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Bi-Polar Disorder

What is bipolar disorder?

Bipolar disorder is characterized by opposing moods which accompany the illness. People with bipolar disorder experience great highs (manic stage) and great lows (depressive stage). Bipolar illness often begins with a depression in adolescence or early adulthood, although the first manic episode may not occur until several years later.

  • Bipolar disorder affects 1% of the population.
  • The first major depression usually occurs during a person’s 20s.
  • Depression is 4 to 5 times higher in people between ages 18-44.
  • If untreated, 20% of depressive episodes can last for up to two years.

What causes bipolar disorder?

There is no single cause of bipolar disorder. Researchers believe however that biological factors such as genetics and the brain’s chemistry seem to play a major role in producing the illness. One’s personality, along with stresses in the environment, may also play a part in bringing on an acute episode of mania or depression. Stress management along with medication has been very helpful in controlling manic and depressive episodes.

What are the symptoms?

An individual who has bipolar disorder experiences both mania and depression. Attacks of mania come on very quickly, sometimes within a single day, or can build slowly. Manic episodes can last for hours, weeks or months.
Symptoms of the manic phase (some or all may be present):

  • a sudden onset of exhilaration and giddiness that increases in intensity – the individual’s mood seems excessively good
  • expressions of unwarranted optimism and lack of judgment – self-confidence can reach the point of grandiose delusions, including beliefs such as having a special connection with God
  • the individual may think that nothing, not even the laws of gravity, can prevent the accomplishment of a goal – as a result, the person may think it possible to step off a building or out of a moving car without being hurt (hallucinations may occur)
  • excessive plans or participation in numerous activities – the individual fails to recognize that there is not enough time in the day to complete all his or her tasks
  • mania can result in reckless driving, spending sprees, increased intake of alcohol or other drugs, foolish business investments or sexual behavior unusual for the person
  • flight of ideas – thoughts race uncontrollably and words spill out in a non-stop rush
    ideas change abruptly from topic to topic – in a severe manic episode, loud rapid speech becomes difficult to interpret because thoughts are so disorganized and incoherent
  • decreased need for sleep – the individual can go for days with little or no sleep without feeling tired
    distractibility – attention is easily diverted to inconsequential or unimportant details
  • sudden irritability, rage, paranoia – when the individual’s grandiose plans are thwarted or excessive social overtures are refused, an emotional outburst may ensue.

Without treatment the manic phase can last for about 4 months. The individual may then have a period of normal mood and behaviour, but the depressive stage soon sets in. In some people, the depressive mood occurs immediately or within a few months. For others a long interval of a few years may precede the next manic or depressive interval. Depressions come and go more slowly.
Symptoms of the depressive phase (some or all may be present):

  • feelings of worthlessness, hopelessness, helplessness, total indifference, and/or guilt
  • prolonged sadness or unexplained crying spells
  • jumpiness, irritability
  • withdrawal from formerly enjoyable activities, social contacts, work, sex
  • inability to concentrate or remember things
  • thoughts of death or suicide
  • loss of appetite or noticeable increase in appetite
  • persistent fatigue or lethargy
  • insomnia or noticeable increase in the amount of sleep needed

What are the treatments?

Bipolar disorder responds well to treatment once the illness has been diagnosed. The diagnosis should be made by a physician who is familiar with bipolar disorder and depression, since the symptoms of bipolar disorder can be confused with other illnesses. There are many different types of medication that can be used to help manage an individual’s mood swings. Through a combination of psychotherapy and medication, an individual can lead a full, productive life. Any medication must be monitored carefully by a trained physician.

Where can one go for help?

Remember, you are not alone. You will be taking a major step toward recovery when you begin to seek help. For more information contact the Canadian Mental Health Association, Ontario Division, toll-free at 1-800-875-6213 or the Mood Disorders Association of Ontario at 416-486-8046/1-888-486-8236.

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Copyright (c) 2004 by the Canadian Mental Health Association, Ontario. This Fact Sheet may not be reproduced without written authorization from CMHA Ontario.
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