Detroit Central City

Everyone experiences changing moods. Sometimes we feel happy and full of energy while at others we feel a bit down or lacking our usual energy level. But when someone experiences extreme shifts in mood, energy and functioning, she or he may have a serious brain disease called bipolar disorder (also called manic-depressive illness).

There is a tendency to romanticize bipolar disorder. Many famous artists, musicians and writers have suffered from the mood swings. But, in truth, many lives have been ruined by this disease; and without effective treatment, the illness is associated with an increased risk of substance abuse and suicide.

Bipolar disorder affects about 2.3 million Americans and men and women are equally likely to develop it. It does tend to run in families. Typically, it emerges in late adolescence or early adulthood, and occasionally, in childhood. Cycles, or episodes, of depression, mania, or "mixed" manic and depressive symptoms typically recur and may become more frequent, often disrupting work, school, family, and social life. Episodes may be triggered by stress, physical illness or even a rapid, dramatic weather change such as a sudden warm spell during a very cold January.

The symptoms of bipolar disorder include alternating periods of depression and mania.

• Depression: These symptoms include a persistent sad mood; loss of interest or pleasure in activities that were once enjoyed; significant change in appetite or body weight, difficulty sleeping or oversleeping; physical slowing or agitation; loss of energy; feelings of worthlessness or inappropriate guilt; difficulty thinking or concentrating; and recurrent thoughts of death or suicide.
• Mania: These symptoms include abnormally and persistently elevated (high) mood or irritability accompanied by at least three of the following symptoms: overly-inflated self-esteem; decreased need for sleep; increased talkativeness; racing thoughts; distractibility; increased goal-directed activity such as shopping, gambling; physical agitation; and excessive involvement in risky behavior or activities.
• "Mixed" state: The symptoms of both mania and depression are present at the same time.

Severe depression or mania may be accompanied by symptoms of psychosis. These symptoms include: hallucinations (hearing, seeing, or otherwise sensing the presence of stimuli that are not there), and delusions (false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person's cultural concepts).

Bipolar disorder is often complicated by co-occurring alcohol or substance abuse. Not infrequently, the person afflicted with bipolar disorder reports a history of using alcohol and other mood altering drugs in a misguided attempt to “self-medicate� his or her mood swings.

A variety of medications and therapies strategies are used to treat bipolar disorder. Medications can help stabilize moods and help relieve depression and other severe symptoms. Counseling therapy for the patient and family, as well, are helpful. Substance abuse treatment may also be needed.

Finally, the patient himself has a key role in managing his illness. Faithfully taking medication and persisting with other therapies are important to good symptom control.