What is Bipolar Disorder?
Bipolar Disorder (previously known as Manic Depressive Reaction (DSM-I) and
Manic Depressive Illness (DSM-II)) is a mood disorder characterized by a
long-term episodic cyclical course of extreme fluctuations in mood resulting in
significant impairment in social, interpersonal and occupational functioning.
The results of repeated extreme unstable fluctuations in mood can be devastating
to the individual and family members over time. Bipolar Disorder is a serious
illness that requires psychiatric and psychological treatment. Untreated
individuals with bipolar disorder have a significantly higher lifetime rate of
attempted and completed suicide.
The most severe form of the disorder, Bipolar I Disorder, is characterized by
one or more Manic or Mixed episodes of sufficient severity to cause marked
impairment in social and occupational functioning most often resulting in a
psychiatric hospitalization.
Typically, individuals with Bipolar I disorder experience extreme
fluctuations in mood ranging from Severe Depression to Mania. During Manic
Episodes individuals experience very elevated or irritable moods in which they
may become highly energized, have an inflated sense of self-esteem, experience a
markedly reduced need for sleep, become very talkative, have racing thoughts,
may take on multiple projects at once and become easily distracted.
Typically, individuals in a more severe state of mania may lose their normal
sense of judgment and may undertake risky behaviors with the potential for
painful negative consequences. In the most severe stages of Mania individuals
will become disorganized in their behavior and thought process, may appear
bizarre to others and may experience strange or unusual ideas. The disorganized
and sometimes frightening behavior can lead to a psychiatric hospitalization.
Individuals with Bipolar Disorder also experience significant periods of
severe Depression in which they may experience depressed mood and loss of
interest or pleasure as well as the following symptoms: significant weight loss
or decrease or increase in appetite, sleeping too much or too little, being
agitated or slowed down or feeling fatigued. During depressed periods
individuals often report feelings of worthlessness or excessive or inappropriate
guilt, diminished ability to think or concentrate, or indecisiveness, or
suicidal thoughts or plans. These problems or symptoms cause significant
distress or impairment in social, occupational, or other important areas of
functioning.
Careful assessment before prescribing medication is important because
individuals with Bipolar Disorder experience significant periods of depression
as well as distinct periods of high moods. About 60% of individuals who present
initially with mainly Depressive symptoms may go on to experience a Manic or
Hypomanic Episode. Individuals who receive an anti-depressant may experience a
medication induced Manic or Hypomanic Episode.
Bipolar II Disorder is characterized by one or more Major Depressive Episodes
with at least one Hypomanic Episode in which the patient’s functioning is not
compromised severely enough to cause marked impairment in social or occupational
functioning. Bipolar II Disorder, while by definition not involving an episode
severe mania, has a high risk of suicide and is often associated with a severe
depressive course no less impairing than that experienced in Bipolar I
disorders.
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