Bipolar Disorders: Sky High, Sad to Death

Bipolar disorders were known as manic-depressive illnesses until a few years ago. Affected individuals suffer from extreme, volitionally uncontrollable swings in drive, activity, and mood. These fluctuate far outside normal levels toward depression (extremely depressed mood, drastically reduced drive) or mania (inappropriately euphoric or irritable mood, restlessness, overdriven drive). The likelihood of developing bipolar disorder in one’s lifetime is 1 to 1.6 percent. Consequently, at least one in a hundred people will fall ill. In Germany, there are about two million people affected.

Progressions

The first signs of bipolar disorder can become apparent as early as adolescence and usually begin with depression (60-80 percent). Nevertheless, they are not easy to recognize: Depressive and manic states alternate.

In between, the symptoms may well disappear for a while. Rapid symptom changes and mixed states make diagnosis difficult. Three forms of the disease are distinguished, classified as Bipolar I, II and III:

  • Bipolar I disorder presents with depression and severe mania.
  • In bipolar II disorder, the manic phases are absent. Depressive phases are followed by hypomanic (lighter form of mania).
  • Bipolar III disorder is also known as rapid cycling. It is characterized by at least four mood swings per year.

In addition, there are mixed forms. This is always spoken of when depressive and manic symptoms occur in rapid succession or when they mix by occurring simultaneously. The transitionless change between mania or hypomania and depression is called switching.

There are still major deficits in diagnosis. Bipolar disorder is often only recognized after eight to ten years. If correctly diagnosed in time, sufferers are spared a long period of suffering. In many cases, bipolar disorder appears as a lifelong, chronic illness. Treated appropriately with medication and therapy, however, the sufferer can learn to live with it.

Concomitant diseases (comorbidity).

Abuse of alcohol or other drugs is common in adults with bipolar disorder. Less common, but quite common, is excessive use of medications.

Panic disorder and personality disorders are also among the comorbidities of bipolar disorder. Heart disease and cancer are also more common in this population than in the general population.

Suicide Risk

In bipolar sufferers, the risk of suicide is generally increased many times over. About one in four sufferers attempts suicide. Approximately 15 percent of sufferers die as a result.

Depressions in which the drive is not yet paralyzed or has already improved are considered to be particularly risky. In these phases, the intention to commit suicide is often put into practice. Mixed episodes also carry a risk of suicide as a result of the despairing mood of dejection and enormously high drive levels.