Issue Date: February 10, 2008
Living with bipolar disorder
It can be difficult to diagnose, but there are many treatment options.
Symptoms often vary from the "classic profile" of the disorder.
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When I was in medical school in the 1980s, the number of medicines available to treat bipolar disorder was small. Since then, our ability to treat it has improved. Formerly called manic depression, bipolar disorder is a serious illness that can be disruptive to a person's relationships, to his or her ability to hold down a job and even to the ability to care for oneself.
A big hurdle to the treatment of bipolar disorder is identifying those people who have it. Although textbooks describe the illness as characterized by extreme mood swings, this is not what a lot of sufferers experience. In reality, folks with bipolar disorder differ widely in the nature and pattern of their symptoms, so the "classic" profile of the disorder should be more of a framework to guide diagnosis rather than a checklist.
Bipolar disorder can be difficult to diagnose in part because people who have it aren't always fully incapable of productivity. When someone who has generally shown "normal" behavior starts acting irrationally, family members and friends often conclude that the person is behaving irresponsibly. But he or she may, in fact, need medical help.
It's important to consider symptoms at both ends of the bipolar spectrum. On the "high" side, although we all experience periods of happiness sometimes, a person with bipolar disorder has phases, lasting a week or longer, of behavior marked by a combination of symptoms that may include unusually strong happiness, seemingly boundless energy, increased sex drive, easy distractibility and rapid speech. During such episodes, that person shows a shift in demeanor from euphoria to irritability and has grandiose ideas that can lead to making poor decisions, like engaging in excessive spending sprees.
At the other end of the spectrum are the "lows." The depressive phase is displayed in acute and inappropriate feelings of loneliness, sadness and hopelessness.
A manic phase is not necessarily followed by a depressive phase, making diagnosis even more difficult. Yet both the manic and depressive phases can be dangerous. People who are affected may develop a psychosis that makes it impossible for them to deal with reality. For this reason, the possibility of suicide is a real concern.
Medications are available to treat bipolar disorder, so talk with your doctor if you or a loved one experiences symptoms that may be caused by this condition.
Contributing Editor Tedd Mitchell, M.D., president of Dallas' Cooper Clinic, writes HealthSmart every week.
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