Expert Q&A

Bipolar disorder (formerly known as manic-depressive disorder), while not as common as depression, can be a debilitating psychiatric illness. There are multiple variations on the condition, the most prevalent being bipolar I disorder, bipolar II disorder, and cyclothymia.

Types of Bipolar

This condition involves a clear period of expansive or euphoric mood for at least one week. This is called a manic episode. Most people erroneously assume that this period always involves feeling happy and elevated. However, it is often the case that a person's mood during this time is irritable and distracted. He or she requires little sleep, may engage in dangerous activities (e.g., excessive spending, gambling, risk-taking), and have racing thoughts.

It is often very difficult for the person to engage productively with society as he or she seems to be functioning at an abnormally fast speed, often without reaching any goals. Although the diagnostic term implies both highs and lows, adepressive episode is not required to be considered suffering from bipolar I disorder.

This disorder is also characterized by expansive mood, but both the duration (i.e., at least fourdays) and the severity are less than that seen in bipolar I. This mood shift is known as hypomania. Additionally, bipolar II requires a depressive episode.

The major feature of this condition is fluctuating mood (both hypomania and depressive episodes that are not considered to be major depressive disorder) over the course of at least two years.

Bipolar disorder is considered a brain disease, although it is not clear exactly what structures or parts of the brain are involved. Like depression, the best treatment option for bipolar disorder is a combination of medication and psychotherapy.

Treatment

Various medication options are available, with mood stabilizers such as lithium being the most common. Psychotherapy is often used as an adjunct to medicine to help patients recognize when they may be moving into a manic or depressive episode, as well as process and understand what it means to have this disorder. Unfortunately, there is little research to support the use of psychotherapy alone as an effective treatment.

Most mental health professionals consider bipolar disorder to be a chronic, even lifelong condition. Therefore, it needs to be treated aggressively and consistently. Patients often make the mistake of stopping their medication when they enter into a manic episode--because they sometimes report feeling very happy--which can often lead to an increase in symptoms and perhaps hospitalization.

Patients sometimes feel hopeless when they get depressed and abandon their treatment, which can lead to suicidal thoughts and actions. Because there is no "cure" for bipolar disorder, it is sometimes required to make changes in medication (either type or dosage) to address the symptoms that may consistently appear. Psychotherapy sessions may also increase in frequency at times to help monitor the patient's mental health more closely.

Prognosis

While the initial picture of bipolar disorder may appear bleak, all is not lost. Patients who work with both a medical and mental health professional can lead fulfilling lives as they manage their illness. Those who challenge themselves to note their symptoms, take their medication regularly, and use their support systems to notice any significant changes in behavior, have much greater success than those who take a passive approach to treatment.

Life with bipolar disorder is certainly not easy, but it need not define a person. If you suffer from bipolar disorder, make a commitment now to make your mental health a major priority. Those who do so will be much more satisfied with their quality of life.