Bipolar disorder: overview, symptoms, causes, and treatment

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).

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.