Bipolar Disorder
Bipolar disorder, formerly known as manic-depressive illness or manic depression, is a psychiatric disorder categorized under mood disorders. It is defined by the presence of one or more intervals of abnormally elevated energy levels, cognition, and mood, with or without one or more intervals of depression. Clinically, these elevated moods are referred to as mania, and if they are mild, they are known as hypomania.
People who experience manic episodes also undergo depressive episodes or symptoms. Additionally, they may encounter mixed episodes that feature characteristics of both mania and depressive episodes simultaneously. Between these episodes, individuals typically experience a period of normal mood. However, in some patients, depression and mania alternate rapidly, a condition known as rapid cycling. Episodes of extreme mania can lead to symptoms such as delusions and hallucinations.
This disorder has subtypes, including Bipolar I, Bipolar II, and Cyclothymia, among others. The classification depends on the severity and nature of the mood episodes, and the range of mood episodes is usually referred to as the bipolar spectrum.
The diagnosis of this disorder is based on the patient’s self-reported experiences and observed behavior. Bipolar disorders are often associated with distress, disruption, and a high risk of suicide, especially during depressive episodes. However, in some cases, they may be linked with creativity, goal striving, and positive achievements.
Both genetic and environmental factors play a role in the development of bipolar disorders. Treatment options include mood stabilizers and other psychiatric medications. Patients who do not pose a risk to others can also be treated with psychotherapy; otherwise, involuntary commitment may be necessary. Bipolar disorder is sometimes misdiagnosed as schizophrenia.
Who Gets Bipolar Disorder
Anyone can be diagnosed with bipolar disorder at any time in their life. The most common age for diagnosis is early adolescence, meaning that most people are diagnosed between the ages of 13 and 15.
Bipolar disorder is largely an inherited condition. Children with a bipolar parent have a 75% chance of developing the disorder.
Those diagnosed before the age of 12 may have the disorder as a symptom of another mental illness. On the other hand, those diagnosed after the age of 40 might exhibit the disorder as a symptom of dementia or other mental illnesses commonly diagnosed in older people.
The disorder has even been linked to certain cardiovascular diseases as a symptom.
Symptoms of Bipolar Disorder
Bipolar disorder was known as manic depression in the past, and some people still refer to it by this name. Manic depression is similar to bipolar disorder because a person’s mood swings between mania and depression. These mood swings can last for hours, days, weeks, or even months.
When you experience any symptoms that last for a week, it is known as an episode. If you experience four or more episodes of mania and/or depression in a year, it is diagnosed as rapid cycling bipolar disorder.
The symptoms of the depressive episode of bipolar disorder are persistent feelings of sadness, anxiety, guilt, anger, isolation, or hopelessness in addition to disturbances in sleep and appetite, fatigue and loss of interest in usually enjoyable activities, more problems concentrating, loneliness, self-loathing, apathy or indifference, depersonalization, loss of interest in sexual activity, shyness or social anxiety, irritability, chronic pain which can be with or without a known cause, lack of motivation, and morbid suicidal idealization. Severe cases can lead to delusion or hallucinations and this condition can last for even six months if left untreated.
1. Irritability or Euphoria:
Have you ever experienced times in your life when you simply felt like yelling at someone for no apparent reason? Someone with bipolar disorder experiences this to a more significant degree than someone without the disorder. Although hypomania is sometimes expressed as the more outgoing and overly happy side of bipolar disorder, many people with this condition can also quickly swing back to depression.
2. Excessive Talking:
A person with a severe condition will often speak quickly and tend not to let you have a word in the conversation. Because their mind is racing so quickly, it can be difficult to follow what they are talking about.
Manic episodes are characteristic of bipolar disorder and are diagnosed by the presence of a distinct period of elevated mood, which can escalate into euphoria. Patients may experience sleepless nights without feeling tired, pressured speech, a low attention span, distractibility, aggression, intolerance, or intrusiveness. The patient may also start using alcohol and other depressants like cocaine, other stimulants, or sleeping pills.
Bipolar disorder is thought to be connected with a person's creativity; those who are more creative have a higher chance of having bipolar disorder. Temperament is also a factor responsible for bipolar disorders. Sometimes, setting high goals in life can be a cause of bipolar disorder, as can low self-esteem and difficulties in social adjustment.
