Bipolar Disorder Overview

The mood swings a bipolar patient experiences are more intense than the natural mood swings of a healthy person. The disorder typically shows up between the ages of 15 and 25 in both men and women and is characterized by periods of mania and periods of depression [source: Healthline].

The National Institute of Mental Health (NIMH) lays out the symptoms that are common to a manic episode. These include:

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a certain number of manic symptoms must be present for at least a week for those symptoms to add up to a manic episode. Manic episodes can affect people differently. For some, euphoric symptoms make it a wonderful, desirable experience. For others, mania makes them extremely irritable and easily angered. A less severe kind of mania is called hypomania, which may include a less intense form of any of the above symptoms. Hypomania does not interfere with one's daily life and relationships as much as a regular manic episode [source: MedicineNet]. If left untreated, hypomania could progress into mania.

The following is the NIMH's list of depressive episode symptoms:

For these symptoms to add up to a depressive episode, a certain number of these symptoms must persist for at least two weeks.

It is possible for bipolar patients to actually experience manic and depressive symptoms at the same time. When this happens for at least a week, it is referred to as a mixed episode [source: DBSA]. In addition, some may experience rapid cycling which is characterized by a year of at least four episodes of mania, hypomania or depression [source: DBSA]. During a more severe manic or depressive episode, a bipolar patient can experience psychotic symptoms. These can include delusions (false beliefs) and hallucinations (false sensations) [source: NIMH]. Because these symptoms are usually associated with schizophrenia, doctors can easily misdiagnose these bipolar patients.

The kinds of episodes patients experience determines the type of bipolar disorder they are diagnosed with. Classifications for the disorder include:

Now that we can more easily recognize the disorder and what bipolar patients experience, let's take a look at what people think might cause this mysterious illness.

Researchers don't know exactly what causes bipolar disorder. Most likely, there's no single factor but rather multiple factors that cause bipolar disorder to develop. Genetics do play a role and increase the likelihood that someone will develop the disorder. But you can't always determine who will get it based on genetics. For example, although the disorder does run in families, one twin may develop the disorder while the other twin never does. Statistics show that the children of bipolar patients have a higher risk than the general population of developing it. Attempts to find the specific genes that lead to the disorder have failed, but research is ongoing [source: NIMH]. 

Environmental factors might actually contribute to the development of the disorder in someone who is genetically predisposed. For instance, stressful periods and major life-altering events -- both good and bad -- can trigger the disorder. Other environmental factors have the potential to cause specific manic and depressive episodes in bipolar patients. These include drug and alcohol abuse, seasonal changes and even antidepressants [source: Helpguide.org].

Chemicals in the brain could also predispose people to bipolar disorder [source: CCI]. Researchers suspect that the levels of neurotransmitters dopamine, serotonin, norepinephrine, and GABA (gamma aminobutyric acid) might be involved in the disorder. Because cocaine and amphetamine, which release dopamine, can instigate mania, it is possible that high dopamine levels could lead to a manic episode [source: Davies]. This theory is supported by the evidence that manic and psychotic symptoms correlate with increased dopamine levels [source: Frank]. In addition, researchers have found low serotonin activity during manic and depressive episodes [source: Frank]. Also, hypomania often correlates with increased norepinephrine levels. Compared to healthy patients, bipolar patients have lower levels of an enzyme used in the transfer of GABA in the brain. It is thought this plays a role in causing the disorder because anticonvulsant drugs, which are effective in combating bipolar disorder, increase the levels of GABA [source: Frank].

The more scientists find out about the causes of the condition, the more progress they can make toward finding effective treatments. Luckily, many bipolar patients benefit from existing medications. Next, we'll take a look at the most common medications used to treat bipolar disorder.

Because the cause of bipolar is largely unknown, the search for effective treatments is difficult. Though certain medications, such as lithium, prove helpful for many bipolar patients, scientists don't know why. Doctors have found that bipolar disorder is a long-term illness that requires consistent, long-term treatment. This usually includes taking prescribed medications even during periods of healthy moods.

Because patients respond differently to the various drugs used to treat the disorder, adjusting the dosage or the kind of medication is often necessary to find the best treatment for an individual. The following is a list of the most popular medications used for bipolar disorder.

Lithium: In the 1970s, the Food & Drug Administration (FDA) approved lithium for treating bipolar disorder, and it is still one of the first lines of treatment for the condition. Lithium is a mood stabilizer, effective against both depressive and manic episodes. After starting on lithium, patients have to visit the doctor for frequent blood tests to monitor lithium levels. After finding a healthy dosage, patients won't have to take the blood tests as often.

Anticonvulsants: Like lithium, anticonvulsants are also mood stabilizers. Anticonvulsants work by stabilizing the overactive parts of the brain. They also are commonly used to prevent seizures in epileptic patients. Different anticonvulsants work in different ways. Some work by increasing levels of the GABA neurotransmitter [source: Frank]. Used alone or with lithium, anticonvulsants can be effective for many bipolar patients.

Atypical Antipsychotics: For people who don't respond to lithium and anticonvulsants, doctors may prescribe atypical antipsychotics, such as clozapine. These kinds of drugs, which are also used to treat schizophrenia, work by affecting the levels of certain neurotransmitters in the brain, such as dopamine.

Benzodiazepines (Anti-Anxiety Drugs): If a bipolar patient is having sleeping problems, benzodiazepines can help promote healthy sleeping routines. These should be used with caution, however, and usually for only a short period because of the possibility of addiction [source: NIMH].

­Antidepressants: Because they can trigger manic episodes, antidepressants are not prescribed to treat bipolar disorder as commonly as they used to be [source: MayoClinic]. Depending on the kind, antidepressants work by adjusting levels of serotonin or norepinephrine in the brain. To learn more about them, read How Antidepressants Work.

In addition to the normal potential for side effects, it is dangerous for pregnant or nursing mothers to take certain mood-stabilizing drugs. Lithium isn't likely to harm a fetus in the womb, but certain anticonvulsants can cause birth defects [source: NAMI]. Changing medications too much during pregnancy can cause negative effects as well [source: NAMI]. Because unexpected pregnancy can make the choice difficult, it's best to discuss the options with a doctor.

Medications are not the only option for fighting bipolar disorder. The National Institute of Mental Health maintains that the best treatment incorporates both medicines like those listed above and psychosocial treatment [source: NIMH]. In the next section, we'll explore these and other kinds of treatments.

Various therapies have proven helpful for bipolar patients as a supplement to medicinal treatment. Taking part in any of the following can lessen the severity and give the patient more control over symptoms:  

In addition to these therapies, it's a good idea to avoid drugs and alcohol, as they can potentially trigger an episode. 

As we've seen, just learning more about the disorder might provide comfort and hope. Bipolar patients should realize that they are not alone and that it is a treatable condition. Various kinds of research and advancements in technology that allow for more precise studies of the brain offer promising signs that the disorder will continue to get more manageable. To learn more about related subjects, such as the brain and how it is studied, read the links on the next page.