Bipolar disorder

Bipolar disorder is the established short name for bipolar affective disorder (BAS). BAS is a mental illness that belongs to the mood disorders (affective disorders).

The disease manifests itself through extreme, bipolar fluctuations that affect mood, drive and activity level. These swings occur in phases and extend far beyond the normal level. Those affected oscillate back and forth between depression and mania without being able to control these changes voluntarily.

Between the acute episodes of the disease, depending on the form of progression, there may be more or less long periods in which the affected person has no complaints at all. Drive and emotional life are then subject to the "normal" fluctuations again. BAS occurs in varying degrees of severity. Individuals with bipolar disorder may appear to have a charismatic personality during the manic episode. However, possible negative social consequences of the disorder for the individual can be very severe.

Depending on the course, stabilisation can be achieved through treatment if the disorder is recognised at an early stage. In addition to the use of medication, psychotherapy is recommended as a supplement, but not as an alternative. A bipolar disorder does not suddenly appear in a previously completely healthy person, but develops gradually.

The socioeconomic impact of this disorder on the national economy was $45 billion in 1991 in the United States alone. According to the World Health Organization, bipolar disorder is one of the ten most debilitating diseases in the world. The increased risk of suicide should also not be underestimated: approximately 25% to 50% of all people with bipolar disorder make at least one suicide attempt. About 15 % to 30 % of those affected kill themselves.

Designations

Until a few years ago, bipolar disorder was usually called manic-depressive illness, manic-depressive psychosis or manic-depressive insanity (coined by psychiatrist Emil Kraepelin in the late 19th century). Colloquially, it is sometimes called manic depression, which is misleading.

The terms manic-depressive illness or manic-depressive disease are also commonly used as synonyms and are generally better understood by the public. However, they suggest that it is a temporary and curable change, which again is misleading. A term often used for bipolar disorder among doctors and authorities is bipolar psychosis or affective psychosis.

The word psychosis is used differently in the professional world: Some subsume only delusions under it, others use the term for all serious mental disorders (to which bipolar disorders certainly belong).

The term Bipolar Disorder originates from Karl Kleist's distinction - since 1911 - between unipolar and bipolar mood disorders (affect disorders). "Bi-" is a prefix of Latin origin meaning "two", and "pole" is understood to mean one of two (extreme) ends. One end is considered the extreme opposite of the other (see History of Research section).

Description

Bipolar affective disorder is characterized by an episodic course with depressive, manic, hypomanic, or mixed episodes:

• Depressive phases are characterized by above-average depressed mood and reduced drive. In the case of severe depression, suicidal thoughts may occur.
• A manic episode is characterized by increased drive and restlessness, often accompanied by inadequately exuberant or irritable mood. In the process, the ability to check reality is sometimes severely impaired, and sufferers can get themselves into a lot of trouble.
• Hypomania is defined as mania that is not severe, typically without serious social consequences. However, hypomania is already significantly above a normal activity and/or mood swing.
• A mixed episode is characterized by the simultaneous or rapidly alternating occurrence of symptoms of mania and depression. For example, increased drive coincides with a depressed mood.

Most often, bipolar disorder begins in adolescence or early adulthood. Often it is not recognised by both sufferers and medical professionals until many years after onset. Often, therefore, a long period of suffering has already existed before treatment begins.

Since the symptoms have a strong impact on decisions and relationships, at the time of diagnosis, life paths can already be significantly influenced by them, especially since they usually begin at a young age, when the personality is not yet consolidated. Often there are problems in education, work and family life or abrupt changes in the life course. If the disorder is recognised, the effects can possibly be alleviated with appropriate treatment by specialists.

Bipolar disorder is often associated with creativity. Those affected include many successful people. The increased drive during hypomanic phases can inspire unusual and daring projects, and goals are often pursued with great commitment.

Bipolar disorder is a fairly common disorder: if milder cases are also taken into account, according to some studies, three to four percent of the population in industrialized countries are affected by it at some point in their lives.