Bipolar Disorder (Manic Depression)
The hallmark of Bipolar
Disorder (BPD), also called Manic Depression, is that the patient has
manic episodes. They usually also have
episodes of depression but not necessarily.
Manic episodes are defined as periods of time where the person has an
excessive amount of energy which may be described as euphoric,
irritable, or both. Commonly the person has racing thoughts,
rapid speech, lack of need for much sleep and they still feel
well, over indulgence in pleasurable activities that have a high
chance for adverse results (i.e., extremes of buying items or
investments, using drugs, promiscuity, or even psychotic behavior
like directing traffic half naked). The person will usually also
eventually have depressive episodes. Some persons even have both
manic (rapid speech, racing thoughts, lack of need for sleep,
etc) and depressed symptoms (lack of energy, tearfulness,
hopelessness, etc.) at the same time (this is called a mixed state).
If the manic symptoms are not severe the person may be said to
have hypomania.
Persons with hypomania may be very productive, creative and
charismatic. The down side is that they may eventually burn-out
into exhaustion or full mania, or drop to depression. Others may
not be able to keep up with their energy level, they may have a
level of irritability and aggression, and they may go to excess in
pleasurable activities (i.e., dangerous sports, substance abuse,
promiscuity, etc.)
BPD affects 1% of the population, with an equal ration of men
and women. The average age of onset is around 20 years-old.
Depression, hypomania, and Bipolar Disorder are much more common
in first-degree relatives of persons with BPD suggesting a
genetic component. The concordance rate for monozygotic twins
with bipolar disorder is about 70%. If you put “genetics and
bipolar disorder”, or “biology and bipolar disorder”, or
“brain scans and bipolar disorder in the Pub Med
web site of the U.S. National Library of Medicine, you can get a
feel of the biologic findings and nature of BPD.
Many persons with bipolar disorder are talented and creative.
Some have made volumes of great artistic or scientific work in
relatively short periods of time. This does not mean it is
favorable to have this illness as these persons eventually suffer
exhaustion, depression, and alienation of their social circle. In
addition, persons with some degree of mania often deny they have
any problem, enjoy the energy they have, and do not want to admit
any personal weakness. If they have an aggressive mania they will
blame others. These factors make it extremely common for persons
with bipolar disorder to refuse to accept their illness or
treatment.
The Diagnostic and Statistical Manual of Mental
Disorders-IV details three major categories of bipolar
disorder, bipolar
I, bipolar II, and cyclothymia.
Bipolar I requires one or more manic or mixed episodes. A
depressive episode is not required for the diagnosis of bipolar I
disorder but it frequently occurs. Bipolar II, which occurs more
frequently, is usually characterized by at least one episode of hypomania and at
least one major depression.
Cyclothymic
disorder requires the presence of numerous hypomanic
episodes, mixed with mild depressive episodes that do not meet
criteria for major depression. Some psychiatrists will also
include medication-induced
mania, as well as a family history of mania as subtypes of
bipolar disorder.
For completeness we will also note that clinical depression
may be seen in the context of post-partum depression,
seasonal depression, or as premenstrual dysphoric disorder.
After reading about all these mood disorders it may become
evident that there are a multitude of variations of depression
and mania that one can experience. There is evidence that
unipolar depression and bipolar depression may be separate
disorders, however many patients often fall into a grey area.
Go to depression page four.
Summary of Depression Links:
Depression｜
Personality Disorder｜
Psychodynamic Psychotherapy｜
Core Issue-Defense｜
Cognitive Therapy ｜
Anxiety｜
Unipolar Depression｜
Dysthymia｜
Rationalization｜
Denial｜
Mania ｜
Pub Med｜
Hypothalamic-Pituitary-Adrenal Axis｜
Cytokines｜
Neurotrophic Factors｜
Serotonin Transporter Allele｜
Molecular Biology Studies｜
Recurrent Brief Depression｜
Circadian Rhythms｜
Projection｜
Atypical Depression｜
bipolar disorder (Manic Depression)｜
Mixed State｜
Diagnostic and Statistical Manual of Mental Disorders-IV｜
Bipolar II｜
Cyclothymia｜
Hypomania｜
Medication-Induced Mania｜
Post-Partum Depression ｜
Seasonal Depression｜
Premenstrual Dysphoric Disorder｜
Antidepressants ｜
Depression Treatment
