Bipolar Disorder FAQ

What is bipolar disorder?

Bipolar disorder is officially defined as a mood disorder characterized by extreme mood shifts from depression to episodes of mania.  It has also been called manic depression, manic-depressive disorder or bipolar affective disorder. Bipolar disorder is considered a long-term, usually chronic medical condition which responds very well to available treatments.

How does a person know if he/she has bipolar disorder?

The patient will need to meet with a trained psychiatrist and describe his/her specific behaviors and mood episodes.  If a patient has had at least one manic and one depressive episode, he/she my be diagnosed with bipolar disorder and a comprehensive treatment plan developed.

Are there other conditions that are mistaken for bipolar disorder?

There are a number of conditions that can have symptoms that may be mistaken for bipolar disorder, and vice versa. These include

-Thyroid disease

-High dose corticosteroid therapy

-Dementia, including Alzheimer’s disease

-Brain infections from Lyme disease, HIV, syphilis, meningitis, encephalitis, etc.

-Neurological conditions like epilepsy, brain tumors, strokes

-Severe deficiencies in certain vitamins

-Adverse reactions to psychotropic medications

-Schizophrenia

-Intermittent Explosive Disorder

-Attention Deficit Hyperactivity Disorder (ADHD)

-Schizoaffective Disorder

Are there different types of bipolar disorder?

There are two main types of bipolar disorders, type I and type II.  Bipolar disorder type I is the “classic” form of bipolar disorder and is characterized by cycles of mania and depression.  In bipolar disorder type II, there is still a cycle of an “up” phase and depression, but the “up” phase no full-fledged manic episode, instead the it is know as hypomania (which means literally “mild mania”).

What are the symptoms of bipolar disorder?

Symptoms of bipolar disorder depend on the mood state.  If the patient is manic, then the symptoms will include:

• Heightened sense of self-importance
• Significant decreased need for sleep
• Poor appetite
• Exaggerated positive outlook
• Racing speech and thoughts
• Poor concentration
• Excessive irritability
• Aggression
• Poor financial decisions, spending sprees

Patients in a depressive state will exhibit some of the following symptoms:

• Feeling hopeless and extremely sad
• Loss of interest in activities that normally provide pleasure
• Difficulty sleeping
• Loss of energy and lethargy
• Negative thoughts, particularly about the future
• Poor concentration
• Weight changes, loss or gain
• Suicidal thoughts

Does stress, alcohol or drug use, or abuse history cause bipolar disorder?

There is no clear known cause of bipolar disorder. Having an immediate relative with bipolar disorder greatly increases the risk of developing the disorder. Stressful events and alcohol or drug use do not cause the disorder but are thought to often be the precipitating events or stressors that causes the disorder to develop in individuals already genetically predisposed to bipolar disorder. The “Diathesis-Stress Model” is used to explain the concept that one is born with a disposition towards developing an illness but it takes a certain type of stress to make the illness actually manifest in that individual, and others who have that predisposition but do not experience that particular type of stress will never go on to develop the illness.

Is there a test someone can take to tell if they have bipolar disorder?

Currently, there is no test to determine if a person has, or may inherit, bipolar disorder.  Diagnosis requires meeting with a trained psychiatrist.

Are people with bipolar disorder violent?

There is tremendous stigma connected to mental illness, part of which is the idea that mentally ill people are violent. A minority (estimated to be around 11 to 16%) of bipolar people will experience a violent episode at some point in their illness, but those are not necessarily directed at other people nor are they necessarily part of an ongoing pattern of violence. Those episodes are frequently connected to drug or alcohol use, not simply bipolar disorder. People with mental illness are at high risk for drug and alcohol use, and substance use can greatly worsen psychiatric symptoms as well as causing anger or violence.  In addition, those few bipolar people who do get violent impulses without drug or alcohol use tend to get them during severe manic episodes, which in many patients are prevented through medication use. Research shows people with bipolar disorder are at much greater risk of harming themselves than harming other people. They are at risk for self-injury, suicide and substance abuse.

Do people with bipolar disorder have to stay on medication forever?

Not all people with bipolar disorder need to be on medication forever., though it is encouraged to minimize the mood cycles. There are people whose manic and depressive episodes are mild enough, or rare enough, that they are not on continuous medication for their whole lives. However, many people with the disorder will need life-long medication. This decision is best made with the help of a therapist and psychiatrist who are familiar with your symptoms.

What is mania and is it fun?

Mania rarely feels fun. Mania takes self-control away from a person, leading them to make impulsive decisions that can destroy their relationships, careers, financial security, or physical health. It can feel fun for a little while and then suddenly become extremely scary. Mania often involves agitation, anger and paranoia.

Do most bipolar people commit suicide?

Studies have shown a range of 5% to 50% of people with bipolar disorder committing suicide. However, the statistic that is most widely accepted is 15%, which is 30 times higher than the overall suicide rate for the general population. It is estimated that 1 in 3 people with bipolar disorder have had at least one suicide attempt during their lives. Keep in mind, however, that people with mental illness have a harder time accessing health care, are more likely to have substance abuse issues, may lack support systems, and are much more likely to be homeless. Thus, there are a variety of factors that play into suicide rates beyond just the mental illness itself, but with medication and accompanying psychotherapy, depressive states can be minimized and the patient’s outlook greatly improved.

At what age does bipolar disorder develop?

The average age of onset is 21, but the majority of people aren’t diagnosed until they are between 25 and 50 years of age. Many bipolar adults report having had symptoms even in early childhood. Bipolar disorder can begin to manifest, and be diagnosed, in children and adults of all ages.

What is the treatment for bipolar disorder?

Treatment almost always includes medications, which include mood stabilizers, anitdepressants, antipsychotics and atypical antipsychotics.  Medications are generally combined with psychotherapy and even alternative therapies like acupuncture and support groups.