Bipolar Mania / Hypo-mania Symptoms
Have you ever experienced times in your life when you simply felt like yelling at someone for no apparent reason? Someone with bipolar disorder experiences this to a more significant degree than someone without the disorder. Although hypomania is sometimes expressed as the more outgoing and overly happy side of bipolar disorder, many people with this condition can also quickly swing back to depression.
2. Excessive Talking:
A person with a severe condition will often speak quickly and tend not to let you have a word in the conversation. Because their mind is racing so quickly, it can be difficult to follow what they are talking about.
3. Inflated Self-esteem:
During times of hypomania, someone with bipolar disorder tends to have a little extra pep in their step. This means they appear to have an inflated ego and more self-esteem than usual. Generally, someone with a more severe form of bipolar disorder may exhibit extreme arrogance, making it difficult to be around them.
4. Unusual Energy, No sleep needed:
Have you ever seen someone under the influence of a stimulant drug? This is similar to how someone experiencing hypomania may act, except they don't need any drugs to get the same result. They may talk a lot and have lots of energy. Some people with hypomania may go shopping all day, perhaps even into the late night hours, seemingly unaware of the passing time.
5. Quick desire for self-gratification:
Unfortunately, many people with serious bipolar disorder hypomania episodes find themselves in significant debt. During hypomanic episodes, individuals often make impulsive purchases of items they don't need and can't afford. Some end up with multiple vehicles they can't afford, while others lose their homes due to poor financial decisions. Some even withdraw money from their retirement accounts to spend on clothes or other items, forcing them to continue working for the rest of their lives.
Bi-Polar Depression Symptoms
Generally, someone in a bipolar depressive state will exhibit symptoms such as a desire to stay indoors all the time, very low self-esteem, and even isolating themselves behind closed doors away from others in the household. They might also sleep much more than a typical person naturally would. These are just a few signs that someone may be experiencing a form of depression, which could also be linked to bipolar disorder symptoms.
When you experience five or more of the following symptoms for most of the day, almost every single day, and it lasts longer than two weeks, this is known as a depressive episode:
- Feeling sad, anxious, or irritable
- Losing energy
- Feeling hopelessness, guilt, or worthlessness
- Losing interest in things you once enjoyed doing
- Difficulty concentrating
- Crying uncontrollably for no reason
- Difficulty making decisions
- Feeling constantly tired and wanting to sleep all the time
- Insomnia
- Weight gain or loss due to a change in appetite
- Thoughts of suicide or death
- Attempting suicide
10 Signs of Bipolar Disorder
When it comes to mental illness, it is challenging to pinpoint specific and obvious signs and symptoms of the condition. This is particularly true for bipolar disorder, where clear signs of mood episodes are difficult to identify. Carrie Bearden, PhD, an associate professor in residence of psychiatry and behavioral sciences and psychology at the David Geffen School of Medicine at UCLA, states: “Chalking it up to moodiness or trouble at work or tiredness is pretty common. The disorder varies in severity.”
Here are ten signs of bipolar disorder that are challenging to analyze in a patient:
1. Elevated Mood:
Bipolar disorder involves episodes of both mania and depression. During a manic episode, the patient is often disconnected from reality. Another sign of bipolar disorder is hypomania, where the patient feels excited, has high spirits, and increased energy, yet maintains a grip on reality.
Dr. Bearden describes hypomania as a “pretty enjoyable state” where patients experience elevated mood, increased energy, and heightened creativity. This state can lead to euphoria, which is the peak of bipolar disorder enjoyment.
2. Procrastination or Incomplete Tasks:
A prominent sign of bipolar disorder is having many unfinished tasks. However, patients who harness their elevated energies during the hypomanic phase can be highly productive.
Don Malone, MD, the director of the Center for Behavioral Health and chair of the Department of Psychiatry at the Cleveland Clinic in Ohio, comments on these individuals: “They can be quite distractible and may start a million things and never finish them.”
3. Depression:
The depressive phase of bipolar disorder resembles regular depression. Dr. Malone notes: “They have the same problems with energy, appetite, sleep, and focus as others with plain old depression. Antidepressants can be downright dangerous in people with bipolar because they can induce mania.”
Antidepressants alone do not effectively treat bipolar depression; they can worsen the condition and trigger a manic episode.
4. Irritability:
Some bipolar disorder patients experience mixed mania, a combination of mania and depression symptoms. In this state, the patient can be highly irritable.
