By: Dr. David Prescott

Bipolar Disorder – As With Many Psychiatric Disorders, Undertreated: A recent story in Florida, concerning a man who entered a school board meeting with a gun, highlights the need to ensure that people with mental illness receive professional treatment. News reports suggest that this man had bipolar disorder, a mood disorder involving wide fluctuations in mood, energy, and activity. But, like many psychiatric disorders, only a fraction of people with bipolar disorder receive proper treatment. Consider these facts:

• Just under 3% of people in the United States experience bipolar disorder in any given year.
• Almost 90% of these people are estimated to experience severe symptoms or disruption in functioning.
• 51% of people with bipolar disorder receive no treatment
• Only 39% of people with bipolar disorder are believed to receive adequate treatment.

Famous People with Bipolar Disorder: Artist Vincent Van Gogh; performers Carrie Fisher, Dick Cavett, Margot Kidder, and Patty Duke; author Viginia Woolf. All of these well known personalities have, or are thought to have had, bipolar disorder. People with bipolar disorder may experience periods of time where they are creative, driven, and highly energetic. However, in spite of such periods of productivity, the disorder typically causes significant strain on relationships, families, and careers.

Characteristics of People with Bipolar Disorder: While all of us experience “ups and downs” in our mood, people with Bipolar Disorder have mood swings which are extreme. Along with Major Depression, Bipolar Disorder is a psychiatric diagnosis that carries a relatively high risk for suicide or attempted suicide.

The characteristic pattern involves periods of “up” mood (mania or hypomania) and periods of “down” mood (depression). Current classification of Bipolar Disorder involves Type I (full episodes of mania and depression), Type II (mild episodes of mania and full episodes of depression) and rapid cycling (mood fluctuations occur in time period of a day or even several hours, rather than weeks).

Signs and symptoms of Mania (lasts one week or more):
• Excessive energy, activity, or restlessness
• Excessive “high” or good mood
• Rapid and pressured speech
• Significant decreased sleep
• Irritability
• Poor judgment
• Denial that anything is wrong


Signs and symptoms of Depression
• Decreased energy or activity level
• Sad or depressed mood
• Preoccupation with death or suicide
• Lack of interest in activities
• Excessive sleep or difficulty falling asleep
• Change in appetite (usually diminished)


Can Children or Adolescents have Bipolar Disorder? Like many psychological disorders, bipolar disorder is more difficult to identify in children and adolescents. Some experts argue that the disorder does not truly exist in children, while others argue that it is under-identified and treated. Especially with bipolar disorder, a thorough assessment by a licensed mental health provider, like a psychologist or psychiatrist, is a good first step.


How is Bipolar Disorder Treated? Author Kay Redfield Jamison, a physician who writes about her own experience with bipolar disorder, talks about the importance of combining medicine with counseling to address bipolar disorder. Treatments for Bipolar Disorder Include:

* Medicines such as lithium have proven highly effective in controlling mood swings. Newer medicines, like Depakote or atypical antipsychotic medications may also help some people with bipolar disorder.
* Behavioral Treatment to Help Keep Daily Activity and Sleep Routines Consistent: While behavioral treatments do not make bipolar disorder go away, the impact of bipolar disorder can be greatly reduced by helping people maintain consistency in their daily routines (for example, meal times, physical activity) and sleep.
* Cognitive-Behavioral Therapy and Education: Recognizing early signs of an extreme mood swing is important in treating bipolar disorder. Counseling can help people with bipolar disorder identify early signs of mood swings, help people adjust to a less energized lifestyle, and help them avoid patterns of thinking which lead to more severe depression or mania.

For More Information:

National Institute of Mental Health: http://www.nimh.nih.gov/health/publications

American Psychological Association: http://www.apa.org/topics/bipolar

National Alliance of Mental Illness: http://www.nami.org

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