Of all mental illnesses, bipolar disorder is, perhaps, the most mysterious.
Often referred to as the dark side of creativity, it disproportionately affects people otherwise known as uncommonly gifted or even geniuses.
The list of celebrities known to have bipolar disorder is long and glorious: writers Edgar Allan Poe, Ernest Hemingway, and Jack London; artists Vincent Van Gogh, Edward Munch, and possibly Picasso; movie stars Robin Williams, Catherine Zeta-Jones, and Ben Stiller
Winston Churchill was remembered by his friends as either “at the top of the wheel of confidence or at the bottom of an intense depression”.
Florence Nightingale, a social reformer renown as the founder of modern nursing, shifted between “periods of extreme productivity, creativity, and insights that go beyond what would normally be possible, and bouts of severe depression” for most of her life.
And even the genius of geniuses, Albert Einstein, was known to experience periods of extreme productivity and deep despair, which nowadays would most likely be diagnosed as bipolar.
The Cost of Bipolar Disorder
The cost of being a genius is high.
Make no mistake — bipolar disorder is a dangerous illness. It causes serious shifts in mood, energy, thinking, and behavior—from the highs of mania on one extreme, to the lows of depression on the other.
More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with the person’s ability to function.
Manic Episodes and Episodes of Depression
Manic symptoms include impulsively quitting a job, charging up huge amounts on credit cards, or feeling rested after sleeping two hours.
He/she may engage in reckless sex or carelessly abuse drugs and alcohol and may enter into psychosis, being unable to tell the difference between reality and their hallucinations.
During a depressive episode, the same person might be too tired to get out of bed and full of self-loathing and hopelessness over being unemployed and in debt. At the extreme, a person with untreated bipolar disorder is substantially more likely to commit suicide.
There’s also a type of episode called hypomania. The difference between mania and hypomania is one of severity. This is usually seen in bipolar II disorder. During a hypomanic episode, a person may feel the same symptoms of mania but will not become psychotic or hallucinate.
Types of Bipolar Disorder
There are several different types of bipolar disorder.
Bipolar I disorder is the most severe, with both manic and depressive episodes.
Bipolar II is less severe, with hypomania and depression.
Cyclothymic disorder is similar to bipolar II but has episodes that are shorter and even less severe.
Bipolar | More Common Than Expected
According to the National Institute of Mental Health, bipolar disorder affects approximately 5.7 million adult Americans or about 2.6% of the U.S. population.
Although bipolar disorder is equally common in women and men, research indicates that approximately 3X as many women as men experience rapid cycling.
Women may also have more depressive episodes and more mixed episodes than do men with the illness (Journal of Clinical Psychiatry, 58, 1995).
How Bipolar Disorder Is Diagnosed
To diagnose bipolar disorder, a mental health professional will first ask a series of questions to see if you’ve ever experienced the symptoms of bipolar disorder to see if you have depressive symptoms or episodes of mania.
If it’s the case that you have experienced mania or depression that’s in line with the symptoms of bipolar disorder, then your physician will come up with a treatment plan unique to your needs.
Bipolar Disorder | Causes, Triggers, and Treatment
Unfortunately, the mechanism of bipolar disorder remains mysterious. We know that genetic factors play a significant role.
About half of the people with bipolar disorder have a close family member with a mood disorder. A person who has a parent with bipolar disorder has a 15% to 25% chance of having the condition, which is much more than population average of 2% to 3%.
And yet, although a person with a bipolar identical twin (same genetic material) is much more likely to have the same condition, it is certainly not always the case.
Bipolar and Neurotransmitters
We know that several complex chemicals, so-called neurotransmitters or chemical messengers in the brain, such as norepinephrine, serotonin (and probably many others), are involved.
Yet how exactly they interact and what triggers their malfunction that manifests in abnormal mood swings is still not fully clear.
Bipolar at Earlier Ages
It is also remarkable that bipolar disorder is appearing at increasingly early ages. It is possible that this apparent increase in earlier occurrences is due to advanced diagnostic capabilities that were not available in the past.
But it could also be possible that this change in the age of onset may be a result of social and environmental factors. We simply don’t know.
Is There Hope for Those Suffering from Bipolar?
Does it mean that there is no hope for the people who suffer from bipolar? Not at all!
Several treatments are already available that can be used to control the mood swings, including talk therapy and medication.
Some patients respond to older medications, such as lithium, which are reliable and well-tolerated by most.
There are newer, more expensive medications that may provide greater symptom relief, but also have greater side effects. In some cases, combinations of different drugs are prescribed.
No doubt, eventually the puzzle of bipolar will be solved and the genius who will find the solution will be named a Nobel Prize winner.
For now, finding the right treatment remains a matter of identifying medication that will work for a given patient. What works for one may not work for the others.
To be successful, doctors need to have a broad spectrum of treatments. This is why the pharmaceutical industry is actively developing new medications, promising even more effectiveness with, hopefully, fewer side effects.
Several of these are in clinical trials now.
Learn More About Clinical Trials for Bipolar Disorder
Click to learn more about Boston Clinical Trials and sign up for a future Bipolar study.
Dr. Stolyar is Associate Director of Psychiatry at Boston Clinical Trials. He has conducted over thirty clinical research studies in the areas of mental health and behavioral disorders