Bipolar Depression

What is bipolar disorder?

Bipolar disorder, also known as manic-depressive illness or bipolarism, is a psychiatric diagnosis that describes a category of mood or brain disorders that cause unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.  The disorder has been subdivided into bipolar I, bipolar II, cyclothymia, and other types, based on the nature and severity of mood episodes experienced.  It is defined by the presence of one or more episodes of abnormally elevate mood clinically referred to as mania or, if milder, hypomania.  Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes in which features of both mania and depression are present at the same time.  These episodes are usually separated by periods of “normal” mood, but in some individuals, depression and mania may rapidly alternate, known as rapid cycling.  Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. Bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Studies have shown that genetic factors contribute substantially to the likelihood of developing bipolar disorder, but environmental factors have also been implicated.  Bipolar disorder is commonly treated with mood stabilizer medications, and occasionally with other psychiatric drugs.  Psychotherapy may also play a significant role leading to the recovery of stability.  In serious cases in which there is a risk of harm to oneself or others involuntary commitment may be used; these cases generally involve severe manic episodes with dangerous behavior or depressive episodes with suicidal ideation. There are widespread problems with social stigma, stereotypes and prejudice against individuals with a diagnosis of bipolar disorder. People with bipolar disorder exhibiting psychotic symptoms can sometimes be misdiagnosed as having schizophrenia, which is a different yet serious mental illness.

Bipolar disorder commonly develops in a person's late teens or early adult years. At least half of all cases start before age 25. Some people have their first symptoms during childhood, while others may develop symptoms late in life. Data on lifetime prevalence within the United States varies, but indicates a rate of around 1% for Bipolar I, 0.5–1% for Bipolar II or cyclothymia, and 2–5% for subthreshold cases meeting some, but not all, criteria.  Diagnosis may be based on the person's self-reported experiences, as well as observed behavior.  Episodes of abnormality are associated with distress and disruption, and an elevated risk of suicide, especially during depressive episodes. In some cases it can be a devastating long-lasting disorder; in others it has also been associated with creativity, goal striving and positive achievements.

The current term "bipolar disorder" is of fairly recent origin and refers to the cycling between high and low episodes (poles). A relationship between mania and melancholia had long been observed, although the basis of the current conceptualization can be traced back to French psychiatrists in the 1850s. The term "manic-depressive illness" or psychosis was coined by German psychiatrist Emil Kraepelin in the late nineteenth century, originally referring to all kinds of mood disorder. German psychiatrist Karl Leonhard split the classification again in 1957, employing the terms unipolar disorder (major depressive disorder) and bipolar disorder.