While everyone can be irritable at times, it becomes a significant issue in people with bipolar disorder. Dr. Bearden remarks: “We are all irritable or moody sometimes, but in people with bipolar disorder, it often becomes so severe that it interferes with their relationships – especially if the person is saying, ‘I don’t know why I’m so irritable… I can’t control it.’”
5. Pressured Speech:
Some people are naturally talkative, but pressured speech is a distinct sign of bipolar disorder.
Dr. Bearden explains that pressured speech occurs when the patient dominates the conversation, talks rapidly, and jumps between unrelated topics. This behavior is most evident during the manic phase.
6. Work Issues:
Bipolar disorder patients often face significant challenges at work due to their symptoms hindering their productivity and positive interactions with others.
In addition to the aforementioned problems, they also experience sleep disturbances, irritability, and inflated self-esteem during the manic phase. Dr. Malone emphasizes that most work-related issues are interpersonal.
7. Substance Abuse:
Dr. Bearden states that about 50% of bipolar disorder patients also struggle with substance abuse, especially alcohol.
People use substances during both manic and depressive phases, either to slow down in the former or to elevate mood in the latter.
8. Erratic Behavior:
During the manic phase of bipolar disorder, patients often exhibit inflated self-esteem and ego. Dr. Malone notes: “They feel grandiose and don’t consider consequences; everything sounds good to them.”
During this phase, patients may engage in reckless spending sprees or exhibit increased and unexpected sexual behavior. Dr. Malone further observes: “I have had a number of patients who have had affairs who never would have done that if they weren’t in a manic episode… during this episode, they exhibited behavior that is not consistent with what they would normally do.”
9. Sleep Disturbances:
Bipolar patients often experience sleep issues. During the depressive phase, they may oversleep and feel constantly tired. Conversely, during a manic phase, they may sleep very little but still feel energetic.
Dr. Bearden recommends establishing a regular sleep schedule for bipolar disorder patients.
10. Flight of Ideas:
This sign of bipolar disorder is hard to detect but is most common during the manic phase. The patient experiences racing thoughts and struggles to control or slow down their ideas.
This flight of ideas is often accompanied by pressured speech, with the bipolar patient typically denying that their thoughts are racing or their ideas are out of control.
Types of Bipolar Disorder
There are three types of bipolar disorder that you need to be aware of. The patterns and severity of the symptoms or episodes—both highs and lows—determine which type of bipolar disorder you have.
Bipolar I Disorder is characterized by one or more manic episodes or mixed episodes. Mixed episodes occur when symptoms of mania and depression are present for a week or more, every single day, along with one or more extreme depressive episodes. Bipolar I disorder is considered the most severe form of the disease, marked by extreme manic episodes.
Read more here on → Bipolar Disorder Type 1: Symptoms, Treatment, Risk, Prevention
Read more here on → Bipolar Disorder Type 2: Symptoms, Treatment, Risk, Prevention
Read more here on → Cyclothymia (Cyclothymic Disorder): Symptoms, Causes, Treatment, Risks
In summary, Bipolar I is the more severe form characterized by alternating depression and mania and may include additional symptoms such as hallucinations and delusions. In contrast, Bipolar II mainly consists of longer depressive episodes and hypomania, which is a milder form of exhilaration.
There is also a more dramatic type of bipolar disorder known as Mixed Bipolar Disorder. This type combines both manic and depressive symptoms, meaning the patient experiences these two polar opposite moods simultaneously.
Causes of Bipolar Disorder
The causes of bipolar disorder vary among individuals. Studies have indicated that both genetic and environmental factors play a role in the development of bipolar disorder. These studies, which include twin studies, show different results between monozygotic (identical) twins and dizygotic (fraternal) twins. The rate of Bipolar I in monozygotic twins is consistently around 40%, whereas the rate in dizygotic twins ranges from 0-10%. The likelihood of the disorder occurring in the next generation is approximately 0.71.
There are three main factors that cause bipolar disorder, which are described below:
1. Genetic Factors:
Certain chromosomal sites and genes have been observed that appear to contribute to the development of bipolar disorder. However, these results are not consistent and can vary. The genetic contribution to bipolar disorder is not uniform across all cases.
The law of heterogeneity suggests that different genes are responsible for bipolar disorder in different families. Genes related to serotonin, dopamine, glutamate, and other cell growth hormones consistently show results in studies.
