What is Bipolar Disorder?
Bipolar disorder is a serious illness. It is characterized by intense mood swings from a euphoric "high," or mania, to deep depression. These mood swings are more extreme than the regular happy and sad moods experienced by most people. The extreme moods of bipolar disorder typically cycle with periods of more moderate moods. In others, the disorder appears as long periods of unstable moods. Bipolar disorder typically occurs in late teens or early adulthood. The diagnosis is difficult and often takes several years because symptoms are missed or ignored.
The symptoms of bipolar disorder vary according to the cycle. During the manic phase, symptoms include excessive euphoria, irritability or agitation, fast talking, restlessness, insomnia and behavioral changes, such as sexual promiscuity, overspending or risk-taking. During a depressive episode, symptoms include long periods of worry, loss of interest in activities, inability to concentrate, irritability and suicidal thoughts. Abuse of alcohol or other substances is common among people with bipolar disorder.
Can Trauma Cause Bipolar Disorder?
The cause of bipolar disorder is unknown. Researchers believe several factors contribute to a chemical imbalance in the brain, resulting in the cyclic mood swings. Trauma may be a factor contributing to bipolar disorder. Researchers have found that people tend to have a history of physical or sexual abuse, and many also have post-traumatic stress disorder as well (PTSD). Head trauma or brain injury is not associated with bipolar disorder, although it may cause other types of mood or behavioral disturbances.
Treatment
Bipolar disorder has no cure. It is a lifelong condition, but it can be controlled with a combination of medication and psychotherapy. The treatment goal is to prevent relapses and minimize the extremes of the mood swings. Everyone reacts differently and several different medications may need to be tried before the most effective one is found.
Mood stabilizers are the first choice of treatment. These include lithium, valproic acid (Depakote) and lamotrigine (Lamictal). Atypical antipsychotics may also be used. Examples of drugs in this class include olanzapine (Zyprexia), quetiapine (Seroquel), risperidone (Risperdal), aripiprazole (Abilify) and ziprasidone (Geodon). Antidepressants may also be used, such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft). Associated side effects include drowsiness, dizziness and dry mouth. The atypical antipsychotics have been associated with weight gain and heart arrythmias.
The herb St. John's wort is called a natural antidepressant, but its effectiveness has not been proven. When used in bipolar disorder, it may exaggerate the manic episodes.
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