Bipolar Disorder

Manic-Depressive Disorder - or bipolar disorder, severe mental disorder involving manic episodes that are usually accompanied by episodes of depression. The term was introduced by the German psychiatrist Emil Kraepelin in 1896. The manic phase of the disorder is characterized by an abnormally elevated or irritable mood, grandiosity, sleeplessness, extravagance, and a tendency toward irrational judgment. During the depressed phase, the person tends to appear lethargic and withdrawn, shows a lack of concentration, and expresses feelings of worthlessness, self-blame, and guilt. The dual character of manic-depressive disorder has given it the name bipolar disorder, in contrast to the unipolar depression symptomatic of the majority of mood disorders. The symptoms range in intensity and pattern and may not be recognized at first. Individuals suffering from bipolar disorder may have long periods in their lives without episodes of mania or depression, but manic-depressives have the highest suicide rate of any group with a psychological disorder.

Incidence

Estimates suggest that about 2 million Americans suffer from bipolar disorders. Symptoms usually appear in adolescence or early adulthood and continue throughout life. The disorder occurs in males and females equally and is found more frequently in close relatives of people already known to have it.. It has had notable incidence among creative individuals, affecting such artists as Hector Berlioz, Gustav Mahler, Ernest Hemingway, and Virginia Woolf.

Treatment

Therapy includes lithium (to control mania and stabilize mood swings), anticonvulsant drugs such as valproate and carbamazepine, and antidepressants. Electroconvulsive therapy has been useful in cases where other treatments have had little success. Psychotherapy can provide support to the patient and the family.

Bibliography

See F. K. Goodwin and K. R. Jamison, Manic-Depressive Illness (1990); publications of the National Institute of Mental Health.

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