2. Physiological Factors:
Certain brain circuits are essential for normal bodily function, and abnormalities in these circuits can lead to bipolar disorder. Two meta-analyses of MRI scans have reported an increase in lateral ventricles, globus pallidus, and white matter hyperintensities. Individuals who are genetically predisposed are more susceptible to bipolar disorder and may easily become its victims. Bipolar disorder is characterized by sudden mood changes. Mood episodes can occur spontaneously. Abnormalities in the HPA axis due to stress can lead to bipolar disorder.
Depression is associated with poor neuron firing, while mania is linked to hypersensitive neuron firing. Both are caused by mitochondrial dysfunction and sodium ATPase pump abnormalities. These are the causes of Bipolar Disorder Type I. Bipolar Disorder Type II has different causes, including circadian rhythms and melatonin activity.
3. Environmental Factors:
Experimental evidence has shown that environmental factors not only trigger bipolar disorder but also exacerbate its effects. Environmental factors are particularly influential in people who are genetically predisposed. These factors consistently show that certain events in daily life can trigger and exacerbate different mood episodes, leading to bipolar disorder.
These environmental factors can include various events or interpersonal relationships that can induce bipolar disorder. Patient histories often reveal that they have experienced abusive or traumatic events during childhood or adolescence, which later become the cause of bipolar disorder. This onset can worsen and result in PTSD.
How is Bipolar Disorder Diagnosed
A diagnosis of bipolar disorder is made by carefully observing symptoms, which can include their severity, duration, and frequency. The most common symptom is extreme mood swings that do not follow a consistent pattern, ranging from extreme highs to extreme lows.
The doctor you see for a diagnosis, typically a psychiatrist, will ask you numerous questions. These questions may cover topics such as your personal and family history of mental illness, any bipolar symptoms you've been experiencing, their duration, and frequency. Other questions may focus on your memory, your ability to express yourself, and your relationships with others.
Blood and urine tests, including toxicology screening, can be conducted to help rule out other potential causes of your symptoms. During these screenings, samples of your blood, urine, or hair will be tested for the presence of drugs. Blood tests will also check your thyroid stimulating hormone level (TSH) because depression can sometimes be linked to thyroid function.
After receiving a diagnosis of bipolar disorder, it's important to work closely with your doctor to develop a treatment plan tailored to your specific type of bipolar disorder, whether it's Bipolar I, Bipolar II, or another type. Your treatment will depend on the type of bipolar disorder you have.
Treatment of Bipolar Disorder
The diagnosis of bipolar disorder depends primarily on the patient’s experiences and secondarily on the experiences of the psychiatrist, nurse, social worker, clinical psychologist, or other clinician. It is determined by the presence and duration of the symptoms.Other mental disorders, such as schizophrenia, schizoaffective disorder, drug intoxication, brief drug-induced psychosis, schizophreniform disorder, and borderline personality disorder, may be mistaken for bipolar disorder due to similar symptoms.
Various pharmacological and psychotherapeutic techniques are used to treat bipolar disorder. Patients can also contribute to their recovery through their personal recovery journey. For more severe cases, psychotherapy is employed to alleviate core symptoms, recognize episode triggers, reduce negative emotions in relationships, and practice recovery-promoting behaviors. Cognitive behavioral therapy, family-focused therapy, psychoeducation, and interpersonal and social rhythm therapy are considered the most effective treatments for bipolar disorders.
Several types of medications are also used to treat bipolar disorder, such as mood stabilizers like lithium carbonate or lamotrigine. Lithium carbonate reduces suicidal feelings in bipolar patients, while lamotrigine is used to prevent depressive episodes. In some severe cases, lithium-based products may be used in combination with other medications.
Acute manic episodes can be treated with antipsychotic medications such as chlorpromazine and atypical antipsychotics like quetiapine and olanzapine. After the symptoms have been reduced with medication, they should not be discontinued abruptly, as this can lead to relapse.
Discontinuation of medication can cause the disorder to recur, and if the patient is under or over-medicated, relapse can occur.
The mortality rate among bipolar disorder patients is relatively low, as none of them has ever attempted suicide.
