Archives for 

manic bipolar

What Type of Bipolar Disorder Is It?

Each bipolar disorder illness is unique!

Uniqueness of Bipolar DisorderWhen nearly anyone thinks about bipolar disorder, they think of the symptoms of “regular” bipolar disorder.  Not that any person with bipolar disorder is “regular” (and most would not want to be), but there are several different subtypes of bipolar disorder.

One big problem with bipolar disorder is that each illness is unique.  Psychiatrists may classify them into categories – but they don’t always fit.  Here are some case scenarios: (bipolar episodesbipolar groups)

•    Jennifer has episodes where she is extremely agitated and unhappy and never seems to sleep very much.  These periods seem to last for a long period of time – but can alternate with months where she is simply unhappy and doesn’t feel like doing anything.
•    Max has had periods of depression before.  A lot of times, they go away after a couple of months and then he seems normal but recently he “disappeared” for a couple of weeks after some really bizarre behavior.  His friends never knew that he was any kind of bipolar until he told them he had been at the hospital.
•    Ben has periods of depression that can last for several months but when he is not depressed, he is productive and seems quite outgoing.
•    Sandra’s mood state can switch erratically.  One day she is all about shopping and the next time you call her, she is still in bed at noon.   This is a constant issue – and you never know what you are going to get.

These are three examples of bipolar disorder that don’t seem to fit the “normal” pattern.  None of these patients seems to be “regular” bipolar.

Bipolar disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as:

Bipolar Disorder TypeBipolar I Disorder: manic or mixed episodes that last at least 7 days – or if manic symptoms are severe enough to need hospitalization.  This, usually, includes periods of depression that last at least two weeks.
Jennifer and Max both fit into this category.  Even though Max never had a severe manic episode, having a bipolar episode that warrants medical attention, he qualifies for the Bipolar I category.  Jennifer has mixed episodes – rather than euphoria or traditional mania – she has periods of “dysphoria” where she is agitated, irritable and irrational but with an excess of energy.

Bipolar II Disorder: depressive and hypomanic episodes in a pattern – but manic episodes are not severe.
Ben has Bipolar II disorder.  He has periods of depression that are debilitating, but his non-depressed periods are quite productive, and he doesn’t exhibit manic behavior.

Bipolar Disorder Not Otherwise Specified: (Bipolar Disorder NOS) symptoms of illness don’t meet any other group, but the symptoms are clearly not within the standard range.
Sandra has BP-NOS.  She is what is commonly called a “rapid cycler,” meaning that she switches back and forth from mania to depression much faster than other people with bipolar disorder.

There is also a very mild form of bipolar disorder known as cyclothymia.  It is a cyclical pattern of hypomania alternating with periods of mild depression.  Many people would not even realize this is a problem.

Bipolar disorder is hard to classify.  It may be easy to determine that someone has a problem – but the uniqueness of each bipolar case makes it more difficult for even a patient to identify with the diagnosis.  Each type of bipolar disorder is, usually, treated the same medically. With an anti-manic agent (Lithium), anti-epileptic (Lamictal, Depakote) or atypical antipsychotic (Abilify, Zyprexa) – and sometimes with an antidepressant.

Melissa Lind

Bipolar Disorder – Euphoria vs. Dysphoria or Mixed Episode

Most symptoms of Manic Episodes appear to be positive

Manic-depression or Bipolar disorder is usually perceived on of two ways – a person who alternates between depression and euphoria – or a person who alternates between depression and craziness.

Often a person who is told that they are bipolar will identify one of those two states – and will object based on the fact that they have never been “euphoric“, and they have never been actually psychotic or “crazy”.

Bipolar disorder or Manic-Depression is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) – “the Bible” of psychiatric disorders – as “…clinical course that is characterized by the occurrence of one or more Manic Episodes…”

7 “points” retrieved from: DSM IV Criteria for Manic Episode – Food and Drug Administration

A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week. With three or more of:

1. Inflated self-esteem or grandiosity
2. Decreased need for sleep (e.g., feels rested after only three hours of sleep)
3. More talkative than usual or pressure to keep talking
4. Flight of ideas, or subjective experience that thoughts are racing
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6. Increase in goal-directed activity (either socially, at work or school or sexually) or psychomotor agitation
7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

There is another specifier – “The symptoms do not meet criteria for a Mixed Episode” which is left out in a lot of thought processes.

