Bipolar disorder or bipolar affective disorder, historically known as manic-depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or more depressive episodes.
The risk for suicide is very high in patients who suffer from bipolar disorder and who do not receive medical attention. Between 10 - 15% of patients with bipolar disorder I commit suicide, with the risks being highest during episodes of depression or mixed mania (simultaneous depression and mania). Some studies suggest that the risk for suicide in patients with bipolar disorder II is even higher than it is for those with bipolar disorder I or major depressive disorder. Patients who also suffer from an anxiety disorder are also at greater risk for suicide. (Rapid cycling, although a more severe variation of bipolar disorder, does not appear to increase the suicide risk in patients with bipolar disorder.)
An off-kilter body clock can throw off our sleep-wake cycle, eating habits, body temperature and hormones—and mounting evidence suggests a malfunctioning clock may also underlie the mood cycles in bipolar disorder.
In a new study led by psychiatrist Alexander Niculescu of Indiana University, researchers found that children with bipolar disorder were likely to have a mutated RORB gene, which codes for a protein crucial to circadian clock function. The team’s previous work identified alterations to this gene and other clock genes in animal models of the disorder.
In its early stages, bipolar disorder may masquerade as a problem other than mental illness. For example, it may first appear as alcohol or drug abuse, or poor school or work performance.
If left untreated, bipolar disorder tends to worsen, and the person experiences episodes of full-fledged manic episodes and depressive episodes.
Mood-stabilizing medication can help control the symptoms of bipolar disorder. However, patients often need help and support to take medicine properly and to make sure that mania and depression are treated as early as possible.
Some people stop taking the medication as soon as they feel better or because the mania feels good. Stopping medication can cause serious problems.
In truth, childhood bipolar disorder is quite difficult to diagnose. Many of the disorder's characteristic symptoms overlap those of other disorders, particularly attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD). In fact, studies indicate that as many as 90 percent of all children with bipolar disorder also have ADHD, and that roughly 50 percent also have comorbid CD. Further complicating diagnosis, the presentation of childhood mania differs dramatically from that in adults.
Until about 1980 most mental health professionals believed that bipolar disorder did not occur in children. Although a few still hold this view, the general opinion of the psychiatric community has drastically shifted over the past 30 years, a period in which diagnoses of the disorder in kids have skyrocketed. In a study published in 2007 psychiatrist Carmen Moreno, then at Gregorio Marañón University General Hospital in Madrid, and her colleagues found a 40-fold increase between 1994 and 2003 in the number of visits to a psychiatrist in which a patient younger than 19 was given this diagnosis.
Bipolar disorder has a strong genetic component. Depending on which studies you look at, the gentics acount for anywhere from 40-60% of the vulnerability. While that seems like a high number it also means 40-60% of the risk of developing the disorder despite having the same genes comes from the environment. Only 40-60% of every set of identical twins will develop the disorder.
There are many theories regarding the cause of Bipolar disorder. Much of the research suggests there is an imbalance of specific neurotransmitters in the brain. Neurotransmitters are chemicals that facilitate information passing between nerve cells in the brain.
Scientists are unclear exactly how these neurotransmitters impact the development of Bipolar disorder. However, medications that allow an increase or decrease in specific neurotransmitters help to reduce bipolar symptoms.
Bipolar disorder is classified according to the pattern and severity of the symptoms as bipolar disorder I, bipolar disorder II, or cyclothymic disorder. Patients with one type may develop another. Nevertheless, they are distinct enough to merit separate classifications. Some doctors believe these conditions are actually separate disorders with different biologic factors that account for their differences.
Bipolar disorder — sometimes called manic-depressive disorder — is associated with mood swings that range from the lows of depression to the highs of mania. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may occur only a few times a year, or as often as several times a day.