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Bipolar Affective Disorder

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Bipolar mood disorder, also known as manic depression, is a treatable illness involving extreme changes in mood, thought, energy, and behavior. A person with bipolar disorder has moods that usually alternate between mania, or extremely "up" mood, and depression, or extremely "down" mood. This change or "mood swing" can last for hours, days, weeks, or even months. Typically, someone with bipolar mood disorder experiences one or two cycles a year, with manic episodes generally occurring in the spring or fall.

Manic episode

A distinct period of elevated, enthusiastic or irritable mood lasting at least one week (or less than one week if hospitalization is required), that includes at least three of the following bipolar mood disorder symptoms :

¤ Increased physical and mental activity and energy
¤ Exaggerated optimism and self-confidence
¤ Excessive irritability, aggressive behavior
¤ Decreased need for sleep without becoming tired
¤ Grandiose thoughts, extreme sense of self-importance
¤ Racing speech, racing thoughts
¤ Impulsiveness, poor judgment
¤ Reckless behavior such as spending sprees, impulsive business decisions, erratic driving and sexual indiscretions
¤ In severe cases, delusions and hallucinations

Hypomanic episode

Similar to a manic episode, except that it is less severe and there are no delusions or hallucinations. It is clearly different from an individual`s non-depressed mood with a clear change in activity and attitude, and visible behavior that is unusual or out-of-character.

Major depressive episode

A period of two weeks or more during which five or more of the following bipolar mood disorder symptoms are present :

¤ Prolonged sadness or unexplained crying spells
¤ Significant changes in appetite and sleep patterns
¤ Irritability, anger, worry, agitation, anxiety
¤ Pessimism, indifference
¤ Loss of energy, persistent exhaustion
¤ Unexplained aches and pains
¤ Feelings of guilt, worthlessness and/or hopelessness
¤ Inability to concentrate; indecisiveness
¤ Inability to take pleasure in former interests; social withdrawal
¤ Excessive consumption of alcohol or use of chemical substances
¤ Recurring thoughts of death or suicide

Mixed state (also called mixed mania)

A period during which symptoms of a manic and a depressive episode are present at the same time. People who experience mixed states describe feeling activated and "revved up," but also full of anguish and despair. Rapid, pressured speech can co-exist with impulsive, out-of-control thoughts of suicide and self-destruction or aggression. Hopelessness, irritability, uncontrollable swings between racing thoughts and a feeling of "being in blackness" can all happen over the course of minutes.

Who gets bipolar mood disorder ?

Bipolar disorder affects more than two and a half million adult Americans during any given year. The illness usually begins during a person’s late teen years, although it can sometimes start in early childhood or as late as a person’s 40s or 50s. An equal number of men and women develop this illness, and it affects people of all races, ethnic groups and social classes.

What causes bipolar mood disorder?

The exact cause of bipolar mood disorder is not known. We do know that it is a brain-based medical illness and that certain structures of the brain related to emotions, behavior, and thinking are affected. Bipolar mood disorder may be related to an imbalance in certain chemicals in the brain, called neurotransmitters. There is a genetic component, meaning the illness runs in families, although genetics does not completely predict who will develop bipolar mood disorder and who will not.

Are there different types of bipolar mood disorder?

Physicians and researchers agree there are several kinds of bipolar mood disorder. Most people who have the illness experience episodes of mania and periods of depression, but the length, frequency, and pattern of these highs and lows vary. Sometimes individuals with bipolar mood disorder experience frequent mixed states. Some of the different combinations of symptoms may not be medically significant, while others are important enough to be classified as specific types of bipolar disorder that may be treated in very different ways.

Another View
 

What Causes Bipolar Disorder?

Scientists are learning about the possible causes of bipolar disorder through several kinds of studies. Most scientists now agree that 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, researchers have been searching for specific genesthe microscopic "building blocks" of DNA inside all cells that influence how the body and mind work and growpassed down through generations that may increase a person's chance of developing the illness. But genes are not the whole story. Studies of identical twins, who share all the same genes, indicate that both genes and other factors play a role in bipolar disorder. If bipolar disorder were caused entirely by genes, then the identical twin of someone with the illness would always develop the illness, and research has shown that this is not the case. But if one twin has bipolar disorder, the other twin is more likely to develop the illness than is another sibling.

In addition, findings from gene research suggest that bipolar disorder, like other mental illnesses, does not occur because of a single gene. It appears likely that many different genes act together, and in combination with other factors of the person or the person's environment, to cause bipolar disorder. Finding these genes, each of which contributes only a small amount toward the vulnerability to bipolar disorder, has been extremely difficult. But scientists expect that the advanced research tools now being used will lead to these discoveries and to new and better treatments for bipolar disorder.

Brain-imaging studies are helping scientists learn what goes wrong in the brain to produce bipolar disorder and other mental illnesses.New brain-imaging techniques allow researchers to take pictures of the living brain at work, to examine its structure and activity, without the need for surgery or other invasive procedures. These techniques include magnetic resonance imaging (MRI), positron emission tomography (PET), and functional magnetic resonance imaging (fMRI). There is evidence from imaging studies that the brains of people with bipolar disorder may differ from the brains of healthy individuals. As the differences are more clearly identified and defined through research, scientists will gain a better understanding of the underlying causes of the illness, and eventually may be able to predict which types of treatment will work most effectively.

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