Bipolar - EuphoricOne problem that is often encountered when diagnosing Bipolar disorder – or when trying to convince someone who has Bipolar disorder that they do, indeed have the illness – is that most of the “symptoms” of a Manic Episode appear to be “positive” or “happy.”  If you examine the wording – it looks on the surface and is often described as periods of “Euphoria” or extreme happiness.

In truth, many people with Bipolar disorder don’t have periods of “euphoria,” they don’t have what is perceived as “inflated self-esteem or grandiosity“, and they don’t seek out “excessive involvement in pleasurable activities.”  They may have “dysphoria,” they may believe that they have to do everything themselves, they may experience psychomotor agitation…they may be in a really active bad mood.

This is a state of “dysphoria.”  It is also called a “mixed state” where the Manic Episode and the Depressive Episode occur at the same time.  Features may include the racing thoughts, irritability, lack of sleep, psychomotor agitation of a Manic Episode but also include anhedonia or lack of enjoyment, inappropriate guilt, or suicidal thoughts which are symptoms of depression.

Unfortunately, this disconnects in presentation, and lack of awareness of mixed states (in both the patient and some professionals) often gives the bipolar patient an “easy out” in acceptance of the diagnosis.

Melissa Lind

Mixed Episode or Manic Episode with Mixed Features is given too little attention!

Teen Bipolar Disorder and Their Unique Challenges

Teen bipolar disorder is diagnosed more frequently.

bipolar-imagesBecause of the unique challenges, Teen bipolar disorder is diagnosed more frequently each year – as it should be. Manic depression is always a serious disorder, but when younger people are in the throes of the disease, it poses some additional challenges. Let us look at some of the unique problems of handling teen bipolar disorder.

First, we should probably take a moment to discuss what bipolar disorders are. In the simplest of terms, one is bipolar when they cycle between deep emotional lows and inappropriate emotional highs. Those who are bipolar experience periods of depression and, on the other end of the emotional spectrum, episodes of outright mania. Behavior on both ends is often potentially dangerous, and this illness can be exceptionally challenging for anyone.

Teen bipolar disorder refers to cases of the disorder diagnosed in young people.

Manic depression is difficult for any sufferer, but teens often have a more difficult time than others do. There are a few reasons.

First, the teen years are a period during which self-confidence is already often lacking. It is a trying period of self-discovery for emotionally healthy kids. There are those who try to take the gauntlet of issues, and learning experiences that are essential to the phase of life while simultaneously suffering from a debilitating mental health issue. This is not surprisingly, but can be quite traumatized by the experience.

This trauma is multiplied, in some sense, by the fact that younger people are yet to develop solid coping skills. Bipolar disorder can adversely affect even the most world-weary adult, but when it occurs with a younger person, they may be totally blindsided by its challenges.

Additionally, the nature of the age makes teen bipolar disorder more difficult for families and loved ones to spot the illness. Hormonal changes and social pressures often make teens “moody.” It can be hard for many parents to distinguish between manic depressive tendencies and traditional teen behavior. Catching the disease early in its development is always preferable, but when manic depression strikes a teenager, that can be extremely difficult.

Third, teen bipolar disorder takes place at a horrible time in terms of social development. Kids in this age group are involved with school, activities and socialization that can help them to learn how to function successfully as adults. That learning process can be short-circuited when a child is simultaneously dealing with manic depression.

Fortunately, teen bipolar disorder is treatable. Pharmaceutical and cognitive therapies can help bring the condition under control, allowing the victim to experience a tremendously improved quality of life. Successful treatment of the problem does require professional medical intervention. If one is, or knows, a teen who is exhibiting signs of a potential bipolar disorder, medical intervention is essential.

Although no mental health condition is “easy,” circumstances can create additional layers of challenge. Such is the case with teen bipolar disorder.

Curse of the Ferrari Brain: the Other Side of Bipolar Disorder

Manic Episode: Another Side of Bipolar Disorder.

Welcome back, my friends!

My apologies for the extended absence. I’ve been very busy with other projects, which I’ll have to return to soon. Also, I wanted to make sure this article was perfect, because this one’s a little tricky.

So far, most of my articles have focused on depression. As someone with type II bipolar disorder, that’s the side I know best. Also, it’s the side that’s easiest for a person who doesn’t have bipolar disorder to understand. Everyone has been bummed at some point. Wanna understand bipolar depression? Take your depression, magnify by about a jillion, and there ya go. Pretty easy to understand, right? The other side of the coin isn’t as straightforward. A good metaphor, I hope, will make it easier to understand.

