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. Its 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 childs mood disorder but also how these powerful
drugs might affect the childs 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, its
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"
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
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
Click here to learn more about treatment
as well as resources available for finding