Bipolar disorder carries an increased risk for suicide and substance abuse, can significantly impair thinking and memory, creates serious behavioral problems, and more.

In spite of the fact that medications are very helpful for the treatment of most bipolar disorder patients, only one-third of bipolar disorder sufferers receives therapy.

Bipolar Disorder and Risk for Suicide

It is important to note that an estimated 15% to 20% of patients who suffer from bipolar disorder and who do not receive medical attention commit suicide. The risk is greater in the following individuals:

• In a 2001 study of bipolar disorder I disorder, more than 50% of patients attempted suicide; the risk was highest during depressive episodes.
• Some studies have suggested that the risk with bipolar disorder II patients is even higher than it is in patients with bipolar disorder I or major depression disorder.
• Patients with mixed mania, and possibly when it is marked by irritability and paranoia, are also at particular risk.
• Many young pre- and early adolescent children with bipolar disorder are more severely ill than are adults with the disease. According to a 2001 study, 25% of children with bipolar disorder are seriously suicidal. They have a higher risk for mixed mania (simultaneous depression and mania), multiple and frequent cycles, and a long duration of illness without well periods.

Rapid cycling, although a more severe bipolar disorder variation, does not appear to increase the suicide risk for patients with bipolar disorder.

Thinking and Memory Problems in Those With Bipolar Disorder

A 2000 study reported that bipolar disorder patients had varying degrees of problems with short- and long-term memory, speed of information processing, and mental flexibility. Medications used for bipolar disorder, however, could have been responsible for some of these abnormalities and more research is needed to confirm or refute these findings.

Behavioral and Emotional Effects of Manic Phases on the Patient

A small percentage of bipolar disorder patients demonstrates heightened productivity or creativity during manic phases. More often, however, the distorted thinking and impaired judgment that are characteristic of manic episodes can lead to dangerous behavior, including the following:

• A person may spend money with abandon, causing financial ruin in some cases.
• Angry, paranoid, and even violent behaviors are not uncommon during a manic episode.
• Some people are openly promiscuous.

Often such behaviors are followed by low self-esteem and guilt, which are experienced during the depressed phases. During all stages of the illness, patients need to be reminded that the mood disturbance will pass and that its severity can be diminished by treatment.

Bipolar Disorder and Substance Abuse

Cigarette smoking is prevalent among bipolar patients, particularly those who have frequent or severe psychotic symptoms. Some experts speculate that, as in schizophrenia, nicotine use may be a form of self-medication because of its specific effects on the brain; further research is necessary.

Up to 60% of patients with bipolar disorder abuse other substances (most commonly alcohol, followed by marijuana or cocaine) at some point in the course of their illness.

The following are risk factors for alcoholism and substance abuse in bipolar disorder patients:

• Having mixed-state episodes rather than ones of pure mania.
• Being a man with bipolar disorder.

continue: Bipolar Disorder's Effects on Loved Ones