Let’s say that the average human brain is like a Volvo.The Volvo gets great mileage and is one of the safest, most dependable cars on the road. You wanna get to work on time, day after day and with very little fuss and worry? A Volvo is the car for you.Average human brain - Volvo

The bipolar brain is more like a Ferrari.

Bipolar brain - like a Ferrai

“Farrah”

The Ferrari is fast and flashy. Its sleek, predatory looks practically demand that you drive it at dangerous speeds. You want to make it to work in forty seconds flat? Then the Ferrari is the car for you. Unfortunately, it guzzles gas like your Aunt Janie guzzles gin and tends to spend more time in the shop than on the road. The insurance premiums are astronomical and you are almost guaranteed to wrap it around a tree someday.

Now then… bipolar depression is like the times when the Ferrari is in the shop. It’s up on the lift, and you’re going nowhere. You can’t even show it off by rolling it into your driveway. Not only that, but you gotta walk to work while all the Volvo drivers practically blaze by at 35 mph. In your mind’s eye, they laugh at you as it starts to rain. Your anxiety tells you they are ALL aiming for puddles near you, and the occasional sociopath WILL soak you for his or her amusement.

But then the shop owner calls. Your chariot awaits! You go down to the shop, pay the exorbitant bill, and fire up that 16-cylinder Italian ego trip.

“I’ve missed you, Farrah,” you say, not caring about the look the shop owner gives you. If HE had a Ferrari, he’d name her Farrah, too. Your foot barely taps her gas pedal and she purrs delightedly. She’s missed you, too.

“Good girl,” you say, then ease Farrah’s shifter into first, the action so smooth that instinct alone tells you that she’s out of neutral. You pull out of the shop’s parking lot and into traffic. At first, she’s just glad to be off of that horrible rack and back on the road where she belongs, but every red light, every school zone is an irritant, and sand only makes pearls in oysters. Sand in an engine is death, but Farrah complies and stays below the speed limit… for now.

As you pull into the parking lot at work, all eyes turn to you and your beautiful machine. You pull into your space and reach for the key to kill her ignition, but you stop short.

“It’s been so long. Just once,” she begs. “Pretty please?”

You know this is how it starts, but you’re still in control. Just once won’t hurt anything, right? It’s not like you’re doing anything dangerous. Besides, what’s the point in owning a car like Farrah if you can’t show her off?

With Farrah’s gears in neutral, your foot presses hard on her accelerator and her engine screams ecstatically. Those who weren’t looking before certainly are now. Many are impressed. Many others are jealous. And Farrah, at long last, feels warm and tingly.

“Mmm… baby,” she purrs. “You’re the only one who knows how to touch me right. Again. Please.”

“Sorry, babe,” you say, a little defeated. “I gotta go to work now.”

Farrah pouts as you shut off the engine, sputtering just a little to let you know she’s put out. You promise her a full tank of premium and a stretch of deserted highway tonight followed by a loving sponge bath. You know that will make her happy, but she’s still sulking.

When five o’clock rolls around, you dash into the parking lot to find Farrah waiting. It’s a beautiful day, so you decide a little sun would be good for you both. You drop her top, fire up her engine and gun the accelerator—just a little—as you exit the parking lot. No harm done, and at last you’re out on the open road where both of you are more happy… for all of about twenty seconds.

Gridlock. No one’s going anywhere fast. The traffic jam drives you nuts, but you try to smile regardless. You’ve gotten so many “nice car, man” comments from the Volvos that your ego has slipped into overdrive. Eventually, though, it gets old. You’re sick of hearing how nice your car is. You wanna FEEL how nice she is, and in this traffic, how can you? You can’t even get out of first gear! You’ve got to MOVE!

Speed isn’t Farrah’s only good quality. She maneuvers like… well… like a gdamn Ferrari! Each time you see an opening in traffic, you seize it. At first, you make sure there’s plenty of space, but soon ANY amount of space is enough as long as it moves you forward. Other drivers stop saying “nice car” and start saying “watch it, a-hole!”

“Fuc.. them,” Farrah says. “They’re just jealous, baby.”

Finally, you come upon a stretch of open highway, just begging to be devoured. You stomp Farrah’s accelerator and instantly know that what she said is true. Who wouldn’t be jealous of this speed? This freedom?

