Bipolar Disorder

Bipolar Disorder is a mood disorder characterized by episodes of mania alternating with episodes of depression. The manic episodes usually include symptoms of increased energy, decreased need for sleep, racing thoughts, grandiosity, hypersexuality, risk-taking behaviors, irritability, and impulsivity. The depressive episodes include poor sleep, either increased or decreased appetite, decreased energy, hopelessness, helplessness, suicidal thoughts, decreased interest in usual activities, and impaired concentration.

It turns out that bipolar disorder is actually a heterogeneous groups of disorders which include the classic presentation described above, but also a spectrum of disorders which are characterized by differing degrees of severity of symptoms. A less severe form of mania is called hypomania. People suffering this usually like this state of mind because they feel euphoric, have much energy, are overly productive, may have rapid speech, and a lot of new ideas. However, judgment is usually at least mildly impaired, so it often leads to trouble.

Treatments for the bipolar disorders should always include medicine, particularly the class of medicines called mood stabilizers. These include lithium, divalproex acid (Depakote), carbamazepine (Tegretol), and the so-called second generation antipsychotic medicines, such as quetiapine (Seroquel), olanzapine (Zyprexa), aripiprazole (Abilify), and asenapine (Saphris). Sometimes, they need to be combined with antidepressants, but this may be risky since it increases the likelihood of changing a depressive episode into a manic episode (“a switch”).

Psychotherapy should always play an important role as well. People with the bipolar disorders usually have impaired insight so that they have difficulty accepting that they are suffering from an illness and often have little awareness of how they affect those around them.
The prognosis is generally good as long as the individual accepts treatment.