Bipolar Disorder

Bipolar disorder is a psychiatric illness that limits the functioning of many patients.  It is similar to major depression but different in some important ways.  Bipolar disorder mainly involves the chemistry of the brain and does not have as many psychological factors involved as does depression.  It tends to run in families with a heritable component.  To have a diagnosis of bipolar disorder, a patient must have experienced at least one episode of mania in his or her life.  Mania involves a week-long period of limited need to sleep, racing thoughts, and bizarre ideas.  A patient with mania will often feel special and believe to have special powers or abilities.  That patient will often spend money without discretion or get involved in bad situations with the police.  They can often experience hallucinations in the form of hearing voices or seeing things.

When a patient with bipolar disorder is not in a manic state, that patient may feel fine or have periods of depression.  The symptoms of depression are the same as that seen with major depressive disorder.

Treatment of bipolar disorder is often difficult.  It requires medications to help the patient avoid mania while alleviating symptoms of depression.  The most medications used are called mood stabilizers.  These meds are taken on a daily basis and help to prevent the intense mood volatility of bipolar disorder.  Examples of these meds include Lithium and Depakote.  Unlike the medications used for depression, the mood stabilizers often cause difficult side effects.  If a med is well-tolerated by a patient, it can often be very life saving for him or her.

Psychotherapy can also be helpful in treating bipolar disorder.  The therapy provided is often different from the therapy for depression.  The overall goal is to improve coping skills for the patient and to regulate effective daily routines.  The therapist helps the patient to learn certain triggers that may lead to mood instability.  Because disrupted sleep is an important sign of mania, the therapist will help the patient to manage sleep effectively.

Once again, bipolar disorder involves the chemistry of the brain and responds with medications.  Simply having mood swings and outbursts of intense anger in relationships does not constitute a diagnosis of bipolar disorder.  Instead, this often indicates psychological issues that respond best with therapy.