“At last!” she screams as you tear away from the nightmare behind you. The wind whips your hair as the speedometer climbs. This is what she’s DESIGNED to do, you tell yourself. It’s just you and Farrah and all is well in the world. You drive off into the sunset, victorious, just like in the movies.

But real life isn’t the movies, and sunset only means the end of the day, not the end of the film. You pull into your garage and park Farrah for the night. You have to work in the morning, but you’re too wired to sleep. You try watching TV. You try a hot shower. Nothing works. Sleep just won’t come, not with Farrah calling to you from the garage.

“Sleep is for those Volvo people,” she says, spitting out the word Volvo as if it had the arsenic taste of bitter almonds. “You’re better than them, baby. All you need is me. Come on. Let’s go for a drive.”

But you know better. You’ve been down this road before. With the help of a few Benadryl, you ignore her voice and drift off, but your sleep isn’t like real sleep. Your body lays motionless but your mind spins like a screeching tire. Dreams and reality melt together for a few fitful hours of sleep and traffic nightmares.

You’re awake long before sunrise, but you force yourself to stay in bed until the alarm goes off, then you’re up in a flash. You sing in the shower. You skip breakfast. You rush to the garage.

“Good morning, sexy,” she says. “Ready to play?”

“Are you?” you ask, smirking as you sink into a kid leather bucket seat that fits you like a glove. You deftly slip your key in her ignition and give it a twist. As you pull on your driving gloves, the temperature gauge begins to rise. “Like that, do you?”

“Sailor baby, you get me hotter than Georgia asphalt,” she purrs.

You bet your sweet a-h I do, you think as the garage door rises to release you from your prison. Your house isn’t your home. Here with her. This is home. This is where you belong.

Now, there are two different ways this scenario can end…

END #1

The garage door is barely up before you’re skidding out of the garage and into… another fu–ing traffic jam! No! No no no no NO NO NO!!! You honk madly. Farrah’s engine growls at any Volvos who get too close. The admiration in the Volvo drivers’ eyes is gone. Today, they look upon you with fear, but you don’t give a damn. They’re just in your way, anyway, right? One Volvo tries to pull in front of you. You stomp the accelerator and he weaves out of your way just in time.

“My lane, a-hole,” you shout. “Mine!”

Your lane or not, the traffic light turns red and you’re stuck. Time stands still. You scream and rev your engine, both you and Farrah quickly reaching redline. The temperature warning light comes on, but you ignore it. It just wants to slow you down, too. You smell oil smoke, but don’t care.

“Go baby,” Farrah shrieks. “Go! Go! GOOOO!”

KABLAM!

Something snaps. Thick gray smoke boils from the engine compartment. Farrah’s engine chokes and sputters as the light turns green. She’s got just enough strength to ease to the side of the road.

“This is all your fault,” she says, dying. You weep at what your anger has done.

The tow truck guy clucks his tongue as he winches Farrah’s front end into the sky. “Damn shame,” he says. “Such a nice car.”

In your mind, you finish his sentence. If only you knew how to treat it.

Welcome back to depression.

Or, it could end like this…

END #2

The garage door is barely up before you’re skidding out of the garage and onto the open road. Your floor it and Farrah jumps over the speed limit like an antelope. There’s no traffic, no cops, nothing but miles of open road. You cut each corner closer, but not because you’re out of control. You do it because you’re fucking amazing! Every move you make is the right one. The world is yours and everything is perfect…

…until you run out of gas in the middle of nowhere during a thunderstorm and have to walk to the nearest payphone (you forgot your cell in your hurry to hit the road) only to find you don’t have any change, so you have to walk all the way back to your house. Once at your house, you reach into your pocket and find that you’ve lost your keys somewhere along the way.

Welcome back to depression.

George Carlin, one of the funniest men to ever live, once said that the cliché phrase “more than happy” sounded like a medical condition.” Well, he was right. “More than happy” is called euphoria, and euphoria is sometimes a symptom of a manic episode. Sometimes, bipolar disorder feels WONDERFUL. At the beginning of the upswing, you have hypomania, and hypomania can be very, very good. It’s your chance to really shine.

Sometimes, when you’re hypomanic, you are the life of the party—charming, witty, friendly and filled with energy. Your mind becomes razor sharp, your reflexes like those of a kung fu master. You make friends easily, accomplish incredible amounts of work, and have flashes of brilliance that astound and amaze everyone around you. I LOVE it when hypomania works that way!

