Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.
Scientists have not yet discovered a single cause of bipolar disorder. Currently, they believe several factors may contribute, including:
- Genetics. The chances of developing bipolar disorder are increased if a child’s parents or siblings have the disorder. But the role of genetics is not so absolute. Studies of identical twins have found that, even if one twin develops the disorder, the other may not.
- Stress. A stressful event such as a death in the family, an illness, a difficult relationship, divorce or financial problems can trigger a manic or depressive episode. Thus, a person’s handling of stress may also play a role in the development of the illness.
- Brain structure and function. Brain scans cannot diagnose bipolar disorder, yet researchers have identified subtle differences in the average size or activation of some brain structures in people with bipolar disorder.
Manic and Depressive Episodes
People with bipolar disorder have periods or episodes of:
- depression – feeling very low and lethargic
- mania – feeling very high and overactive (less severe mania is known as hypomania)
Types of Bipolar Disorder
- Bipolar I Disorder is an illness in which people have experienced one or more episodes of mania. Most people diagnosed with bipolar I will have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. To be diagnosed with bipolar I, a person’s manic episodes must last at least seven days or be so severe that hospitalization is required.
- Bipolar II Disorder is a subset of bipolar disorder in which people experience depressive episodes shifting back and forth with hypomanic episodes, but never a “full” manic episode.
- Cyclothymic Disorder or Cyclothymia is a chronically unstable mood state in which people experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood, but these periods last less than eight weeks.
- Bipolar Disorder, “other specified” and “unspecified” is when a person does not meet the criteria for bipolar I, II or cyclothymia but has still experienced periods of clinically significant abnormal mood elevation.
Treatments and Therapies
Right now, there is no cure for bipolar disorder, but treatment can help control symptoms. Most people can get help for mood changes and behavior problems. Steady, dependable treatment works better than treatment that starts and stops. Treatment options include:
Different kinds of psychotherapy, or “talk” therapy, can help people with bipolar disorder. Therapy can help them change their behavior and manage their lives. It can also help patients get along better with family and friends. Sometimes therapy includes family members.
- Cognitive Behavioral Therapy (CBT), as individual or family-focused therapy, can help prevent relapses.
- Interpersonal and Social Rhythm Therapy, combined with CBT, can also help with depressive symptoms.
2. Other treatments.
Some people do not get better with medication and therapy. These people may try ElectroConvulsive Therapy (ECT).This is sometimes called “shock” therapy. ECT provides a quick electric current that can sometimes correct problems in the brain.
ElectroConvulsive Therapy (ECT)
Electroconvulsive therapy, also known as ECT or electroshock therapy, is a short-term treatment for severe manic or depressive episodes, particularly when symptoms involve serious suicidal or psychotic symptoms, or when medicines seem to be ineffective. It can be effective in nearly 75% of patients.
In electroconvulsive therapy, an electric current is passed through the scalp to cause a brief seizure in the brain. ECT is one of the fastest ways to relieve symptoms in people who suffer from mania or severe depression. ECT is generally used only when medicines or other less invasive treatments prove to be unhelpful. It is also used when mood or psychotic symptoms are so severe that it may be unsafe to wait until drugs can take effect. ECT is also often thought to be the treatment of choice for severe mood episodes during pregnancy.
Prior to ECT treatment, a person is given a muscle relaxant and put under general anesthesia. Electrodes are placed on the patient’s scalp, and an electric current is applied that causes a brief seizure. Because the muscles are relaxed, the seizure will usually be limited to slight movement of the hands and feet. The patient is carefully monitored during the treatment. The patient awakens minutes later, does not remember the treatment or events surrounding the treatment, and may be briefly confused.
ECT is usually given up to three times a week, typically for two to four weeks.