Bipolar Disorder Treatment Options
There are several types of treatments for bipolar disorder, which are described below:
1. Comprehensive Treatment for Bipolar Disorder:
Comprehensive treatment addresses all aspects related to the disorder, including symptoms, restoration of abilities, and resolution of problems caused by the disorder. It aims to reduce and manage these issues. The treatment includes the following steps:
Medication: The cornerstone of bipolar treatment is the use of mood-stabilizing drugs. These medications help reduce the highs and lows of bipolar disorder and ultimately control its symptoms.
Psychotherapy: Consulting a therapist and attending therapy sessions is crucial for managing bipolar disorder. Therapy helps patients learn to cope with the disorder, address problems caused by the disorder, manage difficult situations, resolve issues, restore relationships, and regulate stress and mood fluctuations.
Education: Understanding the disorder thoroughly is key to managing its symptoms and challenges. The more knowledge patients and their relatives have about the disorder, the better they can cope with it and avoid certain adverse experiences.
Lifestyle Management: Certain lifestyle changes can help manage the symptoms and mood episodes of the disorder. These changes include maintaining a regular sleep schedule, avoiding alcohol and drugs, engaging in regular exercise, managing stress, and getting proper sunlight exposure.
Support: The support of loved ones is invaluable for recovery from bipolar disorder. Patients can also benefit from joining bipolar disorder support groups where they can share their experiences and challenges with others facing similar issues.
For many people with severe bipolar disorder, medication is necessary to control symptoms and maintain stability. Consistently taking medications can not only reduce symptoms and the frequency of mood episodes but also prevent them altogether. The steps involved in medication treatment are:
Regular Sessions with a Physician: Regular blood tests are necessary to check medication levels and ensure they are within the therapeutic range. Proper management of medication dosage is crucial for maintaining stability and preventing symptoms.
Consistent Use of Medications: Do not stop taking medications abruptly, even if you feel slightly better unless instructed by your physician. Some people with bipolar disorder require long-term medication to prevent relapse.
Avoid Extra Expectations: Medications can minimize symptoms like mania and depression but cannot cure the disorder. Lifestyle changes and therapy sessions are also necessary for the best results.
Avoid Antidepressants: Research has shown that antidepressants are not effective treatments for bipolar disorder and can even trigger mania or rapid mood swings.
3. Therapy Treatment:
Therapy has been successful in treating bipolar disorder, providing better, more effective, and faster results. There are three types of therapies used for bipolar disorder patients:
- Cognitive-behavioral Therapy (CBT)
- Interpersonal and Social Rhythm Therapy (IPSRT)
- Family-Focused Therapy (FFT)
Learn more: Living with Bipolar Disorder
You may read also: How to Fix Bipolar Disorder Without Meds
Tips to Take Control of Bipolar Disorder
Just like any chronic disease, such as diabetes, heart problems, or epilepsy, correct treatment, management, and understanding of the health problem are essential. Most people with bipolar disorder can lead complete, productive, and rewarding lives by taking crucial steps to manage and handle their health condition.
Here are some essential steps to consider if you or a loved one has bipolar disorder:
1. Find a Psychological Health Professional You Trust:
A person diagnosed with bipolar disorder needs to establish a relationship with a trusted mental health professional where open and honest communication can take place.
2. Take Medication as Prescribed:
This is first and foremost the most crucial step in taking control of bipolar disorder. Adhering strictly to the prescribed medication regimen is essential. For the medication to work effectively, it needs to be taken consistently and for the long term. It may be tempting to stop taking the medication as symptoms subside and one begins to feel better. However, this could have disastrous consequences.
3. Reduce Stress:
Mental health professionals often believe that increased stress can trigger a bipolar episode. Finding time to relax, delegating extra responsibilities, or simply talking to someone during a stressful event can help induce a sense of calmness. (Find here: 10 Ways to Cope with Stress)
4. Avoid Becoming Isolated:
Do not try to “handle” bipolar disorder alone. Seeking the comfort and understanding of friends and family is crucial to a person’s treatment. Joining a bipolar disorder support group can be very helpful because the people there understand the feelings and challenges of living with the illness. They can provide insight and encouragement to someone facing a diagnosis.
5. Maintain a Healthy Lifestyle:
It is important to establish regular healthy routines such as exercising at the same time every day, going to sleep and waking up at the same time each night and morning, and maintaining a healthy diet. Ensure you get plenty of rest, as irregular sleep patterns can exacerbate bipolar disorder symptoms. Avoid using caffeine or recreational drugs.
