Bipolar disorder, also known as manic-depressive illness, is quite prevalent in USA and the numbers are on a rise with the stressors of life on a rise.

What is bipolar disorder?
Bipolar disorder is a mental illness in whish one faces unpredictable mood swings ranging from depressive symptoms to manic symptoms. It is not necessary that a person has depression to be labeled as bipolar disorder, episodes of mania are sufficient. The most frequent age of onset is between 20 and 30 years but the variations are still present.

What are different types?
There are basically two different types of bipolar disorder type I or type II based on the amount of depressive and manic episodes. For characterizing a person as full-blown mania one should have the symptoms of mania for one week and of depression for two weeks.

How to diagnose Bipolar disorder?
To diagnose bipolar disorder one should have symptoms of mania or symptoms of mania and depression. The symptoms of mania are unrestrained buying sprees, talkativeness, inflated self-esteem, flight of ideas, sleeplessness, distractibility, etc.
To diagnose depression the symptoms are recurrent thoughts of death, insomnia, loss of energy, weight loss, psychomotor agitation, markedly diminished interest, etc.


What are differential diagnoses?
The differential diagnoses are hyperthyroidism, AIDS, Huntington’s, Wilson’s disease, alcohol abuse, etc.

What is the cause?
The cause is not very well understood but it is hypothesized that patients are genetically predisposed. Some give the theory of deficiency of some chemical transmitters. Others give the theory of neurostructural changes.

What is the management?
According to the physicians it is a disorder in which the patient comes to the physician by himself for his problems. For treating the bipolar disorders the treatment options available are lithium, carbamazepine (Tegretol) and valproic acid (Depakote). The side effects of using lithium are fine tremor, hypothyroidism, and neutrophilia besides others. The main problem with lithium is that its blood level should be monitored. Also the effects of it wont appear until 7-10 days of treatment. Carbamazepine has the side effects of rashes, hyponatremia, agranulocytosis, etc. Valproic acid has the adverse effects of tremors, pancreatitis, liver problems, etc.
Besides the medications there are certain other treatment modalities available such as cognitive behavior therapy, yoga therapy and herbal medicines. Through the cognitive behavior therapy the subjects learn to change the negative thoughts. Yoga therapy, thing primarily of the east but now gaining good ground in the west, aims at channelising positive energy throughout the body. As these therapies are not inducing certain chemicals into the body, they are said to be without any side effects.

What are the precautions?
Because of the side effects profile of all the drugs and way the patients behave, the physicians should be extra alert. It is said that the most important time to look after the patient is when he is recovering because it is the time when he is getting energy and hence he can fulfill his thoughts of suicide.