Mental Health Disorders

What is Bipolar Disorder?

Virginia J. Duffy PhD, Psychiatric NP

Please understand that this is a difficult diagnosis to make and is being debated by "experts" around the world. Many people have been given a variety of diagnoses before Bipolar is finally settled on.

Remember, Psychiatry is not an exact science, much of it is theory, and there are many differing opinions.

Bipolar disorder has 2 types, Bipolar I and Bipolar II. Bipolar I is what used to be called Manic Depressive Illness. The symptoms are severe and obvious. They include SEVERE mood changes from a manic state (or to a lesser degree hypomanic) to a depressed state. These usually occur once or twice a year. Persons identified as "rapid cyclers" vacillate between these two mood states more frequently, perhaps once every 2 or 3 months. Rapid Cycling DOES NOT mean changing moods ever few hours or minutes!

Generally Bipolar disorder is a vacillation between euphoria (mania) and depression. Some people may only experience the manic side of the illness. There may be long periods of "normal Mood" in between episodes. Some people may go years without a clear mood change. Others may be considered "rapid cyclers" and shift between these mood states a few times a year.

Bipolar I Disorder is a reoccurring disorder - More than 90% of those who have had a manic episode will have future episodes.

Mixed Episode

To make things more confusing we have episodes said to be mixed. These include symptoms that are both manic and depressive.

Bipolar II

This is a milder form of Bipolar disorder with very similar symptoms to borderline personality disorder. Find more about this in other articles

Facts about Bipolar Disorder

•  Completed suicide occurs in 10% - 15% of individuals with Bipolar I Disorder.

•  Psychotic symptoms (out of touch with reality) can occur during manic and depressed phases.

•  Violent behavior may occur during severe Manic Episodes or during times when psychotic symptoms are present.

•  There are no tests for bipolar disorder; a clinician makes the diagnosis after a through interview and history taking.

•  The first episode of bipolar disorder often occurs in the early 30".

•  Approximately 10% - 15% of adolescents with recurrent Major Depressive Episodes will go on to develop Bipolar I Disorder.

•  Bipolar I Disorder is found equally in men and women .The first episode in males is more likely to be mania. The first episode in females is more likely to be depression

•  The interval between episodes tends to decrease as the individual ages.

•  Individuals with Bipolar I Disorder who have multiple (four or more) mood episodes within a year are considered to have "rapid cycling" this often means a poorer prognosis.

•  Most individuals with Bipolar I Disorder return "normal mood" between episodes However about 25% may still experience mood and relationship problems

•  Mood stabilizers are the main treatment for Bipolar disorder. More recently however antipsychotics are also being used.

Does Bipolar Disorder Run in Families?

Twin and adoption studies provide strong evidence of a genetic influence for Bipolar I Disorder.

First-degree relatives of persons with Bipolar I are said to have anywhere between 5 and 25 % greater chance of having a bipolar diagnosis then the general population.

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