6. Become Knowledgeable About Bipolar Disorder:
Get involved in understanding the symptoms, treatment options, and the impact bipolar disorder can have on friends and family. Consult a qualified mental health professional with questions and concerns. Read books about the disorder or attend lectures by experts. Learn as much about bipolar disorder as possible, as knowledge is a powerful tool in unraveling the mystery of the disease.
7. Enhance Life with Enjoyable Activities:
Make it a priority to engage in activities that bring feelings of joy, happiness, and accomplishment. Hobbies or activities that promote a sense of peace or relaxation are beneficial in managing the challenges of bipolar disorder.
A diagnosis of bipolar disorder does not have to mean the end of one’s community; rather, it can be considered a new beginning. One that, finally, provides an explanation and, most importantly, relief from some of the inexplicable and destructive behaviors an individual may exhibit, enabling them to live rich and fulfilling lives.
Bipolar Disorder in Children
Children with bipolar disorder experience unusual mood changes. 'Mania' and 'depression' are terms associated with the mood swings of the patient. When a child's mood is elevated, it is termed as 'mania', while a gloomy mood is referred to as 'depression'. Unlike typical children, these children display extreme highs and lows in their moods. In severe cases, the child may contemplate suicide. Such children require extra care and affection, often struggling in school and finding it challenging to carry out daily activities.
This disorder is not exclusive to children; it also affects teens and adults. However, it manifests differently in children, often referred to as 'early-onset bipolar disorder'. The severity in children is heightened as they experience this disorder during crucial periods of growth and development, which can have lasting effects.
Factors responsible:
Several factors can contribute to the disorder:
- Genetic predisposition can be a cause of bipolar disorder.
- Stress can also trigger this disorder.
- Brain infections can lead to its malfunction.
The factors responsible for this disorder are not always evident. Some scientists are actively researching to identify the causes.
Symptoms:
Bipolar disorder manifests in episodes, which can be manic or depressive.
During manic episodes, a child may:
- Display irritability.
- Speak rapidly about various topics.
- Experience anxiety.
- Have trouble concentrating.
- Discuss sex frequently.
- Engage in risky behaviors.
During depressive episodes, a child may:
- Feel persistent sadness.
- Experience stomach pain and headaches.
- Sleep either too much or too little.
- Eat excessively or have little appetite.
- Lose interest in activities they used to enjoy.
- Talk and think about death and suicide.
Other Possible Disorders:
Children with bipolar disorder may also exhibit:
- Involvement in drinking or drugs.
- Difficulty focusing on one task.
- Hyperactivity.
- Engagement in activities with potentially extreme consequences.
Diagnosis:
No blood tests or brain scans are required for diagnosis. The doctor primarily assesses the child's behavior and sleeping patterns. However, the doctor may conduct tests to rule out other diseases or disorders. They may inquire about alcohol consumption, family medical history, etc. including any history of anxiety and drinking.
Treatment:
Medication can help manage symptoms. However, it can be challenging for children due to the need for precise dosing. Identifying the right medication and dosage can be difficult.
Various types of therapies can help modify a child's behavior, enabling them to function better in daily activities.
The environment also plays a crucial role in shaping the behavior of these children. Hence, parents, family, and the broader community can significantly influence a child's behavior positively.
Suicide and Bipolar Disorder
Individuals diagnosed with bipolar disorder often experience episodes of deep depression. During these depressive episodes, people may exhibit varying behaviors. Some may sit and cry for hours, while others might engage in risky or dangerous activities. However, a significant number of people, including children diagnosed with bipolar disorder, contemplate or consider committing suicide during these severe depressive moods.Studies indicate that 75% of those diagnosed with bipolar disorder have considered taking their own life, and 60% have attempted to do so.
When contemplating suicide, individuals often become preoccupied with death or deceased individuals, discuss what would happen if they were to die, lose interest in previously enjoyed activities, engage in self-harming behaviors, and may claim to hear voices.
If someone displays these signs, 911 should be called immediately.
Bipolar disorder is a chronic condition that affects the chemical balance of the brain. In classic cases, it causes intense mood swings ranging from psychotic episodes of extreme highs to depressive episodes of debilitating lows, with relatively normal periods in between. It is essential to understand the facts about bipolar disorder to help oneself or others overcome this condition.
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