1) What is bipolar disorder?
Bipolar disorder refers to a mental health condition characterized by alternating periods of mania and depression. Bipolar disorder is also sometimes known as manic depression. Approximately 1 in every 100 Americans suffer from some forms of bipolar disorder. Bipolar disorder is a serious and challenging illness, which leads many health and social consequences. Bipolar disorder is particularly difficult to diagnose. Patients with bipolar disorder also frequently fail to comply with prescribed treatment or medication.
2) Classfication of bipolar disorder
Bipolar disorders are often classified into bipolar I disorder, bipolar II disorder, cyclothymia and bipolar disorder NOS. NOS stands for Not Otherwise Specified. Bipolar I disorder and bipolar II disorder account for the most cases of bipolar disorder.
Patients with bipolar I disorder has a combination of at least one manic episode and depressive episodes. Patients with bipolar I disorder tend to experience more depression than mania.
Patients with bipolar II disorder has a combination of at least one hypomanic episode and major depressive episodes. Patients with bipolar II disorder also tend to experience more symptoms of major depression more than symptoms of hypomania.
3) What are mania and hypomania?
A person with bipolar disorder may experience episodes of mania, hypomania and depression.
A person experiencing a manic episode will feel abnormally elated, irrational, hyperactive, and full of energy. These feelings may persist for 7-10 days. He or she may talk excessively, laugh inappropriately, spend lavishly or engage in excessive sexual activities. Severe mania may require hospitalization.
Hypomania is usually shorter than mania. Hypomania lasts typically for more than 4-5 days. It does not affect a person’s ability to function and in most cases does not require hospitalization.
A manic or hypomanic episode is often followed by depression, during the patient experiences sadness and utterly helplessness. This affects the patient’s ability to function normally. He or she will not able to carry out daily activities. Depression also might lead to health consequences such as excessive weight loss or gain, insomnia or excessive sleeping. Major depression is severe depression that lasts for more than 2 weeks.
4) Prevalence of bipolar disorder
Surveys indicate that the lifetime risk of developing bipolar disorder is approximately 2%. About half of the cases of are attributed to bipolar I disorder, while the rest is due to bipolar II or cyclothymia. Most cases of bipolar disorder are diagnosed in young adulthood or late adolescence.
The annual cost of bipolar disorder in United States is estimated to be in the range of $45-50 billion.
60-70% of patients diagnosed with bipolar disorder does not comply with treatment. Studies of patients diagnosed with bipolar disorder enrolled in Medicaid report that only 40% of patients used a mood stabilizer in the first year following diagnosis and around 6% of patients used mood-stabilizing agents consistently.
Treatment for bipolar disorder includes treatments for mania and treatments for depression.Treatments for mania include (i) mood stabilizers such as lithium , lamotrigine, valproate, and carbamazepine and (ii) antipsychotic medications such as haloperidol, olanzapine.
Treatments for depression include (i) mood stabilizers such as as lamotrigine and lithium, (ii) antidepressants such as serotonin, bupropion, and phenelzine, and (iii) electroconvulsive therapy.
Psychotherapy can be used together with medications to preventing recurrence of manic and depressive episodes and maintain remission