According to the National Institute of Mental Health, more than 2 million American adults have bipolar disorder, a severe brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. On July 14, 2005 our guest, Kay Redfield Jamison, PhD, author of "The Unquiet Mind," shared her perspective as both a psychiatric expert in the disease and someone living with bipolar disorder.

Bipolar Disorder Overview Bipolar disorder, with its extreme mood swings from depression to mania, used to be called manic depressive disorder. Bipolar disorder is very serious and can cause risky behavior, even suicidal tendencies.

Nearly 6 million American adults have bipolar disorder. Bipolar disorder is life-threatening -- yet hard to recognize.

Bipolar Disorder: What Is Bipolar Disorder?

Bipolar disorder used to be known as manic depressive disorder. It's a serious illness, one that can lead to risky behavior, damaged relationships and careers, even suicidal tendencies -- if it's not treated.

Bipolar disorder is characterized by extreme changes in mood (poles) -- from mania to depression. Between these mood swings, a person with Bipolar disorder may experience normal moods.

"Manic" describes an increasingly restless, energetic, talkative, reckless, powerful, euphoric period. Lavish spending sprees or impulsive risky sex can occur. Then, at some point, this high-flying mood can spiral into something darker -- irritation, confusion, anger, feeling trapped.

"Depression" describes the opposite mood -- sadness, crying, sense of worthlessness, loss of energy, loss of pleasure, sleep problems.

But because the pattern of highs and lows varies for each person, bipolar disorder is a complex disease to diagnose. For some people, mania or depression can last for weeks or months, even for years. For other people, bipolar disorder takes the form of frequent and dramatic mood shifts.

"There's a whole spectrum of symptoms and mood changes that have been found in bipolar disorder," says Michael Aronson, MD, a clinical psychiatrist and consultant for WebMD. "It's not always dramatic mood swings. In fact, some people seem to get along just fine. The manic periods can be very, very productive. They think things are going great."

The danger comes, he says, when the mania grows much worse. "The change can be very dramatic, with catastrophic results. People can get involved in reckless behavior, spend a lot of money, there may be sexual promiscuity, sexual risks."

The depressed phases can be equally dangerous: A person may have frequent thoughts of suicide.

Bipolar disorder is equally difficult for families of those affected. The condition is the most difficult mental illness for families to accept, Aronson tells WebMD. "Families can more easily accept schizophrenia, to understand that it is an illness. But when a person is sometimes very productive, then becomes unreasonable or irrational, it wreaks more havoc on the family. It seems more like bad behavior, like they won't straighten up."

If this rings true -- either for you or a loved one -- the first step in tackling the problem is to see a psychiatrist. Whether it's bipolar disorder or another mood-related problem, effective treatments are available. What's most important is that you recognize the problem, and start looking for help.

Bipolar Disorder: Who Gets Bipolar Disorder?

According to the National Institute of Mental Health, more than 2 million American adults have bipolar disorder. Unlike depression, bipolar disorder is equally common in men and women. Some studies have shown that bipolar disorder is genetically inherited, occurring more commonly within families.

Although the onset of bipolar disorder typically occurs in a person's early 20s, the first symptoms can appear in early childhood or even late in life. Children and adolescents can develop a severe form of this disorder, often in combination with attention deficit hyperactivity disorder (ADHD).

Children and Teens With Bipolar Disorder

Although bipolar disorder more commonly develops in older teenagers and young adults, it can appear in children as young as 6. In recent years, it's become a controversial diagnosis. Some experts believe it is rare and becoming over-diagnosed; others think the opposite. At this point, it's hard to be sure just how common it is.

So it's important not to jump to conclusions. If your child is diagnosed, you might want to get a second opinion before embarking on a treatment plan. Make sure you're comfortable with your child's health-care provider.

The Difference in Children
Diagnosing bipolar disorder in young children is difficult, because many of the symptoms are similar to those of attention deficit hyperactivity disorder (ADHD) or conduct disorders -- or even just normal, childhood behavior. One problem is that the medications used for ADHD are stimulants, which can trigger mania in children with bipolar disorder.

Young children in a manic phase might be more irritable than adults; they may be more likely to have psychotic symptoms, hearing and seeing things that aren't real. During a depressive episode, they might be more likely to complain of physical symptoms, like aches and pains.

One of the most notable differences is that bipolar disorder in children cycles much more quickly. While manic and depressive periods may be separated by weeks, months, or years in adults, they can happen within a single day in children.

Bipolar Disorder Therapy

Along with medication, ongoing psychotherapy, or "talk" therapy, is an important part of treatment for bipolar disorder. During therapy, you can discuss feelings, thoughts, and behaviors that cause you problems. Talk therapy can help you understand and ultimately master any problems that hurt your ability to function well in life. It also helps you stay on your medication -- and helps you deal with effects of bipolar disorder on your social and work life. It can help you maintain a positive self-image.

