What does it mean to be bipolar?

In bipolar disorder (or manic depressive disorder), as in major depressive disorder, there is a basic disturbance in the background emotional tone we call mood. Unlike people with major depression (or unipolar disorder), bipolar patients have a variable pattern of depressed and manic episodes.

Mania is the opposite of depression: exuberance, exalted mood, rapidity of speech (flight of ideas), expansiveness, grandiosity, hyperactivity, impulsivity, and poor judgment (which can lead to spending sprees). Delusions and hallucinations can occur. Untreated mania can wreak havoc with a person's life because of the great energy devoted to creating all sorts of complications. Bipolar disorder has strong familial tendencies and begins anywhere from childhood (rarely) to age 50 with an average age of onset around 30.

In 1949, Dr. John Cade, an Australian psychiatrist, found lithium to be an effective treatment of mania. In the years that followed, lithium has become the mainstay of treatment for bipolar disorder. A steady regimen of lithium is taken to prevent manic and depressed episodes. Blood levels need to be checked periodically to avoid toxic levels. Sometimes other drugs such as the antiseizure drugs valproic acid and carbamazapine are used. With modern pharmacologic treatment, many bipolar sufferers can live quite normal and productive lives, completely or relatively free of disruptive, whipsawing mood swings.

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