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Understanding bipolar disorder

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"I'm fine, but I'm bipolar. I am on seven medications, and I take medication three times a day. This constantly puts me in touch with the illness I have. I am never quite allowed to be free of that for a day. It's like being a diabetic."

Carrie Fisher

Bipolar disorder is a serious enduring mood disorder affecting approximately 6 million Americans or roughly 2.5% of the adult population. Bipolar disorder results in an average of 9.2 years reduction in expected life span, and as many as one in five patients with bipolar disorder completes suicide

There is no cure for bipolar disorder but it can be effectively managed with medication. The typical age of onset for this disorder is late adolescence or early adulthood; the average age of onset is 25.

Men and women are affected in equal numbers and there is a strong biological predisposition associated with this disorder, meaning your risk for developing bipolar is elevated if you have a first-degree relative with bipolar disorder.

The primary feature of bipolar disorder are the mood swings where a person will alternate between varying degrees of “highs” intermixed with varying degrees of “lows”.

There are generally three types of Bipolar Disorder:

Bipolar I, This is the most severe form of the disorder. A person experiences full-blown mania and major depressive episodes. Bipolar I is often associated with alcoholism, drug abuse, eating disorders, ADHD, panic disorder, and social phobia.

Bipolar II, A person experiences mild highs (hypomania) along with major depressive episodes.

Cyclothymia, A person experiences numerous periods of mild mania along with mild depressive episodes.

A variant of bipolar disorder is referred to as "rapid cycling". When a person experiences four or more episodes of major depression or mania during a 12-month period they are referred to as “rapid cyclers”

People with Bipolar I have full manic and major depressive episodes. Most experience an alternating of these episodes where they experience months of mania followed by months of depression. The mania may even include psychotic features that include hallucinations and delusions.

People with Bipolar II alternate between mild manic states, “hypomania”, and severe depressive states. For most people with Bipolar II the depressive states are more common than the manic ones.


People in the throes of mania need constant excitement, involvement, and companionship. They often seek out new friends as well as old ones and have little awareness that their behavior is overwhelming or excessive.

Manic people move quickly as though there were not enough time to do everything they want to do. They may even talk rapidly and loudly. Flamboyance is not uncommon, sometimes dressing in flashy clothes, spending large sums of money, and even getting involved in dangerous activities.

Mania makes people use poor judgment and, as a result, often take actions without considering possible pitfalls or negative repercussions. People with mania have an inflated opinion of themselves and sometimes their self-esteem approaches grandiosity. During the most severe cases of mania, some people have trouble remaining coherent and can even lose touch with reality.

Treatment for bipolar disorder usually involves the use of mood stabilizers. These include medications such as Lithium, Depakote, Tegretol, Lamictal and Topamax. These medications are also used as anti-seizure medications for epilepsy and other brain disorders.

Psychotherapy has also shown to be effective in treating patients with bipolar disorder. The ideal treatment would combine drug therapy with talk therapy. Although the medication therapy for bipolar disorder usually must be lifelong, the majority of bipolar patients are noncompliant and stop their medication after one year.

Famous people who have been diagnosed with bipolar disorder include Patty Duke, Carrie Fisher, Connie Francis, Linda Hamilton, Vivien Leigh, Kurt Cobain, Dick Cavett, Vincent Van Gogh, Charley Pride, Jean-Claude Van Damme, and Jonathan Winters.

Take an online assessment to see if you may be suffering with bipolar disorder at Psych Central.

NIMH, APA 2000, DSM-IV, Wikipedia,