Bipolar disorder is not a single disorder, but a category of mood disorders defined by the presence of one or more episodes of abnormally elevated mood, clinically referred to as mania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes which present with features of both mania and depression. These episodes are normally separated by periods of normal mood, but in some patients, depression and mania may rapidly alternate, known as rapid cycling. The disorder has been subdivided into bipolar I, bipolar II and cyclothymia based on the the type and severity of mood episodes experienced.
Doctors and researchers don’t know exactly what causes bipolar disorder. But a variety of biologic, genetic and environmental factors seem to be involved in causing and triggering episodes of this illness.
Evidence indicates that differences in the chemical messengers between nerve cells in the brain (neurotransmitters) occur in people who have bipolar disorder. In many cases, people with a bipolar disorder may have a genetic disposition for the disorder.
In adults, mania is usually episodic with an elevation of mood and increased energy and activity. In children, mania is commonly chronic rather than episodic, and usually presents in mixed states with irritability, anxiety and depression. In adults and children, during depression there is lowering of mood and decreased energy and activity. During a mixed episode both mania and depression can occur on the same day.
How is bipolar disorder treated?
Bipolar disorder can be treated by your family doctor. Your family doctor may want you to see a psychiatrist too. You and your doctors will work together to control your mood swings and make sure you stay well.
Bipolar disorder is treated with medicines to stop the mood swings. Mood stabilizers are used to even out highs and lows in your mood. Antidepressant medicine can help reduce the symptoms of depression. Your doctor may add other medicines as you need them. These medicines don’t start to work right away, but you will start to notice a difference in your moods after a few weeks. Be sure to take your medicines just as your doctor tells you.
Typically, bipolar disorder is treated with more than one medication. This is due to the dual nature of bipolar disorder. Most patients need at least two medications: one to control depression and one to control mania. The combination of these two types of medication works to obtain balance in moods and stop mood cycling. Often, a third medication, called a mood stabilizer, is also prescribed. The most common mood stabilizer is Topomax.
Popular medications for treatment of mania in bipolar patients include lithium, valproate (Depakote), carbamazepine (Tegretol), olanzapine (Zyprexa), and ziprasidone (Geodon). Lithium has long been considered the miracle drug of bipolar disorder. It is a sodium based medication that helps to balance the chemical imbalance in the brain that causes manic episodes in bipolar patients.
Valproate, or Depakote, was originally developed as a seizure medication. However, its effects on bipolar patients who have rapid cycling bipolar (moods that cycle every few hours or days rather than weeks or months), it has been quite effective. Carbamazepine, or Tegretol, is another anti-seizure medication. While it appears to have similar effects on bipolar disorder as Depakote, it has not yet been approved by the Food and Drug Administration for use as a bipolar disorder treatment.
Olanzapine, or Zyprexa, and Ziprasidone, or Geodon, are both anti-psychotic drugs, and are particularly effective for treatment of bipolar disorder in which mania becomes so severe that psychotic symptoms are present.