Bipolar Disorder

Bipolar disorder (manic depressive disorder, manic depression, bipolar affective disorder, bipolar spectrum) is characterized by mood swings, or separate and lasting periods of mania and depression (mood states). Depression is experienced as a sad, hopeless, low energy state. Mania lies at the opposite side of the mood spectrum, where the person experiences a state of euphoria, elation, and often greatly increased energy. These mood states may fluctuate frequently, or may last for prolonged periods. There is much variability in the number of cycles throughout a person's lifetime, with some classified as "rapid cycling" (experiencing many episodes, sometimes yearly). Bipolar disorder affects about 1% of the population, distributed equally among men and women. While we all experience fluctuations in mood, those with bipolar disorder experience longer and much more pronounced mood swings which adversely influence their ability to function and cope with life's challenges.

Those in a state of mania typically experience dramatic rises in mood, feeling elation, increased energy, and a decreased need for sleep. Some in the midst of a mania will go several days without sleep, working through the night on projects or other endeavors. Their behavior is extremely active, with racing thoughts and rapid and pressured speech. They often exhibit poor judgment and planning. This, combined with impulsivity, often creates major problems for the person in the manic state. For example, they may leave school or ruin their business, go on expensive buying sprees, or make wild investments. They may engage in dangerous substance-related behaviors, or promiscuous sexuality. Most concerning is increased and dangerous suicidal activity. Finally, in many cases of mania, the person may become grandiose, with a heightened sense of self-esteem. For about 70% of those suffering from Bipolar Illness, as the mania and accompanying sleep deprivation become more prolonged, the person may lose touch with reality and exhibit psychotic symptoms, such as hallucinations (false sensory experiences) or delusions (false beliefs). At this point, most will need to go into a hospital to help keep them safe and receive stabilization through medication.

Following the mania, a depression (major depression) usually ensues. The length and depth of each episode greatly varies from person to person, with some being "rapid cyclers" experiencing several episodes in a given year. All episodes may be extremely debilitating both socially and vocationally. Persons may experience feelings of hopelessness, worthlessness, irritability, restlessness, and sadness. Fatigue and insomnia may follow these feelings, leading to increased irritability and a loss of enjoyment of daily activities. Eating problems, difficulty concentrating, and somatic symptoms such as pain, headaches, and gastrointestinal problems may also occur.

Research indicates that there is a large genetic component for bipolar illness. First manic episodes typically occur before age 30, but there are cases of later onset. Additionally, the bipolar spectrum runs in families. Children with a family member diagnosed with bipolar disorder are much more likely to develop this illness compared to children without an affected family member.

At Meridian Youth Treatment Center, we have extensive experience in working with those on the Bipolar Spectrum, and a very effective treatment protocol including individual psychotherapy, strong medication management, psycho-education for both the client and their families, and family therapy. We have found that with effective treatment those with bipolar disorder can learn to manage their illness and lead very productive lives.

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