By DR. SELENA SEABROOKS
The Dallas Examiner
Approximately 5.7 million adult Americans, about 2.6% of the U.S. population, are affected by bipolar disorder yearly. An equal number of men and women develop bipolar illness, and it is found in all ages, races, ethnic groups and social classes. According to the World Health Organization, bipolar disorder is the sixth leading cause of disability in the world.
“Data suggest about one percent of people across the world suffer from bipolar disorder that’s diagnosable,” Kathleen Merikangas, Ph.D., chief of the Genetic Epidemiology Research Branch stated, “But another four to five percent may suffer from the symptoms and the syndrome that’s a broader spectrum.”
In recognition of World Bipolar Day, the National Institute of Mental Health recently hosted a Facebook Live event – Bipolar Disorder in Adults. NIMH experts Merikangas and Francis McMahon, M.D., chief of the Human Genetics Branch, led a discussion on signs and symptoms, risk factors, treatments and the latest NIMH-supported research in this area.
Bipolar disorder is a mental illness that causes unusual shifts in a person’s mood, energy, activity levels, and concentration. These shifts can make it challenging to carry out day-to-day tasks, according to the NIMH.
“People with bipolar disorder have manic episodes. These are distinct periods of elevated mood swings during which you may feel very happy, very irritable, very high or some combination of these moods,” McMahon explained. “Manic episodes are not always pleasant experiences for the patient.”
During a manic episode, the person is active, has lots of energy, needs less sleep, talks a lot and has racing thoughts. Being in a manic state affects judgment which can result in the person making bad decisions. In a severe mania state, the person may experience hallucinations, hear voices, see things others cannot or have delusions.
“Most people with bipolar disorder also have episodes of depression. More times often spent feeling depressed than feeling manic for people with this illness,” McMahon said.
During depression, people feel sad, indifferent, hopeless or anxious. Along with mood changes, depressed people may sleep too much, feel a lack of energy, and have trouble thinking clearly or making decisions.
“Suicidal thoughts or behavior can also occur during depression, which makes depression a dangerous, potentially life-threatening condition,” McMahon cautioned.
McMahon indicated that there are four types of bipolar disorder.
- Bipolar I disorder – Defined by manic episodes that last for at least seven days or by manic symptoms that are so severe that the person needs immediate medical care. Depressive episodes occur as well, typically lasting at least two weeks.
- Bipolar II disorder – Defined by a pattern of depressive episodes and hypomanic episodes. These episodes are less severe than the manic episodes in bipolar I disorder.
- Schizoaffective disorder – Defined by the symptoms of psychosis seen with schizophrenia, such as hallucinations or delusions, as well as the symptoms of bipolar disorder, which include cycles of mania and depression.
- Cyclothymic disorder – Defined by recurring hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.
Symptoms of bipolar disorder
Bipolar disorder symptoms usually start in late adolescence, late teens or early adulthood but can also occur later in life. Children may occasionally experience bipolar disorder symptoms; however, this is uncommon.
“Twenty to 30 years ago, it was believed that it didn’t really begin until the ages of 40 and later, and now, the more we move into general population samples, we see the symptoms begin in adolescence and early adulthood,” Merikangas said.
Symptoms of a manic episode include:
- Feeling very up, high, elated or extremely irritable or touchy
- Feeling jumpy or wired, more active than usual
- Having a decreased need for sleep
- Talking fast about a lot of different things
- Racing thoughts
- Feeling able to do many things at once without getting tired
- Having an excessive appetite for food, drinking, sex or other pleasurable activities
- Feeling unusually important, talented or powerful
Symptoms of a depressive episode include:
- Feeling very down, sad or anxious
- Feeling slowed down or restless
- Having trouble falling asleep, waking up too early or sleeping too much
- Talking very slowly, feeling unable to find anything to say or forgetting a lot
- Having trouble concentrating or making decisions
- Feeling unable to do even simple things
- Having a lack of interest in almost all activities
- Feeling hopeless or worthless or thinking about death or suicide
McMahon stated that the exact causes of bipolar disorder are unknown; however, research suggests that a combination of genes, environmental factors, and life experiences is involved.
McMahon touched on ongoing research by the NIMH, which will look at genes that may affect a person’s chance of developing bipolar disorder. The research will focus on rare genes that may have more significant effects on specific individuals or families.
Treatment for bipolar disorder
The proper diagnosis and treatment can help people lead healthy and active lives. Talking with a health care professional is the first step.
“People come to treatment either after a serious suicide attempt, severe depression or something that may lead people to the point that they really need help,” Merikangas commented.
An effective treatment plan usually includes a combination of medication and psychotherapy, also called talk therapy. Other treatment options may include electroconvulsive therapy, repetitive transcranial magnetic stimulation, and light therapy.
Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Long-term, continuous treatment can help people manage these symptoms.
If you or someone you know has a mental illness, is struggling emotionally or has concerns about their mental health, visit https://www.nimh.nih.gov/findhelp to find help. For those that need urgent attention for distress prevention, call to text 988 or chat at https://988lifeline.org.