Answering the Most Important Questions About Bipolar Disorder

Bipolar disorder, also known as manic depressive illness or manic depression, is a brain disorder that affects almost six million adults in the United States. People who have the disorder experience mood swings ranging from high (manic) to low (depressive) and experience changes in thinking, energy, sleep and behavioral patterns. Between the highs and lows, they may feel normal. Some experience a less intense period of mania known as hypomania. According to the National Institute of Mental Health, the median age for diagnosis is 25 years, but symptoms may be seen anywhere from childhood to the age of 60. Men and women are equally affected and the disorder is found in all social classes, ethnic groups, races and ages. There is also a genetic component and three out of four people with the illness have a close family member with bipolar or unipolar disorder. There are four kinds of bipolar disorder: bipolar I, bipolar II, cyclothymia, and bipolar not otherwise specified.

1. How do bipolar I and bipolar II differ?

A: Bipolar I is identified by one or more episode that is manic or mixed and one or more that is depressive. It is the most severe form of the disorder and is characterized by extreme periods of mania. Bipolar II involves one or more episode of depression accompanied by at least one episode of hypomania. Hypomania can be mild enough that it does not cause obvious problems in work or social life, or it can be serious enough to affect daily activities.

2. What is cyclothymic disorder?

A: Cyclothymia is a rare disorder identified by chronic mood changes with periods of hypomania and depression, but the depression is not as severe as major depression. People with cyclothymia may function normally or be extremely productive if they have frequent cycles of hypomania. To be diagnosed, the symptoms must be present for at least two years. Cyclothymia increases the risk of a more serious bipolar disorder and may accompany a diagnosis of attention deficit disorder, sleep disorder, or substance abuse.

3. What is bipolar disorder not otherwise specified?

A: This kind of bipolar disorder is diagnosed when the symptoms of the illness do not fall into one of the first three subtypes or when periods of mania and depression cycle rapidly, usually within days. It may also be diagnosed when it is hard to distinguish between a primary diagnosis or bipolar due to medical causes, such as substance abuse. Treatment is based on individual cases, but mood stabilizers and other medication may be used. Psychotherapy may be helpful, especially if started early.

4. Can the symptoms of bipolar disorder also be caused by other illnesses?

A: Mental illnesses, other than bipolar, can cause symptoms similar to one of the four subtypes. Physical illnesses can also mimic the symptoms of bipolar and other mood disorders. Among these are neurological diseases like multiple sclerosis or brain tumors, thyroid conditions, deficiencies of certain vitamins, medications used to prevent diseases like AIDS and tuberculosis, and brain infections caused by conditions like syphilis and Lyme disease. Bipolar behavior can also be triggered by hormonal and environmental factors, including trauma, significant loss, abuse or extreme stress.

5. Can lifestyle changes reduce symptoms?

A: Successful management of symptoms begins with learning about the illness and finding support. Organizations, such as the Depression and Bipolar Support Alliance, can provide information, as well as a listing of support groups around the country. Healthy habits like maintaining a daily routine and observing good sleep hygiene make it easier to manage symptoms and reduce stress that might trigger episodes. As with all illnesses, diet, exercise, social support, volunteering and hobbies contribute to a healthier lifestyle.