Bipolar Affective Disorder, Bipolar Disorder, "BPAD", or "BP" is a mood disorder typically characterized by fluctuations between manic and depressive states; and, more generally, atypical mood regulation and mood instability.

According to the DSM IV (Diagnostic and Statistical Manual of Mental Disorders), specific categories of the disorder include Bipolar type I, Bipolar type II, cyclothymic disorder, and Bipolar NOS (not otherwise specified). Each varies with intensity and length of the varying manic or hypomanic and depressive episodes. These episodes typically result in unusually extreme highs and lows of an individual's mood, over time.

Bipolar disorder is now generally considered to be a biochemical disorder of the brain and its associated hormonal systems. Without proper treatment bipolar disorder can destroy families, friendships, careers, and even lives. Bipolar disorder can be so profoundly distressing for those that suffer from it that tragically roughly 15% of people with bipolar disorder commit suicide.[1]

It is found in disproportionate numbers in people with creative talent such as artists, musicians, authors, poets, and scientists, and it has been speculated that the mechanisms which cause the disorder may be related to those responsible for creativity in these persons.

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It should be noted that this disorder does not consist of mere "ups and downs". These are experienced by virtually everyone and do not constitute a disorder. The mood swings of bipolar disorder are far more extreme than those experienced by most people. (See cyclothymia for a milder version of this disorder.) Furthermore, mood is experienced very differently in a person with bipolar; in fact it may be best described as a mood regulation disorder. Bipolar persons may feel a little down or up about an event in their lives, just as a normal person would, but a bipolar persons’ mood might not return to normal as a normal patient’s ultimately would. Their mood may intensify until it becomes a full-blown mania or a clinical depression at that point their mood could be "stuck" until it cycles again. In addition, some people with this disorder experience extreme mood instability, where emotions can shift rapidly and unexpectedly from manic to depressed (or vice versa) with little warning or external cause, and some experience symptoms of both depression and mania simultaniously (so called "mixed states").

Mania is often characterized by euphoria, hypersexuality, hyperactivity, insomnia, intense productivity, hyper-imagination, a "flight of ideas," over-talkativeness, and sometimes agitation and even psychosis. Some persons with bipolar disorder may want to feel manic or hypomanic, cherishing the feelings of elation and energization associated with those phases (some use this as a reason to refuse medication). However, people in manic phases often exhibit impulsive, destructive, and irrational behavior which they later regret; and some manic patients report feeling extremely distressed and agitated and sometimes become paranoid or even hear voices.

Depression or clinical depression is often characterized by profound sadness and/or anxiety, slowness to conceive ideas and move, sleep disruptions, even suicidal thoughts or actions.

It should be noted that the mood swings of Borderline Personality Disorder (rapid mood shifts, multiple times a day for months and years; shifting between happiness and anger/depression depending of whether they get their way in situations; manipulative threats of, and dramatic displays of suicidal gestures; and acts of self injury) are NOT typical characteristics of Bipolar Disorder, although some have conjectured that the two conditions are related.

Bipolar disorder was originally believed to be a different form of but the same disorder as unipolar depression, but they are now widely regarded as two different disorders, both symptomatically and biochemically. (In fact, some scientists believe bipolar disorder is actually more closely related to schizophrenia than clinical depression.) In addition, while unipolar depression often occurs as a single episode (i.e. a person is only clinically depressed for one period in their life), bipolar disorder is typically a life-long condition, requiring long-term maintenance treatment.

Note on usage: "Manic-depression" was the original term used for the disorder. While its is still commonly used to refer to bipolar disorder, is now sometimes used by doctors to refer to the entire clinical spectrum of mood disorders that includes both bipolar disorder and unipolar depression. Others are trying to phase out the term entirely.

General description
Bipolar disorder is a condition that causes extreme shifts in mood, energy, and functioning. In most populations it affects around 1 percent of the population. Men and women are equally likely to develop this often-disabling illness. The disorder typically emerges in adolescence or early adulthood and affects sufferers throughout their lifespan. Although traditionally thought of as an adult disorder, there is now recognition that children also suffer from bipolar disorder. There are no definite known causes. Scientists believe that Bipolar Disorder may be caused by a combination of biological and psychological factors. Most commonly this disorder can be linked to stressful life events. 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. The Kindling theory suggests that persons who are genetically prone (toward bipolar) experience a series of stressful events, each of which lowers the threshold at which mood changes occur. Then at some point these mood changes occur spontaneously. The person then "becomes bipolar". This might explain why the cause of bipolar is difficult to pinpoint but is somehow related to genetics and environment.

There is a tendency to romanticize bipolar disorder, especially in artistic circles. Many artists, musicians, and writers have experienced its mood swings, and some credit the condition with their creativity. However, many lives are ruined by this disease, and it is associated with a greatly increased risk of suicide.

Bipolar disorder manifests itself in numerous ways, most notably:

Depression: 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; recurrent thoughts of death or suicide.
Mania: Abnormally and persistently elevated (high) mood and/or irritability accompanied by at least three of the following symptoms (four if the mood is merely irritable): overly-inflated self-esteem; decreased need for sleep; increased talkativeness; racing thoughts; distractibility; increased goal-directed activity such as shopping; physical agitation; hypersexuality; excessive involvement in risky behaviors or activities. There is a less severe form of mania that may also be present -- hypomania
Mixed state: Symptoms of mania and depression are present at the same time. The symptom picture frequently includes agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking. Depressed mood accompanies manic activation. Also known as dysphoric mania (from Greek 'dysphoria', 'dys', difficulty, 'phorós', bearer, and 'mania', mania, insanity). This is the form most often seen in children.
Especially early in the course of illness, the episodes may be separated by periods of wellness during which a person suffers few to no symptoms. When four or more episodes of illness occur within a 12-month period, the person is said to have bipolar disorder with rapid cycling. The rapid-cycling form is often considered more difficult to treat and may be more disabling for bipolar persons since the mood transitions are faster. Bipolar disorder is often complicated by co-occurring alcohol or substance abuse.

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). Psychotic symptoms associated with bipolar disorder typically reflect the extreme mood state at the time. Mania is associated with unwarranted optimism, and depression with unwarranted pessimism.

The source of this article is Wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL
 

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