"It seems as though my mind has slowed down and burned out to the point of being virtually useless. I [am] haunt[ed] with the total, the desperate hopelessness of it all."

"Ideas are fast...all shyness disappears...people, things become intensely interesting...unbelievable feelings of ease, power, well-being...you can do anything."

"The fast ideas become too fast and there are far too many...overwhelming confusion replaces clarity...everything is now against the grain...you are irritable, angry, uncontrollable, and trapped."

What is Bipolar Disorder?

The first bipolar episode often occurs in adolescence or early adulthood and may be triggered by a traumatic event such as the death of a family member. In between episodes, many people are symptom-free, while others are never free of symptoms. Once properly diagnosed and treated, people with BD can lead productive lives.

Symptoms of Bipolar Disorder?

Mania (the "high"): In this phase, the person experiences an abnormally elevated mood (lasting for a week or more), but they also experience at least three of the following symptoms:

1. Inflated self-esteem
2. Reduced need for sleep
3. Excessive talkativeness
4. Racing thoughts
5. Distractability
6. Activities done to excess (for example, spending money)
7. Pursuit of risky behaviors or activities

Depression (the "low"): Mania can quickly and without warning change to a depressive episode. In addition to a general sad mood, a person in the depressive stage may experience:

1. Loss of interest in activities they previously enjoyed
2. Changes in appetite resulting in weight gain or loss
3. Changes in sleep patterns resulting in difficulty sleeping or oversleeping
4. Agitation
5. Loss of energy
6. Trouble concentrating or thinking
7. Repeated thoughts of suicide or death

These episodes of mood changes can also be accompanied by:

1. psychosis: an altered mental state that is characterized by hallucinations (hearing or seeing something which is not really there). An example of a hallucination is seeing a large purple floating rat and believing it is real.
2. delusions: believing something about yourself that is not true. An example of a delusion is believing that you have the ability to fly.

How does BD affect the brain?

Reported changes in the brains of people with BD
	Decreases in the number and density of glial cells in the prefrontal cortex. Decreases in the number of neurons in part of the hippocampus. Increases in the levels of some neuropeptides in the hypothalamus. White matter hyperintensities: small abnormal areas in the white matter of the brain (especially in the frontal lobe) as seen using magnetic resonance imaging. These abnormalities may be caused by the loss of myelin or axons. Decreases in the size of the cerebellum. Reduced activity in the prefrontal cortex during the depressive stage.

What treatments are available?

Medications used for controlling seizures (anticonvulsants) work for some people; in particular, valproate and carbamazepine work in many cases either with lithium or as an alternative to lithium. Newer anticonvulsant drugs (for example, lamotrigine, gabapentin, and topiramate) are being studied to determine how well they work at combating the symptoms of BD.

Some antipsychotic drugs such as clozapine or olanzapine may prevent mania in some people with BD, but more research is needed to see if long-term use is safe and effective.

Is bipolar disorder in children the same as in adults?

1. Saying they want to kill themselves/saying they want to die
2. Trying to jump out of a moving car
3. Throwing tantrums/destructive rages that continue after the age of four

Pediatric cases (under the age of 18 years) generally are treated with lithium, but valproate and carbamazepine may also be used. Researchers are evaluating the safety and effectiveness of these and other medications in children and adolescents. Some studies have shown that valproate causes unwanted hormonal changes in teenage girls and polycystic ovary syndrome in some women. Mood-stabilizing medications must be used first, as treatment with stimulants or antidepressants alone can trigger mania or increased aggression. Modifying the child's environment, such as reducing stress, offering nutritional meals, and encouraging good sleep and exercise habits can help stabilize the child's moods.

Bipolar disorder is a serious, chronic illness. As with adults, it is important to have children examined by mental health professionals. For example, psychiatrists are medical doctors who specialize in mental illnesses and can prescribe medications. The criteria for diagnosis of bipolar disorder in children are the same as in adults.