Bipolar Disorder is a disabling and recurrent psychological disorder that
affects about 1 percent of adult Americans, over 2 million, and is characterized
by extremes of mood. This illness was formerly called "Manic-depression."

Many readers will remember "Manic Depression" as a song by Jimi Hendrix. "Manic
Depression has captured my soul," Jimi sings over his psychedelic guitar-playing
track. As a psychologist I wish that Jimi had consulted me when he was writing
the song. I would have told him…, well, read on.

Bipolar Disorder is characterized primarily by an inability to regulate mood
states and a tendency to experience extremes of both depression and mania. There
are variations, for example, some people have less mania, but experience
excessive irritability. These people can shift unexpectedly and stay in high or
low gear for protracted and disabling periods of time. The diagnosis is given
most often to people between the ages of 15 and 30 years.

This is a life-threatening illness, with as many as one in 5 victims committing
suicide and is complicated by the fact that many Bipolar individuals are not yet
in treatment. Bipolar disorder seems to come in different forms for males and
females, with the males often presenting first with mania, but women seeking
treatment for the depressed pole first.

Besides that, Bipolar Disorder may come in different phases, with some people
having more classic mania, followed by either normal or depressed states and
others having their polarity shift from depression to more normal states. More
severe variations include rapid and mixed states with the mood instability
shifting quickly or having simultaneous symptoms of mania and depression. In
other words, this condition is serious and needs the care of an astute and
attentive clinician.

The word "mania" is derived from one of the Greek root words for "mind" and in
particular seems to reference back to one of the nymphs who attended the
Dionysian rituals of those ancient Greek times — from this we get the sense of
maniac as one who acts like a madman.

So, the original maniac was quite a party animal?

Speaking of partying, everybody knows what it's like to feel really good or even
"high" at times — in psychological terms, this is called "euthymia." When you
feel high or energized for a protracted period of time, this is called
"hypomania" — which is a milder form of mania. When the high starts to keep you
up through the night or is associated with energy that has no off switch, then
it's called mania, or a manic episode.

In manic episodes a person may engage in excessive and risky behavior. An
otherwise well behaved person may become sexually promiscuous, go on spending
sprees, gamble, clean the house all day or all night, or make very ill advised
investments. Other typical symptoms of mania include racing thoughts, talking
excessively fast, distractibility, or inflated feelings of importance. In more
severe manic states, actual psychosis can take place, with hallucinations or
delusions. Bipolar delusions typically follow the mood: in the manic state,
themes like grandeur and excess are common; in the depressed state themes of
worthlessness or emptiness rule.


Bipolar Disorder is presently a life-long condition. We know that there's a
genetic link because relatives of family members are more prone to developing
it, but it's clear that some other factors have to trigger the onset of the
first episodes. Once manic episodes begun, they become recurrent and the primary
goals for treatment are to reduce the number of episodes and to shorten the
length and severity of episodes.

We do that by combining medication and psychosocial therapies. Lithium, which is
actually an elemental salt, was discovered to have anti-manic properties. This
was actually figured out by a veterinarian. This is a medicine that has to be
dosed and monitored carefully by a psychiatrist. In recent years a number of
additional anti-manic medications have been developed, many of which were first
used to treat seizures. Some researchers are hypothesizing that there may be an
explanation why anti-seizure drugs regulate manic states: this seems to lie in
the basic physiology of the way that the brain controls its own levels of
activation.

It's very important that people with mania or some of the symptoms that we've
mentioned receive a medical work up and that those with Bipolar Disorder get
into treatment and stay in treatment as needed. Psychotherapy and Family-based
therapy approaches can be vital, providing an understanding of the condition and
for teaching what we know about controlling these internal states. Sleep and
activity regulation, stress management, and other strategies can help a lot to
reassert control when things start to take off. Everyone should help with
treatment compliance and early detection of the need for medication changes to
deal with potential relapses.

This is one of the serious brain-based mental disorders with serious
complications, including a lot of substance abuse, some of which is no doubt an
attempt to re-regulate from the lows to the highs. Bipolar people need our
support and our compassion. When they're back in control, they're pretty much
like you and me.



Licensed psychologist Allan J. Comeau, Ph.D., is on the clinical faculty at UCLA
and a former president of the Inland Southern California Psychological
Association. Write to him at 2001 S. Barrington Avenue, Suite 304, West Los
Angeles, CA 90025.


V. thank you Dr. Comeau,
Sincerely yours,
Ryan



From the Middle Eastern
Lebanon - Beirut City


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