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About Bipolar Disorder

Bipolar disorder is a mental illness characterized by the presence of at least one manic, mixed, or hypomanic episode. The presence of a Major Depressive Episode is very common in the lifetime of individuals with Bipolar Disorder (more than 90% of these individuals have at least one Major Depressive Episode in their lifetime), but it is not necessary to experience a depressive episode.

Some facts about bipolar disorder:

  • An estimated 1-3% of the general population has bipolar disorder
  • Bipolar disorder affects males and females at approximately equal rates
  • The peak age of onset of bipolar disorder is between the ages of 15 and 25

Treatments for Bipolar Disorder

Treatments are available that control the disorder either by stopping episodes of depression and mania or by preventing or lessening the severity of these episodes.

Treatments for stopping episodes of depression or mania include medications and electroconvulsive therapy. If a person becomes so depressed or manic that he might hurt himself or others, brief hospitalization is also an option. While a person is recovering from an episode, he or she may attend a day treatment program or stay in a halfway house. He or she may also benefit from supportive psychotherapy.

Treatments for preventing or lessening the severity of episodes of depression or mania include medications and psychotherapy.


How can medications help control bipolar disorder?
Multiple medications have been found to help control bipolar disorder.

Some can be used to stop mania, and they may also help stop or lessen the severity of depression. These medications are also used to prevent or decrease the recurrence of episodes of mania or depression.

Some people have good responses to medications, alone or in combination. In many others, the symptoms do not completely go away. They do, however, get less intense and more manageable so that the quality of the person's life improves. Often, people need to take more than one medication at a time for maximal benefit.

More information on specific uses and side effects of medications is available in pamphlets from your physician.


How can psychotherapy help control bipolar disorder?
Cognitive-behavioral therapy, or CBT, can help enhance the effectiveness of medications in controlling bipolar disorder. It can be offered in individual or group format. CBT can help people learn to monitor and control the symptoms of bipolar disorder, to reduce obstacles to medication adherence, and to cope with stressors that may make new episodes more likely.

Cognitive therapy (often included as one component of CBT) is an approach where patients learn to identify and modify the patterns of thinking that accompany mood shifts. For example, people who are depressed may see themselves, their world, and their future in an extremely negative, grim, pessimistic way. They may feel that all is doomed, that they are bad or worthless, and that nothing will ever go right. This way of looking at the world is a distortion which can exacerbate their depressed feelings.

At the opposite extreme, people who are manic or hypomanic tend to see themselves, their world, and their future in a very positive, optimistic, "rose-colored" way. They may feel that luck is on their side, that they are extremely capable or powerful, and that nothing can go wrong. This outlook is also a distortion, and it can lead to unwise or risky choices and serious problems. In cognitive therapy, people can learn to monitor their thoughts and test them out logically in order to counter the distortions that go with depressed and elevated moods.

Insight-oriented psychotherapy can help people with bipolar disorder to address the problems that come up in connection with having the disorder and to deal with the feelings that arise (including grief, anger, fear, etc.). This approach to therapy is most effective during periods when a person's mood is relatively stable. It is best for a person with bipolar disorder to work with a therapist who is knowledgeable and skilled in assessing and treating bipolar disorder. This way the therapist can work with the person to monitor mood and recognize any emerging symptoms. In this kind of therapy, periods of stable mood can be used to work on general life issues and to process feelings about the disorder and its effects. At points when symptoms flare up, the focus is changed to coping with and controlling the symptoms.

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