Bipolar disorder

Georg Cantor, a famous 19th century mathematician suffered from depression, from 1884 to the end of his life. Some people have suggested these problems may have been episodes of bipolar disorder.

Bipolar disorder (also known as manic depression) is a mental illness where a person will have repeated, long-lasting feelings (episodes) of high (mania) and low mood (depression). It may occur with or without cycles of normal mood, called euthymia. A mixed episode occurs when both mania and depression are present at the same time. People with bipolar disorder experience the whole spectrum of emotional feelings from unimaginable grief to full blown euphoria whereas normal people experience only a section of the spectrum of emotional feelings somewhere between extreme grief and extreme happiness.

Symptoms

"Bipolar" literally means "two poles" or two extremes in how much energy the brain has. Sometimes, a person can experience something called mania. Mania is when a person's brain goes into a high-energy state. When in a high-energy state, mania can cause extreme emotions such as panic attacks or extreme happiness such as euphoria. This feeling is often followed by a period of depression, which is a low-energy state. A person who is depressed may act sad or hopeless. People with bipolar disorder switch between these two states.

Mania

People who are in a manic state are often over-confident and very optimistic. This can cause them to take large risks and do things that are not normal for them to do. Manic episodes last for at least a week, but can last as long as three to six months. They are usually followed by a depressive episode. A person who is manic may talk very quickly with no pauses, have thoughts that change very quickly, or act without thinking. They may also experience psychosis, where they cannot tell what is real and what is not. They may think that they are unstoppable or that they are on a mission for God. Mania may become so severe that it can affect the person’s ability to work or interact with others. Every person is different, so it is important to remember that these things do not happen to all people with bipolar disorder.

Hypomania

Hypomania is a less extreme version of mania. Someone who is hypomanic will have symptoms similar to mania. They may have increased energy and may deny that anything is wrong. A hypomanic episode may last from a few days to a few months.

Depression

People who are in a depressive state are often sad and pessimistic. They may lose interest in activities they usually like, or become isolated and lonely. Other symptoms include anxiety, hopelessness, changes in sleep, and suicidal thoughts. A depressive episode can last from a few weeks to several months. When bipolar disorder develops at a young age, the first few episodes are usually depressive. Because a manic or hypomanic episode is needed to diagnose bipolar disorder, some people are diagnosed with major depression at first.

Diagnosis

Bipolar disorder is an illness that can show in different ways. It is often diagnosed in adolescents or young adults. A few subtypes have been identified; these subtypes mostly describe the nature of the "episodes" of the disease:

• Bipolar I disorder: A person with bipolar I has had at least one manic episode. Depressive episodes also occur in people with bipolar I, but are not required for a diagnosis.
• Bipolar II disorder: A person with bipolar II has had no manic episodes, but at least one hypomanic episode. They have also had at least one major depressive episode.
• Cyclothymia: A person with cyclothymia has had both hypomanic and feelings of depression. These feelings of depression are not extreme enough to be considered a depressive episode.

Causes

The exact cause of bipolar disorder is unknown. It is estimated that there is a 71 percent chance of bipolar disorder passing from parent to child. If one identical twin has bipolar disorder, there is a 40 to 70 percent chance that the other will develop bipolar disorder in their lifetime. MRI studies have shown that certain parts of the brain responsible for mood regulation are larger in bipolar patients. It is also possible for bipolar disorder to develop after a stroke, brain injury, or certain infections.

Treatment

Light therapy is one of several approaches to treating bipolar disorder.

Like most mental illnesses, there are ways to treat bipolar disorder. The most common way to treat bipolar disorder is by using medications called mood stabilizers. These medicines prevent and control the manic and depressive episodes. One of the most common mood stabilizers is lithium. Therapy can also be used to control the symptoms. The same treatments and medicines do not work for everyone, and it is not uncommon for people to have symptoms return if they stop taking medication. Things like this can make bipolar disorder a difficult illness to live with, but educating patients about it makes it easier. Sometimes, people need to be treated against their will. Patients may be thinking about or have tried to commit suicide, or they may be unable to see their situation properly. In many cases, teaching people about their disease helps. When they have gone through the phases of the illness a few times, they often see that treatment can make their life easier.

Further reading

• Genetics links between five major psychiatric disorders: autism, ADHD, bipolar disorder, depression, and schizophrenia per recent study.doi:10.1016/S0140-6736(08)61345-8
• 5 Disorders Share Genetic Risk Factors, Study Finds February 28, 2013 The New York Times
• Psychiatric Disorders Linked Genetically February 27, 2013 WSJ

Bipolar Disorder Media

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  An 1892 color lithograph depicting a woman diagnosed with hilarious mania

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  An 1858 lithograph captioned 'Melancholy passing into mania'

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  'Melancholy' by William Bagg, after a photograph by Hugh Welch Diamond

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  Brain imaging studies have revealed differences in the volume of various brain regions between patients with bipolar disorder and healthy control subjects.

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  Since Emil Kraepelin's distinction between bipolar disorder and schizophrenia in the 19th century, researchers have defined a spectrum of different types of bipolar disorder.

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  Simplified graphical comparison of bipolar I, bipolar II and cyclothymia

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  Lithium is the only medication approved by the FDA for treating mania in children.

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  Lithium is often used to treat bipolar disorder and has the best evidence for reducing suicide.

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  Burden of bipolar disorder around the world: disability-adjusted life years per 100,000 inhabitants in 2004*

  *     230*
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  German psychiatrist Emil Kraepelin first distinguished between manic–depressive illness and "dementia praecox" (now known as schizophrenia) in the late 19th century.

References

• Dauben, Joseph W. (1979), Georg Cantor: his mathematics and philosophy of the infinite, Boston: Harvard University Press, ISBN 978-0-691-02447-9.
• Dauben, Joseph (1993), "Georg Cantor and the Battle for Transfinite Set Theory", Proceedings of the 9th ACMS Conference (Westmont College, Santa Barbara, CA), pp. 1–22, archived from the original on 2015-01-08, retrieved 2013-05-01. Internet version published in Journal of the ACMS 2004.

Other websites

• BipolArt - Proof that a high proportion of bipolar people are creative. A fantastic collection of drawings, paintings, inkings, photographs, music, etc. by artists who share this illness.
• Allpsych