong treatment may be required to prevent recurrent manic and depressive episodes. Equally unfortunate is evidence that the illness often goes undiagnosed and untreated for many years; the longer the illness progresses without treatment, the greater the impairment in an individual's psychological, educational and vocational development. Additionally, untreated bipolar disorder carries a high risk of suicide.

5. Is bipolar disorder genetic?

Bipolar disorder, among all psychiatric illnesses, may have the greatest genetic contribution. For instance, if an individual has a parent with bipolar disorder, the chance that the individual's child will have bipolar disorder is about nine-fold greater than in the general population, with the risk rising from about 1% to about 10%. The inheritability of this illness is estimated to be anywhere from 50% to 80%. On the other hand, if a person with bipolar disorder is thinking about having children, there are still good odds that the child will not have bipolar illness. So the genetic determinants of the illness are complicated.

6. How is bipolar disorder treated?

The cornerstone of treatment is medications that treat acute manic, depressive or mixed episodes, and which, in the long run, attempt to prevent the recurrence of these episodes. Such medications include lithium, divalproex (Depakote) and, more recently, some of the atypical antipsychotics as well as antidepressants.

Psychotherapy plays an important role in improving the course and outcome of this illness in people. In particular, those with bipolar disorder often have strained relationships with loved ones because of their experiences during manic or depressive episodes; psychotherapy can help repair these torn relationships. In addition, psychotherapy can educate people about the signs and symptoms of their illness, how to pay attention to warning signs and how to nip emerging episodes in the bud. Psychotherapy can also help individuals cope with the stress that can sometimes precipitate manic or depressive episodes.

continue: Bipolar Medications and the Mood Phases of Bipolar Disorder