Bipolar Disorder

Bipolar Disorder is a type of affective disorder that involves unusual shifts in mood state, energy level and behavior. These dramatic fluctuations may alternate between depression, normal mood, and elation and/or irritability. The effects of Bipolar Disorder frequently contribute to damaged relationships, poor academic performance and other life difficulties. Bipolar Disorder ranges in severity. Bipolar I Disorder, which is characterized by recurrent episodes of both manic and depressive episodes, is the classic form of the disorder. Bipolar II Disorder is more common than Bipolar I, and consists of recurrent depressive episodes with at least one episode of “hypomania,” which is less severe than a manic episode.

Prevalence

According to the National Institute of Mental Health, more than 2 million Americans or about 1% of the population 18 or older have Bipolar Disorder. Bipolar Disorder tends to run in families, and is believed to be a biologically based brain disorder. It often emerges during adolescence or early adulthood, and is very commonly first diagnosed during the college years. Because it is a chronic disorder, early diagnosis of Bipolar Disorder is very important as it needs to be appropriately treated in an ongoing way. The first episode of Bipolar Disorder may be triggered by stress. College students are away from home for the first time, leading to adjustment issues such as loneliness, changes in sleep schedule, daily habits, and the abuse of drugs or alcohol. These kinds of stressors at college may trigger the onset of Bipolar Disorder in a student who is at genetic risk.

Symptoms

The elevated mood states of Bipolar Disorder are referred to as manic or hypomanic episodes. Manic episodes occur in Bipolar Disorder I and are more severe and disruptive to the individual’s functioning than hypomanic episodes. Symptoms of both mania and hypomania may include:

  • Excessively high or euphoric mood, and/or extreme irritability
  • Inflated self-esteem or unrealistic beliefs in one’s abilities
  • Decreased need for sleep
  • Racing thoughts, and talking that is fast, pressured, or jumps from one topic to another
  • Distractibility and inability to focus
  • Increased activity level
  • Poor judgment and risky behavior, such as reckless spending, increased sexual activity or abuse of substances
  • Provocative or aggressive behavior
  • Denial that there is a problem

During the depressed phase of Bipolar Disorder, the following symptoms may occur:

  • Feeling down or depressed much of the day
  • Lack of interest or pleasure in daily activities
  • Social withdrawal
  • Loss of appetite, overeating or digestive problems
  • Excessive sleeping, insomnia or early morning awakening
  • Loss of sexual desire
  • Physical complaints, such as headache, backache or other unexplained pain/discomfort
  • Physical agitation or restlessness
  • Chronic fatigue, loss of energy or lack of motivation
  • Feelings of hopelessness, worthlessness, guilt of selfblame
  • Difficulty concentrating, impaired memory, indecisiveness or confusion
  • Neglect of physical appearance or hygiene
  • Thoughts of death or suicide

Symptoms of mania and depression sometimes occur together in what is called a mixed episode. In a mixed episode, a person may feel depressed and hopeless, while at the same time being agitated and energized. Severe cases of mania or depression in Bipolar Disorder can include symptoms of psychosis, such as hallucinations (e.g. hearing voices, believing something is there that isn’t) or delusions (persistent, false beliefs such as being convinced he/she leads the country, is a famous musician, etc.).

Treatment

A trained mental health professional can diagnosis Bipolar Disorder on the basis of symptoms, the course of the illness and family history. It is important to seek help for Bipolar Disorder as it is a lifelong disorder and is likely to worsen without treatment. Without effect treatment, manic and depressive episodes tend to occur more frequently (“rapid-cycling”) and are more severe. Fortunately, effective treatment can greatly assist the individual with Bipolar Disorder to lead a healthy, productive life. A combined treatment of medication and psychotherapy, in which the individual learns how to track and manage symptoms, is typically very effective in stabilizing the moods of Bipolar Disorder. Bipolar Disorder is usually treated with a class of medications known as “mood-stabilizers” (e.g. Lithium; “Depakote”). Sometimes, the mood stabilizer may be combined with an anti-depressant medication. It is important that a psychiatrist, who is an expert in psychiatric medication, be prescribing and closely monitoring medication for any kind of mood disorder as anti-depressant medications may trigger a manic or hypomanic episode in an individual with a genetic predisposition to Bipolar Disorder.

Counseling is a very valuable tool in coping with Bipolar Disorder. Villanova students are invited to schedule confidential counseling sessions with an experienced, caring psychologist. Appointments can be made by stopping by the University Counseling Center at 206 Health Services Building or by calling 610-519-4050.