Types of psychotherapy used to treat bipolar disorder include:

Behavioral therapy. This focuses on behaviors that decrease stress.
Cognitive therapy. This type of approach involves learning to identify and modify the patterns of thinking that accompany mood shifts.
Interpersonal therapy. This involves relationships and aims to reduce strains that the illness may place upon them.
Social rhythm therapy. This helps you develop and maintain daily routines.

Bipolar Disorder: Emergencies and Suicide Prevention

Bipolar disorder may raise the risk of suicide. Mania and depression, the hallmarks of bipolar disorder, can be dangerous. During a manic phase, a person with bipolar disorder may be reckless. In rare cases, people with mania can become psychotic -- hearing or sometimes seeing things that aren't real. During a depressive state, things may seem so hopeless that life doesn't seem worth living. Mixed states are particularly dangerous: A person might feel depressed but keyed-up at the same time.

Suicide is a very real risk for people with bipolar disorder, whether they're in a manic or depressive episode -- 10%-15% of people with bipolar disorder kill themselves. Many more attempt suicide. It's an alarming statistic, but you have to remember that treatment greatly lowers the risk.

Any person with bipolar disorder needs to know what to do in an emergency.

Your condition -- by its very nature -- may prevent you from seeing things clearly. So when you're feeling well, make a plan with your friends and family for what to do in case you become unsafe. You should agree to:

Call your health care provider, therapist, or a suicide hotline right away if you feel suicidal.
Ask for help from friends or family members.
Stay safe until you can get help.
Remember that mood swings are temporary. Suicidal thoughts are a symptom of your condition. You will feel better with time.

Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.

Is It ADHD or Bipolar Disorder?

Children with bipolar disorder are often misdiagnosed as having ADHD, and ADHD medication won't help. Sometimes, children suffer from both.

Women With Bipolar Disorder

Research shows that women tend to experience more periods of depression than men. Women are more likely to develop bipolar II disorder -- meaning they never develop severe mania, but instead have milder episodes of hypomania that alternate with depression.

Women are also at higher risk for rapid cycling, which means having four or more episodes in one year. Varying levels of sex hormones and activity of the thyroid gland in the neck -- together with the tendency to be prescribed antidepressants -- may contribute to rapid cycling, researchers believe.

Bipolar Medications and Reproduction
Mood-stabilizing medications have been linked with women's reproductive problems -- specifically polycystic ovarian syndrome, a problem related to female hormones. This condition puts women at risk for infertility, diabetes, and possibly heart disease and cancer of the uterus. However, the condition is treatable with medications.

Before and during pregnancy, women should not take lithium and other bipolar medications, says Michael Aronson, MD, a clinical psychiatrist and consultant for WebMD. "The interesting thing is, sometimes pregnancy by itself will stabilize someone with bipolar disorder. At other times, it can destabilize them. The best alternative for someone who is pregnant, who is having problems with depression or mania and cannot be placed on an adequate dose of medication, is using ECT [electroconvulsive therapy]. It's very effective and it's safe."

Women planning to become pregnant should talk with their psychiatrist about their plans. They should never stop taking their medications before talking with their doctor.

Bipolar Medications and Menopause
The hormone fluctuations of perimenopause and menopause can cause mood disorders in any woman -- not just those with bipolar disorder. However, for those already having troubles with major depression, bipolar disorder, or anxiety disorders there usually is an increase in symptoms during this time. Especially during perimenopause, women may be especially vulnerable to depressive symptoms because of declining estrogen levels.

During menopause, hormone therapy may help. A change in antidepressant or mood stabilizing drug also may be the answer. With either individual or group therapy, women can gain support and insight into life transitions that may be adding greater stress to their lives, making their depression worse.

Loving someone with bipolar disorder

The bipolar disorder like any other kind of serious illness can cause problem for family members and friends. When living with someone who experiences extreme and uncontrollable mood swings, it can be very stressful and there are a series of cases about misunderstandings and confrontations.

Abuses of drug and alcohol are very common among people with bipolar disorder and these abuses can make symptoms more severe. These substantial abuses may be a sign of a lack of judgment which is brought by the illness or a self-medication act by the patient. This why experts find it very important to recognize such problems in bipolar patients and ensures that they are treated by specialists as soon as possible before it becomes severe.

Effective management of substance misused has two benefits:

        It either minimizes or prevents the impact negativity of alcohol and drugs on the sufferer and their family.

        Increases the successfulness of bipolar disorder treatment

The penalty of a person with bipolar sufferer has to pay for the euphoric high is a rolling low. It also just as hard to cope with among family and friends. During the manic stage, a sufferer can be the soul and life of the party and the other times, they rather withdraw into themselves.

Bipolar disorder patients tend to be restless or irritable unable to enjoy their usual activities, disturbed eating patterns and sleep. These mood swings can be very upsetting among family members, most specially children who might feel that they have done something wrong to cause these mood swings.

FOR I HOPE THIS CAN GIVE SOME PEOPLE AN IDEA OF WHAT BIPOLAR IS !