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Page 1 of 8 Bipolar disorder, also called manic-depressive illness, is a serious disorder of the brain. More than 2.3 million American adults, or about one percent of the population in a given year, have bipolar disorder. Abnormalities in brain biochemistry and in the structure and/or activity of certain brain circuits are responsible for the extreme shifts in mood, energy, and functioning that characterize bipolar disorder. Fortunately, the intense and disabling symptoms of bipolar disorder often can be relieved through treatment involving combinations of medications and psychotherapy.
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"Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide.
I am fortunate that I have not died from my illness, fortunate in having received the best medical care available, and fortunate in having the friends, colleagues, and family that I do."
Kay Redfield Jamison, Ph.D., An Unquiet Mind, 1995, p. 6. Reprinted with permission from Alfred A. Knopf, a division of Random House, Inc.
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Bipolar disorder typically emerges in late adolescence or early adulthood but in some cases begins earlier. Episodes of depression and mania flare up across the life course, often disrupting work, school, family, and social life. Despite the fact that an episode may remit on its own due to the cyclic nature of the illness, treatment to achieve and maintain a balanced state is extremely important. Without effective treatment, the illness can lead to suicide in nearly 20 percent of cases.
Research is the key to understanding bipolar disorder. The National Institute of Mental Health (NIMH), the world's leading mental health biomedical research organization, conducts and supports studies on the causes, diagnosis, and treatment of bipolar disorder. A variety of research approaches are being used, including neuroscience studies, basic science approaches to brain and behavior, genetic investigations, epidemiological studies, and clinical research. Clinical treatment research is underway to determine the best use of available treatments and treatment combinations. Better treatments and, eventually, ways to prevent and cure the illness will be found only through careful scientific study.
Symptoms and Types of Bipolar Disorder
Bipolar disorder is characterized by episodes of depression, mania, or mixed state that typically recur and become more frequent across the life span. In most patients, these episodes, especially early in the course of illness, are separated by well periods during which there are few to no symptoms. A small percentage of people experience chronic, unremitting symptoms despite treatment.
Depression. Symptoms include a persistent sad mood; loss of interest or pleasure in activities that were once enjoyed; significant change in appetite or body weight; difficulty sleeping or oversleeping; physical slowing or agitation; loss of energy; feelings of worthlessness or inappropriate guilt; difficulty thinking or concentrating; and recurrent thoughts of death or suicide. The depressive episodes of people with bipolar disorder are often indistinguishable from those of patients with unipolar major depressive disorder.
Mania. Symptoms include abnormally and persistently elevated (high) mood or irritability occurring with at least three of the following: overly-inflated self-esteem; decreased need for sleep; increased talkativeness; racing thoughts; distractibility; increased goal-directed activity or physical agitation; and excessive involvement in risky behaviors or activities (e.g., unwise spending sprees, reckless driving, sexual affairs).
"Mixed" state. Symptoms of mania and depression are present at the same time. The symptom picture frequently includes agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. Depressed mood accompanies manic activation.
Sometimes severe mania or depression is accompanied by periods of psychosis. Psychotic symptoms include hallucinations (hearing, seeing, or otherwise sensing the presence of stimuli that are not actually there) and delusions (false fixed beliefs that are not subject to reason or contradictory evidence and are not explained by a person's usual cultural concepts). Psychotic symptoms associated with bipolar disorder typically reflect the extreme mood state at the time (e.g., grandiosity during mania, worthlessness during depression).
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