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Deborah Wiig
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Bipolar disorder, also called manic-depressive illness, is a type of depression characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual.

When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy, or agitated and irritable. A growing body of research recognizes a "bipolar spectrum" with symptoms of bipolarity occurring along a continuum.

Mania and hypomania often affects thinking, judgment, and social behavior. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state. See Symptoms of bipolar disorder.

Causes of depression/bipolar disorder
Because the symptoms, course of illness, and response to treatment vary so much among people with depression, doctors believe that depression may have a number of complex and interacting causes.

Research suggests that vulnerability to bipolar disorder results from both genetic and environmental factors. A serious loss, difficult relationship, financial problems, or any stressful (unwelcome or even desired) change in life patterns can trigger a bipolar/depressive episode. The hormonal system that regulates the body's response to stress also is overactive in many depressed people.

Treatment for bipolar disorder
Lithium has for many years been the treatment of choice for bipolar disorder, as it can be effective in smoothing out mood swings. Other medications have been found to be effective in controlling mood swings, including some mood-stabilizing anticonvulsants.

Most people who have bipolar disorder take more than one medication including, along with lithium and/or an anticonvulsant, a medication for accompanying agitation, anxiety, depression, or insomnia. Working with a doctor to find the best possible combination of these medications is of utmost importance.

Many forms of psychotherapy can help individuals resolve their problems.

"Behavioral" therapists help patients learn how to get more satisfaction through their own actions and how to unlearn the behavioral patterns that contribute to or result from their disorder. Psychotherapy can help people with bipolar disorder, and their families, identify early warning signs and manage emotional stress, which may help prevent a bipolar episode.

Some people with milder forms may do well with psychotherapy alone. Most people with bipolar disorder do best with a combination of medication and psychotherapy.

For more information:
Depression and Bipolar Support Alliance
National Alliance on Mental Illness
The National Mental Health Association

Sources:
The National Institute of Mental Health (NIMH)
National Institutes of Health (NIH)
Food and Drug Administration

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Symptoms of bipolar disorder
Guide to psych meds
Faces of mania
Mixed mania
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Page updated January 1, 2009