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June 28, 2012
What Is Bipolar Disorder?

What is bipolar disorder? Bipolar disorder, also referred to as manic depression or manic-depressive disorder, affects 1 in 20 Americans, so there’s a good chance it will affect someone in your workplace. With symptoms that can affect one's ability to function at work, this is an important health concern for employers. The first step you can take is to understand what bipolar disorder is. In a BLR webinar titled "Bipolar Employees: HR’s Legal and Practical Accommodation Roadmap," Maureen Duffy gave us the answer to that question.

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What Is Bipolar Disorder?

"Bipolar disorder is a brain-based condition that leads to episodes of mania and depression." Duffy told us during the webinar. "This condition causes changes in mood, energy, and activity levels … A mood disorder is a disorder that mainly affects mood. Its presentation is in terms of feeling states and emotional tone and what the prevailing state or quality of feeling is for a person at a given point in time."

Here are some other facts about bipolar disorder that Duffy gave us during the webinar:

  • It is equally common in men and women.
  • "There is a prevalence of about 2.6 to 3 percent in the adult population (which means that, in any given year, approximately 6 million Americans will have bipolar disorder)."
  • "Only around 55 percent of those with the condition receive treatment in any given year . . .a very low percentage."
  • "The peak age for onset of bipolar disorder is late teens or early adulthood, with the median age being 25, meaning 50 percent of first episodes happen before age 25 [and] 50 percent afterward."
  • "People with bipolar disorder have a much higher risk for other kinds of emotional or mental disorders, in particular substance misuse and anxiety disorders." This is called co-morbidity when a person has a mental illness along with a substance problem, and 30 percent of adults with a mental illness also have had a diagnosable alcohol and/or drug disorder in their lives. (Conversely, 53 percent of adults who have had substance abuse disorders have had one or more mental illnesses during their lifetimes.)

What are the Signs and Symptoms of Bipolar Disorder?

Bipolar disorder is a mood disorder that involves feeling states of mania and depression both, which makes it complicated. It’s important to understand that the experience and condition of mania is quite different to the experience and condition of depression.

Mania symptoms include:

  • Elevated mood (euphoria and/or agitation)
  • Flight of ideas
  • Pressured speech
  • Increased energy
  • Decreased need for sleep

These mania symptoms manifest as these feelings or noticeable actions:

  • Feeling high or "weller" than well
  • Feeling agitated, jumpy, edgy, or wired
  • Talking fast, jumping from idea to idea, racing thoughts
  • Being easily distracted
  • Having grandiose and unrealistic beliefs about one’s abilities
  • Being impulsive and exhibiting high risk behavior, such as spending sprees, hyper-sexuality, or questionable business investments (for example)

The depression symptoms, on the other hand, include:

  • Sad, discontented, or hopeless mood
  • Sleep and appetite disturbances (which can be either too much or too little)
  • Loss of interest in previously pleasurable activities
  • Reduced energy, increased apathy
  • Poor concentration
  • Psychomotor retardation or agitation
  • Suicidal thoughts

These depression symptoms manifest as these feelings or noticeable actions:

  • Feeling sad and hopeless, crying a lot
  • Feeling pessimistic, guilty, having low self-esteem
  • Feeling slowed down or exhausted; staring vacantly; having a pained look on one’s face
  • Sitting in a chair or lying in bed for long periods of time
  • Having difficulty concentrating, remembering things, or making decisions
  • Thinking of death and dying, or attempting suicide (between 10 to 20 of people with bipolar disorder commit suicide)

Bipolar Disorder: Cycling Moods

Bipolar disorder is marked by a cycling between mania and depression. Bipolar cycling, as it’s called, is the patterning of the condition. It refers to the swing from one end (mania or depression) to the other. The pattern varies considerably from person to person. Many people have a period between illness episodes, called the "euthymic" or normal period, which can last days, weeks, months, years, or even decades.

However, there is no single template to know how an individual will experience the disorder. Not everyone has a euthymic period between episodes. "In looking at bipolar cycling, the most important aspect from the clinical and practical points of view is not whether a person is manic or depressed, but how often, how frequently they move from one state to another. Most with bipolar disorder have a predilection or preponderance for experiencing either depression or mania rather than experiencing a regular alternating mania or depression." Duffy explained. Some will have mostly manic episodes. Others will have mostly depressive episodes. And others will alternate between the two.

For more information on bipolar disorder, order the webinar recording. To register for a future webinar, visit http://catalog.blr.com/audio.

Maureen Duffy, Ph.D., is a practicing couples and family therapist, consultant, educator, and author (she is the co-author of two books and has published over 40 book chapters and journal articles). Maureen is the relationship education coordinator for Bipolar Advantage and was a recent keynote speaker for the National Alliance on Mental Illness (NAMI) Pennsylvania Annual Conference.

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