Sometimes, however, it doesn’t. Sometimes when you’re hypomanic, you are the total buzzkill—cranky, bitter, sullen… and yet still filled with energy. Your mind is sharp, but it’s your tongue that’s the razor. You’re nerves are so jittery you twitch. Fine silk feels like sandpaper against your skin. You still have that keen focus, but all you focus on is the neighbor’s g-damn stereo and if you had one ounce less of willpower, you’d crash right over and shove the thing straight up his a-h. But that wouldn’t fix the problem, because dammit, you’re pissed and you’re gonna stay that way. I HATE it when hypomania works that way.

Now, if you’re bipolar type II like me, hypomania is the ceiling. You hit it, stay there for anywhere from a few hours to a few weeks (depending on how rapidly you cycle) and then spiral back down into depression. If you’re type I bipolar, then hypomania is just the beginning.

Hypomania basically means “little mania,” so for a full-tilt manic episode, take my description of hypomania and magnify it exponentially: the occasional sleepless night becomes days on end without sleep; the occasional ego trip gives way to full-blown narcissism and delusions of grandeur; euphoria becomes psychosis; irritability becomes hostility and anxiety becomes outright paranoia. Some even experience hallucinations.

No matter how high the ladder goes, unless you drop dead from exhaustion (which does happen occasionally) or wrap your Ferrari around a tree (yes, those on the upswing really do tend to speed) then you’re going to find yourself right back where you started. For some, that’s a relatively normal mood. For others, it’s welcome back to depression. Hope you enjoyed the ride.

And on that note, I hope you, my readers, have enjoyed the ride. I’ll be taking a break from this blog now, but I’m sure I’ll be back I’ve got so many other stories, poems, screenplays and articles to write. I’ve got sketches to draw and music to compose. I’ve got a life without bipolar disorder… or at least a life without thinking about it all the time.

The one thing I want you to remember most of all is that NO ONE IS A DISEASE. They are a person with a disease. Their disease is not their life, at least not unless they allow it to be. Don’t do that, folks. It sucks. Be people. People are OK unless they won’t turn their g-damn stereos down.

Keep fighting, folks!

-Bruce Anderson

 

Dispelling a Few Myths about Bipolar Disorder

Dispelling myths about Bipolar Disorder

Hello again, fellow wackos and electronic rubberneckers!Bipolar?

If you’re here because you’re like me—just a little “off”—then welcome. If you’re here to learn about bipolar disorder, stick around, because I know a thing or two and I like to talk. If you’re here to watch the train wreck happen, hoping I’ll melt down and post something crazy about the talking wombats that live in my refrigerator and their TV viewing habits… well, you’ll probably be a little disappointed. I may be a freak, but I’m not crazy.
Yeah, that’s right. I just called myself a freak. I figure if other people are going to call me that, I can probably get away with saying it myself. Wacko, nutcase, loony, psycho… There are lots of things people say about bipolar disorder, and many of them just aren’t true. Let’s take a look at a few of those things right now.

Bipolar Myth #1People with bipolar disorder aren’t really sick.
Bipolar SkelletonSome people say that bipolar disorder is “all in your head.” They say things like “everyone gets depressed. You just need to suck it up and deal with it like everyone else.” If this is true, then diabetics just need to get over their illness, too. I mean, too much sugar is bad for everyone, right?
Just as a diabetic’s body doesn’t process sugars properly, a person with bipolar disorder’s brain doesn’t process dopamine, serotonin and norepinephrine quite right.
Don’t take my word for it, though. Take it from research scientists at the University of Michigan who’ve studied Abnormal Brain Chemistry Found in Bipolar Disorder. They know what they’re talking about.
I’m just some freak, remember?
So, you can tell me I don’t have a “real” disease and that I just need to deal with it, but first you gotta tell Ms. Diabetic to eat six Twinkies and deal with it. Go ahead. I’ll call 911 while she’s chewing.
This myth is so prevalent that insurance companies are allowed to treat it—or more accurately NOT treat it—like it isn’t a “real” disease. The last health insurance I had would pay for 80% of the bill if I had to have major surgery, but only 50% if I saw a doctor for bipolar disorder. Also, they limited the number of times I could see a doctor for treatment to 12 times a year. Tell you what… let’s limit diabetics to 12 insulin shots per year and see how well they do.
What? We shouldn’t do that because they could get sick and die?
Well, people with bipolar disorder die, too. In fact, without proper treatment, 20% of them commit suicide. That’s one in five, folks. I’d say that constitutes a serious health risk. Maybe this bipolar thing is a real disease after all.

