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Bipolar disorder (also called manic-depressive illness) is a mental illness involving episodes of serious mania and depression.

The person's mood usually swings from overly "high" and irritable to sad and hopeless and then back again, with periods of normal mood in between. Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life.

It is often not recognized as an illness, and people who have it may suffer needlessly for years or even decades. Effective treatments are available that greatly alleviate the suffering caused by bipolar disorder and can usually prevent its devastating complications, which include marital break-ups, job loss, alcohol and drug abuse, and suicide.

Here are some facts about bipolar disorder.

AWARENESS

Bipolar disorder has a devastating impact on many people.

Almost 2 million Americans suffer from bipolar disorder. Bipolar disorder is also hard on spouses, family members, friends, and employers. Family members of people with bipolar disorder often have to cope with serious behavioral problems (such as wild spending sprees) and the lasting consequences of these behaviors. Bipolar disorder tends to run in families and is believed to be inherited in many cases. Progress has been made in identifying a specific genetic defect associated with the disease.

RECOGNITION

Bipolar disorder involves cycles of mania and depression. Signs and symptoms of mania include:

Excessive "high" or euphoric feelings
A sustained period of behavior that is different from usual
Increased energy, activity, restlessness, racing thoughts, and rapid talking
Decreased need for sleep
Unrealistic beliefs in one's abilities and powers
Extreme irritability and distractibility
Uncharacteristically poor judgment
Increased sexual drive
Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
Obnoxious, provocative, or intrusive behavior
Denial that anything is wrong

Signs and symptoms of depression include:

Persistent sad, anxious, or empty mood
Feelings of hopelessness or pessimism
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in ordinary activities, including sex
Decreased energy, a feeling of fatigue or of being "slowed down"
Difficulty concentrating, remembering, making decisions
Restlessness or irritability
Sleep disturbances
Loss of appetite and weight, or weight gain
Chronic pain or other persistent bodily symptoms that are not caused by physical disease
Thoughts of death or suicide and sometimes suicide attempts

Some people with untreated bipolar disorder have repeated depressions and only an occasional episode of mania. In others, mania or hypomania (a mild form of mania) may be the main symptom, and depression may occur only infrequently. Symptoms of mania and depression may be mixed together in a single episode of bipolar disorder. Recognition of the disorder is essential so that the person who has it can obtain effective treatment and avoid the harmful consequences of the disease, which include destruction of personal relationships, loss of employment, and suicide.

An early sign of bipolar disorder may be hypomania and a state in which the person shows a high level of energy, excessive moodiness, irritability, and impulsive or reckless behavior. Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.

Also in its early stages, bipolar disorder may masquerade as some problem other than mental illness. For example, it may appear as alcohol or drug abuse or poor school or work performance. If left untreated, bipolar disorder tends to worsen, and the person experiences episodes of full-fledged mania and clinical depression.

Most people with bipolar disorder can be helped with treatment. Almost all people with bipolar disorder--even those with the most severe forms--can obtain substantial relief from their symptoms. One medication, lithium, is usually very effective in controlling mania and preventing recurrence of both manic and depressive episodes. Other medications are also available and may be of significant value.

For the treatment of depression, several effective medications are available. Psychotherapy may be very helpful in providing support, education, and guidance to the patient and his or her family.

Anyone with bipolar disorder should be under the care of a knowledgeable physician, typically a psychiatrist. The physician should be skilled in the diagnosis and treatement of this disease.