ABOUT BIPOLAR DISORDER (MANIC DEPRESSION)

Bipolar disorder (also known as manic depression) is a mental illness highlighted by alternating episodes of mania and depression -- elation and euphoric highs, followed by melancholy and severe hopelessness. It’s the chronic illness which I have battled for over twenty years. But every day, I am learning how to better live with it. It's an emotional disorder which is often overlooked by the sufferer, friends, family and sometimes even by mental health professionals. And perhaps the most frightening fact is that the suicide rate during a manic depressive episode is extremely high.

Early Onset Bipolar Disorder

While it often appears during the late teenage years or early adulthood (my worst symptoms peaked at about age 29), more and more doctors are diagnosing “early onset bipolar disorder“ which can affect children as young as 7. Diagnosing children is especially difficult, as children tend to cycle frequently (often daily) between highs and lows, and often have concurrent illnesses such as ADHD and conduct disorder. There is also less data on the effectiveness of medicating bipolar disorder in children, which causes great frustration for parents not only concerned with treating their child’s mood disorder but also how these powerful drugs might affect the child’s development and health later in life. Doctors have to be extremely careful in prescribing antidepressants, because when they are used to combat depression in the case of a bipolar patient, they can dramatically increase the risk of manic cycling, self-harm, or even suicide in bipolar children. Bipolar disorder tends to run in families and may even be inherited.

The Mood Spectrum

To understand the different episodes that a bipolar person may have, it’s helpful to think of the complete spectrum of moods involved. A manic episode is defined by symptoms of an severely elevated or irritable mood that can last for one week or longer. Some of the symptoms of mania include an increase in energy, activity and productivity, grandiosity, a decrease in sleep, a sharp increase in sexual activity, overspending, drug and alcohol abuse, rapid speech, racing thoughts and irritability, recklessness (i.e. risky driving), agitation and poor judgment. Some manic depressives experience both visual and auditory hallucinations, much like a schizophrenic. Curiously, hypomania (a milder form of mania) or even the manic state may be a pleasant experience for the sufferer. I was on top of the world when I was manic - - deluded that I was in control of everything in my life - - and I was enjoying every minute of this "out of control" lifestyle!

But when the depressive state arrived, the fun was instantly over. My world came crashing down. This is the other end of the mood spectrum. The depressive state is highlighted by general sadness, hopelessness, worthlessness, guilt, poor sleep, weight loss or gain and suicidal thinking. Women are twice as likely as men to experience the severe depression bipolar disorder can bring. It's interesting to note that when I was in my depressive states, my moods were tornado-like - - I never really experienced melancholy - - I just felt very aggressive and that my depression was "active" - - a rage brewing inside. I was frightened of harming myself and others.

Hippocrates wrote about moods in the 5th century B.C. as a medical condition. More than 600 years later, Greek physician, Areteus recognized that both mania and depression could cycle within the same patient. But it wasn't until the end of the 19th century when a German psychiatrist, Emil Kraepelin coined the term "manic depression." The statistics are startling - - more than 2 million Americans suffer from the illness and millions of others are undiagnosed.

Patterns of Bipolar Disorder

There is no standard pattern for a manic depressive's behavior. Needless to say, this "flip flopping" of moods is usually very destructive and patients are frequently hospitalized and unable to work. The families of manic depressives are forced to deal with the consequences of their loved ones. My parents and sister suffered through a federal court conviction, a prison term, house arrest and ultimately electroshock treatment with me. The "more lucky" manic depressives are the ones who suffer with hypomania - - a mild form of mania, an illness with which they pretty much still function at their jobs or in relationships.

There are different types and patterns of bipolar episodes. Some people may only experience a few episodes in a five year period while others may have ten episodes a year and constantly be going back and forth between the two moods or returning to an "even keeled" state.

Bipolar I and II

It's important to note that there are two separate categories of manic depression recognized in the DSM-IV which stands for the most recent diagnostic and statistic manual of psychiatric disorder that aids in the diagnosing of mental illness. The Bipolar I patient usually tends to experience one major manic episode and chronic depression. The Bipolar II patient experiences hypomania - - basically the same highs as the Bipolar I patient but with less intensity. The typical bipolar patient can expect to have approximately ten episodes in his or her lifetime.

I happen to be a rapid cycling bipolar patient suffering from bipolar 1 disorder - - frequently going from one pole to the other - - and sometimes cycling several times within a short period of time - - sometimes five or six times during a week. A patient must have four or more episodes to be considered a "rapid cycler."

The cyclothymic patient has a slightly different experience. He or she still has "highs" and "lows" and goes back and forth between the two moods, but at a much more moderate level.

Finally, there as those patients who experience mixed mood states. For me, this condition is the most paralyzing. Mania and depression occur simultaneously - - one has intense feelings of euphoria but also feels irritability at the same time.

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