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Everyone has ups and downs in mood. Feeling happy, sad and angry is
normal. Bipolar disorder, or manic-depressive illness, is a serious
medical condition that causes people to have extreme mood swings. These
swings affect how people think, behave and function.
Bipolar disorder typically consists of three states:
- a high state, called "mania"
- a low state, called "depression"
- a well state, during which many people feel normal and function
well.
One to two per cent of adults have bipolar disorder. In adolescents
and young adults, the symptoms may be less typical and may be mistaken
for teenage distress or rebellion.
Men and women are affected equally. In some women, bipolar disorder
may appear during pregnancy or shortly after it. In this case, symptoms
of depression are more common than symptoms of mania.
Symptoms of bipolar disorder
1. Mania
Sometimes, a person may seem abnormally and continuously high, happy,
expansive and euphoric, or irritable, angry, disruptive and aggressive,
for at least one week. If this change in mood is accompanied by at least
three of the following symptoms, the person may be in a manic phase
of bipolar disorder.
- exaggerated self-esteem or feeling of grandeur
- less need for sleep
- increased talking
- flight of ideas or racing thoughts
- speeded-up activity
- poor judgment
- psychotic symptoms.
2. Hypomania
The symptoms of hypomania are less severe than those of mania: people
may feel happy and have lots of energy, but their lives usually are
not seriously disrupted. Hypomania may progress to a full-blown manic
episode or a severe depression, and therefore needs treatment.
3. Depressive Episode
Symptoms of depression in bipolar disorder include at least five of
the following, which must be present for at least two weeks and must
be present most days all day:
- depressed mood
- marked loss of interest or pleasure in activities that used to be
enjoyable
- weight loss or gain
- insomnia or hypersomnia (oversleeping)
- apathy or agitation
- loss of energy
- feelings of worthlessness and guilt
- inability to concentrate or make decisions
- thoughts of suicide (which should always be taken seriously)
Other symptoms
People with Bipolar Disorder maylose touch with reality, hear voices
or have ideas that are not based in reality. These are called "psychotic
symptoms." Psychotic symptoms can be very frightening for the person
having them and for others. Problems with movement, called "catatonic
symptoms," which may include extreme physical agitation or slowness
and odd movements or postures occur in up to 25 per cent of people experiencing
episodes of depression or mania. People with bipolar disorder who have
psychotic or catatonic symptoms are sometimes incorrectly diagnosed
as having schizophrenia, another severe mental illness.
Causes
We do not know the precise cause of bipolar disorder. However, research
shows that genes play a strong role.
Stress or difficult family relationships do not cause the illness.
However, these factors may "trigger" an episode in someone
who already has the illness.
Treatments
Treatment for bipolar disorder includes pharmacotherapy (medications)
and psychosocial treatments (psychotherapy, rehabilitation). Often both
types of treatment are needed, but usually biological treatment is needed
first to bring symptoms under control. Recommendations for maintenance,
or longer term treatment depend on the type of illness. For some people
who have had a mild, single episode, staying on medications for one
or two years may work. For most others, longer-term treatments are recommended.
Recovery
Like chronic disorders such as hypertension or diabetes, bipolar disorder
can be effectively managed and controlled by combining treatment and
a healthy lifestyle. The goal in treating bipolar disorder is to help
people get well again. This includes:
- treating symptoms until they no longer cause distress or problems
- improving work and social functioning
- reducing risk of relapse.
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