Living With Bipolar Disorder

Question: What is bipolar disorder and how is it treated? Is it hereditary, and does it affect both men and women? At what age does it usually appear?

Dr. Hibberd’s Answer:

Bipolar disorder does have genetically inherited characteristics and is hereditary. Its precise genetic loci have not been isolated.

Bipolar disorder affects more than 5 million Americans. Significant environmental factors may influence its expression and exacerbations. It is seen in all races and both sexes equally.

This disorder is most often seen first in adolescence and manifests in others usually by the age of 30 to 40 years. It may be induced into remission, but it is not curable.

Bipolar disorder is a psychotic disorder; affected individuals may not always be aware of their actions. Psychosis is a loss of reality testing, and some who suffer from it may actually become certifiably incompetent without much warning. Substance abuse, illicit drug use, and alcoholism are more prominent in bipolar individuals as they struggle to manage the disorder.

Bipolar implies both extreme highs and extreme lows in mood resulting in behavior that may become life-threatening if the disorder is not treated properly.

An extraordinary number of sufferers of bipolar disorder are very creative and intelligent, except they often lack insight into their own condition. Many deny their bipolar affliction and incorrectly refer to themselves as adults with attention deficit hyperactivity disorder.

Medical management is sometimes neglected until their behavior becomes threatening to themselves or others, and they are brought to care involuntarily.

Treatment involves using a baseline mood stabilizing medication such as Depakote, an anticonvulsant; lithium, which is not used as often now due to toxicity concerns; and other major tranquilizer medications with other agents used to modify neurohormonal receptors. Treatment with antidepressants alone such as Prozac and other newer antidepressants is fraught with hazard and may precipitate a manic spell.

Bipolar treatment involves skilled pharmacological management and supportive therapy. It is best managed by a professional psychiatrist. Hospitalization in an acute-care setting may be necessary when this condition flares, and close family support is mandatory.

Untreated, bipolar disorder can be devastating both to the individual and his/her family, and suicide and other self-destructive behaviors are not uncommon.

If you are or you think you may be bipolar, I urge you to seek professional consultation. The medication groups we use now are a far cry from the older toxic medications used 30 years ago. Most bipolar patients can lead a very rewarding and comfortable life as long as they maintain their care under appropriate psychiatric management and supervision.