Frequently Asked Questions
About Bipolar Disorder
How common is Bipolar Disorder?
Bipolar Disorder affects about 10 to 30 out of every 1000 people
(or 1 to 3%) in the U.S.
Are patients with Bipolar Disorder always either manic or
depressed?
No. Patients with Bipolar Disorder may recover from their depressed
or manic episodes and have a normal mood state. However, they
always run the risk of having futher episodes of depression
or mania, especially if they are not on mood-regulating medication.
In addition, patients may be hypomanic. That is, they may
have some symptoms of mania but not for long enough or severely
enough to interfere with their functioning in a marked way.
This can be difficult to distinguish from feeling "average"
or "normal" in mood.
Finally, patients may have a mixed episode, during which
they show symptoms of depression and mania concurrently or
symptoms of one type or the other on different days within
the same week.
What is the course of the illness?
While some people have only one episode of depression or mania
without recurrence, the vast majority of patients (95%) have
multiple episodes of depression and mania. At first, episodes
may occur in response to stressful events, such as the break-up
of a relationship, the death of a loved one, a move, or the
loss of a job. Later on, episodes may come on "out of the
blue," without connection to stressful events. There is
evidence that the more episodes a person has, the more likely
they are to have new episodes. In addition, the longer a person
has the disorder, the shorter the time until the next episode.
Therefore, as people have more episodes, they spend more and
more time being ill.
The pattern of episodes can vary. Some people have single
episodes of depression or mania with periods of normal mood
in between. Others may have a manic episode immediately followed
by a depressive episode, or a depressive episode immediately
followed by a manic episode. Some people have both manic and
depressed symptoms within a given episode.
Some people have what is know as rapid cycling, where they
have many episodes within a short period of time. While the
frequency of mood switches can vary greatly, a person is considered
to have rapid cycling if he or she has four or more episodes
per year. Thus, a frequency of episodes of every 3 months
is sufficient to diagnose a rapid-cycling course.
What causes Bipolar Disorder?
Bipolar Disorder is thought to be caused by chemical imbalances
in certain brain cells responsible for regulating emotions and
behavior. These imbalances probably come about through an interaction
of genetic factors and life experiences. It is not entirely
genetic or entirely environmental; twin studies suggest it is
approximately half-and-half. Examples of life experiences that
can lead to bipolar disorder in people genetically predisposed
to this illness include stressful life events, medical conditions
(e.g., thyroid abnormalities), or use of medications like steroids.
The disorder is clearly a medical illness, and differences in
brain function can be identified in people who are depressed
or manic compared with a person experiencing a normal mood state.
What are some complications of Bipolar Disorder? Going through
depressed, manic, or mixed episodes can be very debilitating
for the affected person and his or her family. The symptoms
of the illness can interfere with a person's ability to take
part in relationships and to function well at work. For instance,
a person who is depressed may withdraw from friends and family
or feel too irritable to be with him or her. He or she may
be unable to concentrate on work or even to get out of bed
to go to work. A person who is manic may have difficulty communicating
with friends or family and may be irritable and potentially
aggressive. He or she may be too disorganized and distracted
to function at work.
Once the person recovers from the episode, he or she may
face an abundance of debilitating consequences. People may
find that their behavior has lost them their jobs, strained
their relationships, and caused financial hardship or even
homelessness. They may feel embarrassed by the way they behaved
when depressed or manic. These hardships can lead to grief
and demoralization. People often need help, such as psychotherapy
and support groups to cope with these complications.
Suicide is another potential consequence resulting from
Bipolar Disorder, particularly among patients who remain untreated.
Approximately 25% of untreated patients with Bipolar Disorder
commit suicide.
Can Bipolar Disorder be cured?
The disorder cannot be cured, but it can be treated or controlled.
In this way it is similar to chronic medical conditions like
diabetes or heart disease, and just like these conditions, better
treatments are being developed.
How can you help someone with bipolar disorder who does
not want treatment?
About 50% of patients with acute mania do not realize that they
are experiencing manic symptoms. Family members may benefit
from joining organizations like NAMI and MDDA to educate themselves
and the individual who may have bipolar disorder. Talking to
others with bipolar disorder who have experienced the same issues
and benefitted from treatment can be quite helpful. Individuals
should be encouraged to see a psychiatrist or other mental health
professional to ask questions about mania and bipolar disorder
and to respond to their doubts and concerns about being diagnosed
with bipolar disorder.
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