Plain Talk about Bipolar Disorder
Shoukry Matta, M.D.,
Board Certified Psychiatrist

Bipolar disorder, also known as manic depressive illness, is a mood disorder that affects approximately 1-2% of the adult population. This illness is characterized by recurrent episodes of mania and major depression. An affected person’s mood can swing from excessive highs (mania) to profound hopelessness (depression), usually with periods of normal mood in between. Symptoms of mania may include increased energy, activity, restlessness, racing thoughts, and speech. Symptoms of depression may include feelings of hopelessness, pessimism, guilt, worthlessness or helplessness. Some individuals may exhibit mixed symptoms of both mania and depression at the same time, while others may have more moderate symptoms of mania (hypomania).

Most people with this illness experience their first mood episode in their 20’s, but it can start later in life. The type, severity and duration of mood episodes can vary. Some individuals may have a predominance of either mania or depression, whereas some sufferers may experience equal numbers of both. The mood episodes can last for a few days to as long as several months. Depressions tend to last longer than manic episodes. Typically, a person with bipolar disorder can expect an average of ten episodes of mania or depression in his or her lifetime but some sufferers experience much more frequent mood episodes. The frequency of episodes tends to increase with time, and individuals who experience four or more episodes in a year are said to have rapid cycling. Studies have shown that women are more likely than men to be diagnosed as rapid cyclers.

There are many theories as to what causes bipolar disorder. The disorder can run in families, and research is still being conducted to try to identify the genes that may be responsible for the illness. Stressful life events can trigger the illness in some susceptible individuals, but the nature of the susceptibility is not yet clear. Imbalances in chemicals that modulate the function of the brain and message transmission are thought to be directly responsible for the symptoms of the illness, whether they arise from a specific gene difference or other environmental factors.

Bipolar disorder is a lifelong, chronic condition. It cannot be cured, but in most cases it can be managed with treatment. There are three types of medications commonly used in treating bipolar disorder: mood stabilizers, antidepressants, and antipsychotics. Currently, a newly established antiepileptic drug called Lamictal, has been effective in treating both the depression and manic episodes associated with bipolar disorder. Studies have shown that Lamictal is well-tolerated and has improved mood, alertness, and social interactions in some patients.

An accurate and comprehensive assessment for bipolar disorder is the most important step to take in order to properly treat this problem. Early recognition and treatment can enhance the chances for a positive therapeutic outcome.

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