Bipolar Depression (cont.)

Who Gets Bipolar Disorder?

According to the National Institute of Mental Health, over 2 million American adults have bipolar disorder. Bipolar disorder usually begins in early adulthood, appearing before age 35. Children and adolescents, however, can develop this disease in more severe forms and often in combination with attention deficit hyperactivity disorder (ADHD).

Studies indicate that bipolar disorder is sometimes influenced by genetics and may occur more commonly within families.

While bipolar disorder occurs equally in women and men, women with bipolar disorder may have multiple distinct episodes occurring several times per year -- this is called "rapid cycling." Varying levels of sex hormones and activity of the thyroid gland in the neck, together with the tendency to be prescribed antidepressants, may contribute to the more rapid cycling seen in women. Women may also experience more periods of depression than men.

It has been estimated that up to 60% of all people with bipolar disorder have drug or alcohol dependence. It has also been shown to occur frequently in people with seasonal depression and certain anxiety disorders, like post-traumatic stress disorder (PTSD).

What Causes Bipolar Disorder?

A definite cause for bipolar disorder or any type of depression is difficult to determine but can include genetics, changes in the brain, and environmental factors like stress and major life changes. More research is being done to determine the relationship that these factors have in bipolar disorder, how they may help prevent its onset, and what role they may play in its treatment.

How Is Bipolar Disorder Diagnosed?

A diagnosis of bipolar disorder is made only by taking careful note of symptoms and their severity, length, and frequency. The most telling symptoms include the constellation of symptoms that involve highs or lows in mood accompanied by changes in sleep, energy, thinking, and behavior. Sudden or dramatic "mood swings" per se are not part of the definition of bipolar disorder. Talking to close friends and family of the person is often very helpful to distinguish bipolar disorder from major depression or other psychiatric disorders that can involve changes in mood, thinking, and behavior.

If you or someone you know is experiencing symptoms of bipolar disorder, seek the advice of your family health care provider or a psychiatrist. A referral may then be made to an appropriate mental health expert.

A thorough medical evaluation should be performed. Your doctor will ask questions about your personal and family history of mental illness. You may also be asked to complete a depression screening questionnaire -- a series of structured questions that you will be asked to answer verbally or in writing.

What Are the Treatments for Bipolar Disorder?

Bipolar disorder is a long-term illness that requires management throughout a person's life. People who have numerous (four or more) episodes of mood changes (rapid cycling) in a year can be much more difficult to treat. Medication is the primary treatment for bipolar disorder, but the additional use of psychotherapy or "talk" therapy is sometimes recommended to help prevent future episodes.

There are many medications available to treat bipolar disorder, including lithium and Depakote.


Lithium (brand names Eskalith, Lithobid, Lithonate), a mood-stabilizing drug, is the most commonly prescribed drug for people with bipolar disorder. It is helpful in controlling mood swings in both directions but is especially helpful in treating or preventing mania. Lithium will often reduce symptoms of mania within two weeks of starting therapy, but it may take weeks to months before the condition is completely controlled. Thus other drugs like antipsychotic drugs or antidepressant drugs may also be used to help control symptoms.

Common side effects of lithium include:

Thyroid and kidney problems are a concern in people taking lithium, so your doctor will monitor the thyroid and kidney function as well as monitor the levels of lithium in your blood since levels can easily become too high. Anything that lowers the level of sodium in the body, such as switching to a low-sodium diet, heavy sweating, fever, vomiting or diarrhea may cause a buildup of lithium in the body and toxicity. Be aware of these conditions and alert your doctor if you are on lithium and experience them.

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