Bipolar disorders are one of several medical conditions called depressive disorders.
Depressive disorders affect the way a person's brain functions.
Depressive disorders are widespread. In the United States alone, it's estimated
that more than 17.4 million adults have a depressive disorder each year. That works
out to about 1 out of every 7 people, so there's a good chance that you or someone
you know is dealing with a depressive disorder.
Bipolar disorder goes by many names: manic depression, manic-depressive disorder,
manic-depressive illness, bipolar mood disorder, and bipolar affective disorder are
medical terms for the same condition.
Bipolar disorder is classified into four different types:
Bipolar I
Bipolar II
Cyclothymic Disorder
Bipolar Disorder Not Otherwise Specified
Mental health experts separate the condition into these four types because the
symptoms of bipolar disorder show up differently in different people. When doctors
know what type someone has, they can tailor treatment to that person's specific needs.
How Does It Affect People?
Bipolar disorder affects both men and women. For many people, the first symptoms
show up in their early twenties. However, research has shown that the first episode
of bipolar disorder is occurring earlier: It often shows up in adolescence, and even
children can have the disorder.
Recent research suggests that kids and teens with bipolar disorder don't always
have the same behavioral patterns that adults with bipolar disorder do. For example,
kids who have bipolar disorder may experience particularly rapid mood changes and
may have some of the other mood-related symptoms listed below, such as irritability
and high levels of anxiety. But they may not show other symptoms that are more commonly
seen in adults.
Because brain function is involved, the ways people with bipolar disorder think,
act, and feel are all affected. This can make it especially difficult for other people
to understand their condition. It can be incredibly frustrating if other people act
as though someone with bipolar disorder should just "snap out of it," as
if a person who is sick can become well simply by wanting to.
Bipolar disorder isn't a sign of weakness or a character flaw; it's a serious medical
condition that requires treatment, just like any other condition.
What Are the Signs and Symptoms?
A person with bipolar disorder will go through episodes of mania
(highs) and at other times experience episodes of depression
(lows). These aren't the normal periods of happiness and sadness that everyone experiences
from time to time. Instead, the episodes are intense or severe mood swings, like a
pendulum that keeps arcing higher and higher.
Symptoms of mania include:
racing speech and thoughts
increased energy
decreased need for sleep
elevated mood and exaggerated optimism
increased physical and mental activity
excessive irritability, aggressive behavior, and impatience
poor judgment
reckless behavior, like excessive spending, making rash decisions, and erratic
driving
In adults, episodes of mania or depression usually last for weeks or months, although
they can be shorter in length. In children and adolescents, though, these episodes
can be much shorter, and a kid or teen can even go back and forth between mania and
depression throughout the day.
Episodes of mania or depression may happen irregularly and follow an unpredictable
pattern or they may be linked, with a manic episode always following a period of depression,
or vice versa. Sometimes episodes have a seasonal pattern. Mania in the spring, for
example, may be followed by depression in the winter.
Between episodes, someone with bipolar disorder usually returns to normal (or near-normal)
functioning. For some people, though, there is little or no "break period"
between their cycles. These mood swing cycles can change slowly or rapidly, with rapid
cycling between mania and depression being much more common in women, children, and
adolescents.
Some people with bipolar disorder turn to alcohol and drugs because they feel temporarily
better when they're high. But using alcohol and drugs can have disastrous results
for people with bipolar disorder. Substance abuse can actually make the symptoms worse,
as well as making the condition hard for doctors to diagnose.
What Causes Bipolar Disorder?
Doctors and scientists don't know the exact cause of bipolar disorder, but they
think that biochemical, genetic, and
may all be involved.
It's believed this condition is caused by imbalances in certain brain chemicals called
neurotransmitters. If the neurotransmitters aren't in balance,
the brain's mood-regulating system won't work the way it should.
Genes
also play a role. If a close relative has bipolar disorder, a person's risk of developing
the condition is higher. This doesn't mean, though, that if you have a relative with
bipolar disorder you will automatically develop it! Even in studies involving identical
twins raised in the same home, one twin sometimes had bipolar disorder whereas the
other did not. Researchers are now working on identifying the gene or genes involved
in bipolar disorder.
Environmental factors may play a role in bipolar disorder. For some teens, stresses
such as a death in the
family, their parents' divorce,
or other traumatic events could trigger a first episode of mania or depression. Sometimes,
going through the changes of puberty can set off an episode. In girls, symptoms can
be tied to their monthly menstrual
cycle.
How Is Bipolar Disorder Diagnosed?
Most people with bipolar disorder can be helped — but a psychiatrist or psychologist
must first diagnose the disorder. Sadly, many people with the condition are never
diagnosed or are not diagnosed properly. Without proper diagnosis and treatment, the
disorder can become worse. Some teens with undiagnosed bipolar disorder can end up
in a psychiatric hospital or residential treatment center, in the juvenile justice
system, abusing drugs, or committing suicide.
Because children and teens with bipolar disorder do not usually show the same patterns
of behavior as adults who have the condition, a mental health professional will observe
a teen's behavior carefully before making a diagnosis. This includes getting a complete
history of the person's past and present experiences. Family members and friends can
also provide helpful insights into the person's behavior. The doctor may also want
a teen to have a medical exam to rule out other conditions.
Diagnosing bipolar disorder can be difficult. As yet, there aren't any laboratory
tests like a brain scan or blood test that will diagnose it. In teens, bipolar disorder
can sometimes be mistaken for illnesses like schizophrenia and posttraumatic stress
disorder, attention deficit hyperactivity disorder (ADHD), and other depressive disorders.
That's why a complete, detailed history is so important.
How Do Doctors Treat It?
Although there's no cure for bipolar disorder, treatment can help stabilize moods
and help the person manage and control symptoms. Like other teens with long-lasting
medical conditions (such as asthma,
diabetes,
or epilepsy), teens with
bipolar disorder need to work closely with their doctors and other medical professionals
to treat it.
This team of medical professionals, together with the teen and family, develop
what is called a treatment plan. Teens with bipolar disorder will
probably receive medication, such as a mood stabilizer, from a psychiatrist or other
medical doctor. A psychologist or other type of counselor will provide counseling
or psychotherapy for the teen and his or her family. Doctors will watch the symptoms
closely and offer additional treatment advice if necessary.
Living With Bipolar Disorder
Teens normally face ups and downs with school, family, work, and friends. Dealing
with bipolar disorder at the same time is a very difficult challenge. One 16-year-old
reader who was diagnosed with bipolar disorder at 14 wrote to us about the experience:
"I had mood swings that were the worst anyone could have ever seen. My poor
parents thought I hated them, but really I was sick and didn't even realize it. But
now I am on medications for my disorder and I live a pretty normal life. My family
and friends support me, and they, along with my therapist, have helped me get to the
point where I am today. I just want other teens to know that even though it is hard
at times to be bipolar, things will get better."
If you've been diagnosed with bipolar disorder, taking your medications as prescribed,
reporting any changes in how you feel or function, and participating in therapy will
be key to living a successful life. In addition to treatment, making a few lifestyle
changes, such as reducing stress, eating well, and getting enough sleep and exercise
can help someone who is living with the condition. And many teens find it helps to
join a support network such as a local support group for people with bipolar disorder.
