Manic-depression is a mood disorder that affects literally millions of people worldwide. It is classified as a mood disorder because it affects both an individual's emotions as well as how an individual interacts emotionally with others.
Incidence of the condition
Statistical data shows that about 5.7 million American adults, or about 2.6 percent of the population age 18 and older in any given year, have bipolar disorder. The disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them later in life.
It is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated.
Symptoms of bipolar disorder
As mentioned earlier, the most characteristic signs of bipolar disorder are dramatic mood swings – from mania to depression and back again. Periods of normal mood are sometimes found in between, but sometimes there are none. In addition to these changes of mood, there are several other changes, in energy and behavior.
The most common sign of mania include:
- Excessively good, euphoric mood
- Little sleep needed
- Unrealistic beliefs in one's abilities and powers
- Poor judgment
- Spending sprees
- Increased energy, activity, and restlessness
- Extreme irritability
- Racing thoughts and talking very fast, jumping from one idea to another
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
- Distractibility, can't concentrate well
- A lasting period of behavior that is different from usual
- Increased sexual drive
- Drug abuse (cocaine, alcohol, sleeping medications)
On the other hand, common symptoms of depression include:
- Difficulty concentrating, remembering or making any kind of decisions
- Restlessness or irritability
- Lasting sad, anxious, or empty mood
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in activities once enjoyed, including sex
- Decreased energy, a feeling of fatigue
- Sleeping too much, or can't sleep
- Change in appetite and weight loss or gain
- Chronic pain not caused by physical illness or injury
- Thoughts of death or suicide
Correlation with other psychotic disorders
Sometimes severe episodes of mania or depression include symptoms of psychosis. Common psychotic symptoms include hallucinations (audio and visual) and delusions (delusions of grandiosity, guilt or worthlessness).
Also, it is not uncommon for people with bipolar disorder who exhibit these symptoms to be incorrectly diagnosed as having schizophrenia, another severe mental illness.
Possible causes of bipolar disorder
It is difficult to talk about a single cause of bipolar disorder. According to the US National Institute of Mental Health, "There is no single cause for bipolar disorder - rather, many factors act together to produce the illness."
Because bipolar disorder tends to run in families, scientists have been searching for specific genes passed down through generations that may increase a person's chance of developing the illness. They concluded that there is no single gene the mutation of which could cause this illness. However, a family history of bipolar spectrum disorders can impart a genetic predisposition towards developing a bipolar spectrum disorder. Other factors may also be part of the patient's family history. Some of the most common are: anxiety disorders, clinical depression, eating disorders, premenstrual dysphoric disorder, postpartum depression, postpartum psychosis, and schizophrenia
The "kindling" theory
This theory claims that people who are genetically predisposed to bipolar disorder can experience a series of stressful events which lower the threshold at which mood changes occur. Eventually, a mood episode can start (and becomes recurrent) by itself.
A patient’s view on life
Suicide: Some people with bipolar disorder become suicidal because they believe there is no hope for them of living a normal life. Risk for suicide appears to be higher earlier in the course of the illness.
Experts, communicating with people who suffered from this condition, state that signs and symptoms that may accompany suicidal feelings include:
- abusing alcohol or drugs
- feeling like a burden to family and friends
- putting affairs in order
- talking about feeling suicidal or wanting to die
- feeling hopeless, that nothing will ever change or get better
- feeling helpless, that nothing one does makes any difference
- writing a suicide note
- putting oneself in harm's way, especially in life-threatening situations
Creativity: The most interesting and misunderstood aspect of bipolar disorder is its general increase in 'creative energy'. Bipolar disorder is found in a great majority of people with creative talent such as artists, musicians, authors, performers, poets, and scientists, and some credit the condition for their creativity. The disorder's depression symptoms can soon push sufferers into a cycle that many famous talents have had to live with their entire lives. These depression phases of the illness do not allow any concentration on activities, and the manic phases allow for work with minimal need for sleep.
Mortality: Unfortunately, mortality rates have increased in patients with bipolar disorder. The standardized mortality ratio from suicide in bipolar disorder is estimated to be approximately 18 to 25%, further emphasizing the lethality of the disorder.
Hypomania: A commonly mentioned term is hypomania, which represents a less serious form of mania, without progression to psychosis. Patients with hypomania can be perceived as energetic, euphoric, confident, and overflowing with new ideas, but they also often suffer from irritability or aggression.
Mixed State: A mixed state is a condition during which symptoms of mania and clinical depression occur simultaneously. It could be a very complex state because many different symptoms can mix with each other, such as agitation, anxiety, aggressiveness or belligerence, fatigue, guilt, impulsiveness, insomnia, disturbances in appetite, irritability, morbid or suicidal ideation, panic, paranoia, psychosis, pressured speech, indecisiveness and rage.
The problem with these mixed states is that they can result in panic attacks, substance abuse, and suicide attempts.
Rapid Cycling: This symptom is a condition characterized by having four or more episodes per year. It is found in a significant fraction of patients with bipolar disorder, and has been associated with greater disability or a worse prognosis.
Bipolar disorder and other illnesses
Alcohol and drug abuse are very common among people with bipolar disorder. A complication of previous substance abuse problems is common, including self-medication of symptoms, mood symptoms either brought on or perpetuated by substance abuse, and risk factors that may influence the occurrence of both bipolar disorder and substance use disorders.
Also, some anxiety disorders, such as post-traumatic stress disorder and obsessive-compulsive disorder, may also appear in people with bipolar disorder.