Bipolar Myth #2People with bipolar disorder are beyond hope.
He’s got bipolar disorder. He’s crazy. He can’t be helped. He’s a lost cause. Or is he?
The fact is—he isn’t. Bipolar disorder is one of the EASIEST conditions to treat. There are several effective medications, some of which have been in use for quite a while. Lithium, for example, has been around since the 1950’s. Lithium doesn’t work for everyone, though. That’s why there’s Lamictal, Depakote, Zoloft, Tegretol, Wellbutrin, Prozac, Effexor, and a partridge in a pear tree. A psychiatrist can tinker with medications until he finds a combination that works.
Medications can help, but so can just talking. Talk therapy did me more good than any pill ever did. However, without the pills, I probably wouldn’t have listened to anything when I was at rock bottom.
The point is this: people with bipolar disorder CAN be helped. So if you have bipolar disorder or know someone who does, don’t give up. There is hope.
Well gang, it looks like I’m over word count. I told you I like to talk! We’ll talk some more next time when I dispel a few more myths about bipolar disorder.
So to all my friends and fellow freaks, until next time… keep fighting!

Bruce Anderson

Read more here: Words As Weapons And Another Bipolar Myth Dispelled

What Causes Bipolar Disorder?

So, what causes Bipolar disorder?

It appears to be an interplay of genetic and physiological factors, coupled with stressful triggers, that causes Bipolar disorder…

Bipolar doctor

Manic depression, also called bipolar disorder, causes severe mood swings that can last for weeks or even months.

Everyone feels happy or sad sometimes. For someone with manic depression, however, these mood swings are much more intense. Scientists have not identified a single factor what causes bipolar disorder. Instead, it may have one or more of several different causes. These may be broken down into genetic, environmental and physiological causes.

There are three types of manic depression.

Bipolar Type I is characterized by at least one manic episode. A manic episode is a feeling of intense elation, restlessness and loss of inhibitions and over-activity. Sufferers during a manic episode may sleep for only three or four hours a night if at all.

Bipolar Type II, where there may be frequent episodes of depression with only mild manic episodes (called hypomania). Rapid cycling involves four or more mood swings over the period of a year.

Finally, there is Cyclothymia, where the mood swings last longer but they are less severe.

Genes is considered to be a contributing factor.

If one of your relatives has manic depression, there is a reasonable chance that you will develop it, too. Chromosome numbers 6 and 8 appear to have been implicated. Children of bipolar parents have an eight percent chance of developing the condition, compared with one percent in the general population.

A chemical imbalance in the brain may cause the disorder. Nerve signals travel from one neuron to another by way of chemicals called neurotransmitters. These include norepinephrine, dopamine, and serotonin. It is possible that excess levels of norepinephrine may cause a manic episode.

During a depressive episode, levels of this neurotransmitter may be excessively low. The picture, however, is not that simple, as there are other neurotransmitters involved.

Mood swings can also be triggered by stress. Abuse; either physical, emotional or sexual, may trigger an episode. Bereavement or the breakdown of a close relationship may also be a trigger.

Not all stressful triggers are negative experiences. A positive change, such as a marriage or a birth can also make a contribution.

Once diagnosed, the condition can be treated or controlled, although certain risk factors may trigger a recurrence. Failure to comply with medication carries a high risk of recurrence, as do alcohol or drug abuse. Other risk factors include poor support systems. For example, the lack of caring friends or relatives or an erratic lifestyle.

Manic depression can lead to psychosocial disturbances.

For example, Bipolar Type I and Bipolar Type II are associated with a high absentee rate at work. There is also a higher rate of suicide attempts and hospital admissions with these conditions. While both conditions have high rates of attempted suicides, Type II sufferers seem to have fewer hospital admissions than Type I, and consequently miss fewer days at work.

So, what causes bipolar disorder? It appears to be an interplay of genetic and physiological factors, coupled with stressful triggers.

Complying with medication, adopting a stable lifestyle, and developing healthy coping strategies, may all keep the condition under control.

It is essential to consult a medical professional and not attempt self diagnosis.