Basics
Bipolar disorder, also known as manic-depressive illness, is a psychiatric disease characterized by periods of abnormally elevated moods, often followed by episodes of depression. An individual with manic-depressive illness has episodes of mania characterized by an abnormally elevated mood, sleeplessness, racing thoughts, and pressured speech. In severe cases, thoughts become increasingly chaotic, and may become completely removed from reality. Without treatment, the disorder often has disastrous consequences: during manic episodes, peoples' actions may cause them to lose jobs, destroy relationships, go into debt, and even put themselves into dangerous situations. Hospitalization is sometimes required to prevent such consequences or suicide.
Cycles of manic and depressive episodes may occur occasionally or several times a year depending on the individual. Most people feel no symptoms between episodes. If untreated, episodes generally become progressively more frequent and severe. Medications and psychotherapy help to stabilize moods and alleviate symptoms.
Bipolar disorder affects about 1% of the adult population. Manic depressive illness is recognized worldwide, and is about evenly distributed between men and women. The disorder typically begins in adolescence or early adulthood.
Causes
Manic-depressive illness is known to have a strong genetic basis. Bipolar disorder tends to run in families. More than two-thirds of people with the disorder have a close relative with it or with depression. Twin studies also support the genetic basis of the disorder: both members of a set of identical twins are more likely to have depression (33%-90%) than both members of a set of non-identical twins (5%-25%). Although the exact pattern of transmission remains unknown, some genes have recently been identified that are associated with the disease. It appears that multiple genes are involved, a particular mix of which determines the various features of the illness.
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I'm Shereen A. Gharbia, PharmD. Welcome to PDR Health!
